Initial Point of Entry to the Health Care System May Affect Downstream Quality of Breast Cancer Care.

Abstract

Structural racism refers to the manner in which the structures of our society are generally set up to advantage White people while disadvantaging people of color. As an example, underresourced and nonaccredited facilities are more likely to be situated within racial or ethnic minority neighborhoods, which produces inequities at the initial point of entry into the health care system. In the case of breast cancer, resources and accreditation status of the first medical practice or facility that is encountered not only could determine aspects of initial screening but also could have other downstream implications on the timing and quality of diagnostic care (eg, breast imaging fellowship-trained imagers, access to stereotactic breast biopsy) and treatment (eg, on-site access to radiation, chemotherapy, hormone therapy, and targeted therapies; review by a multidisciplinary tumor board) [1].