title: Advanced Breast Imaging Availability by Screening Facility Characteristics.
abstract: OBJECTIVE
  To determine the relationship between screening mammography facility characteristics and on-site availability of advanced breast imaging services required for supplemental screening and the diagnostic evaluation of abnormal screening findings.
  
  
  METHODS
  We analyzed data from all active imaging facilities across six regional registries of the National Cancer Institute-funded Breast Cancer Surveillance Consortium offering screening mammography in calendar years 2011-2012 (n = 105). We used generalized estimating equations regression models to identify associations between facility characteristics (eg, academic affiliation, practice type) and availability of on-site advanced breast imaging (eg, ultrasound [US], magnetic resonance imaging [MRI]) and image-guided biopsy services.
  
  
  RESULTS
  Breast MRI was not available at any nonradiology or breast imaging-only facilities. A combination of breast US, breast MRI, and imaging-guided breast biopsy services was available at 76.0% of multispecialty breast centers compared to 22.2% of full diagnostic radiology practices (P = .0047) and 75.0% of facilities with academic affiliations compared to 29.0% of those without academic affiliations (P = .04). Both supplemental screening breast US and screening breast MRI were available at 28.0% of multispecialty breast centers compared to 4.7% of full diagnostic radiology practices (P < .01) and 25.0% of academic facilities compared to 8.5% of nonacademic facilities (P = .02).
  
  
  CONCLUSIONS
  Screening facility characteristics are strongly associated with the availability of on-site advanced breast imaging and image-guided biopsy service. Therefore, the type of imaging facility a woman attends for screening may have important implications on her timely access to supplemental screening and diagnostic breast imaging services.
authors: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Ave East, Seattle, WA 98109; Department of Health Services, University of Washington School of Public Health, Seattle, Washington. Electronic address: stophlee@uw.edu.
authors: Christoph I
authors: CI
authors: Lee
authors: Group Health Research Institute, Seattle, Washington.
authors: Andy
authors: A
authors: Bogart
authors: Group Health Research Institute, Seattle, Washington.
authors: Rebecca A
authors: RA
authors: Hubbard
authors: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Ave East, Seattle, WA 98109.
authors: Eniola T
authors: ET
authors: Obadina
authors: Department of Internal Medicine, Cancer Research and Treatment Center, University of New Mexico, Albuquerque, New Mexico.
authors: Deirdre A
authors: DA
authors: Hill
authors: Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Dana Farber Harvard Cancer Institute, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts.
authors: Jennifer S
authors: JS
authors: Haas
authors: Department of Medicine, Dartmouth Institute for Health Policy and Clinical Practice, Norris Cotton Cancer Center, Geisel School of Medicine, Lebanon, New Hampshire.
authors: Anna N A
authors: AN
authors: Tosteson
authors: Department of Medicine, Dartmouth Institute for Health Policy and Clinical Practice, Norris Cotton Cancer Center, Geisel School of Medicine, Lebanon, New Hampshire; Department of Community and Family Medicine, Dartmouth Institute for Health Policy and Clinical Practice, Norris Cotton Cancer Center, Geisel School of Medicine, Lebanon, New Hampshire.
authors: Jennifer A
authors: JA
authors: Alford-Teaster
authors: Department of Surgery and Office of Health Promotion Research, University of Vermont, Burlington, Vermont.
authors: Brian L
authors: BL
authors: Sprague
authors: Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors: Wendy B
authors: WB
authors: DeMartini
authors: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Ave East, Seattle, WA 98109.
authors: Constance D
authors: CD
authors: Lehman
authors: Department of Medicine, Dartmouth Institute for Health Policy and Clinical Practice, Norris Cotton Cancer Center, Geisel School of Medicine, Lebanon, New Hampshire; Department of Community and Family Medicine, Dartmouth Institute for Health Policy and Clinical Practice, Norris Cotton Cancer Center, Geisel School of Medicine, Lebanon, New Hampshire.
authors: Tracy L
authors: TL
authors: Onega
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006268:Health Facilities / Q000145:classification / Q000600:supply & distribution; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D061705:Image-Guided Biopsy / Q000706:statistics & numerical data; D008327:Mammography / Q000706:statistics & numerical data*; D011871:Radiology / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Screening; breast cancer; diagnostic imaging; mammography