39 Predictors of Delay in Time From Diagnostic Breast Imaging to Needle Core Biopsy

Background

Time between abnormal breast imaging and needle core biopsy (NCB) is ideally minimized to expedite the care of patients with newly diagnosed breast cancer. Delays in time from imaging to biopsy (time to biopsy [TTB]) have been reported due to social determinants of health, such as lack of transportation access, difficulty paying for medications or utilities, or caretaking burdens. We hypothesized that delays in TTB may be due to such socioeconomic or health factors, and/or location of where the imaging was performed (biopsies are not offered at our satellite location).

Materials and Methods

We conducted a retrospective chart review of women who underwent diagnostic imaging followed by NCB from January 1, 2024 to December 31, 2024, at the main campus imaging center and a satellite location. We queried our internal cancer registry (community hospital in Englewood, NJ). TTB (listed in median days) and percent with an NCB within 9 days of imaging vs greater than 9 days was assessed. Potential predictors of TTB delay analyzed included age, race, non-English speaking, marital status, insurance status, body mass index (BMI), smoking history, history of coronary artery disease, risk of developing breast cancer, asymptomatic presentation, BIRADS 3/4 vs 5 imaging, and site of imaging (satellite vs main campus). A Firth’s logistic regression was utilized for statistical analysis.

Results

A total of 1153 patients underwent diagnostic imaging and NCB in a 12-month time period. TTB was 11 days for all patients (n = 1153). Patients greater than 70 years of age (n = 186) had a TTB of 9 days (44% within 9 days) vs 12 days for patients less than or equal to 70 years of age (n = 967; 41% within 9 days; P = .015). Patients who were symptomatic (n = 194) had a TTB of 6 days (67% within 9 days), compared with asymptomatic patients (n = 959) with a TTB of 13 days (38% within 9 days; P ≤.001). Patients with BIRADS 5 imaging (n = 163) had a TTB of 1 day (80% within 9 days) vs 13 days for patients with BIRADS 3/4 imaging (n = 990; 37% within 9 days; P ≤.001). No socioeconomic, health, or other factors were significant predictors for delay (Table).

Conclusions

At our institution, we found that predictors of delay in timing from imaging to NCB included age less than or equal to 70 years, lower BIRADS status, and an asymptomatic presentation. No socioeconomic, health, or other factors were predictors of delay in TTB. Symptomatic and BIRADS 5 patients were likely prioritized, resulting in a shorter TTB. Institutional factors (access to equipment, staffing limitations) may impact delays in TTB overall.