How often do women visit the breast imaging facility closest to home?

Women are more than twice as likely to travel beyond the closest breast imaging facility for breast MRI than for mammography, according to a recent study published by the Journal of the American College of Radiology.

Tracy Onega, PhD, MA, MS, Geisel School of Medicine at Dartmouth in Lebanon, N.H., and colleagues examined data from the Breast Cancer Surveillance Consortium (BCSC) from 2005 to 2012, comparing travel time to the patient’s closest mammography facility with travel time to the facility they actually visited.

Overall, the team looked at data for more than 825,000 breast screening examinations. More than 23 percent of women undergoing mammographic screening do not use the facility closest to them, and for MRI that number was more than 48 percent.

Onega and colleagues originally believed a patient’s risk of breast cancer may increase their likelihood of using the closest available facility, but that does not appear to be the case.

“Travel time has been shown to be important to the utilization of some breast cancer services, so our a priori hypothesis was that breast cancer risk factors might influence breast cancer screening with MRI,” the authors wrote. “However, we did not find any risk factors or quantitative breast cancer risk score to be significantly related to differential travel time to mammography or MRI. Thus, our findings do not support a role for risk in modifying travel behaviors for women undergoing breast cancer screening for either modality. Women may not know their individual breast cancer risk and so may not factor it into decision making.”

The median actual travel time for all mammograms was 10 minutes; for breast MRI, it was 14 minutes. Looking exclusively at patients who did not use the closest facility, the median differential travel time was 14 minutes for mammography and 20 minutes for MRI.

“Although, overall, for almost all sociodemographic and breast characteristics, differential travel time to MRI was notably longer than to mammography, there was little variation in differential travel time across patient characteristics for most factors,” the authors wrote. “The largest discrepancies in differential travel time between mammography and MRI were seen for women living in rural areas and those who had not been screened in the prior 30 months.”

For women living in “small towns or isolated rural areas,” the median differential travel time was 23 minutes for mammography and 41 minutes for breast MRI. For women not screened in the past 30 months, the median differential travel time was 13 minutes for mammography and 24 minutes for breast MRI.

Onega et al. wrote that their study had several limitations. For instance, their data was limited to BCSC data and not the entire United States. In addition, patients’ insurance was not taken into consideration, and that could explain why some of the patients went beyond the facility closest to their home.