Selection biases in the systematic collection of breast biobank specimens.

A breast biopsy tissue biobank is a valuable resource for studying breast cancer biology and treatment response. However, underrepresentation of certain patient populations in biobanks limits the generalizability of findings. We assessed potential disparities in the recruitment process for an institutional breast biopsy tissue bank. Ultrasound-guided (USG) research biopsy cores were collected immediately after routine clinical biopsy from January 2019 to October 2022 at a large academic center. Eligible patients (age > 18, with a mass > 0.5 cm), identified by a research associate on the day of the biopsy, were invited to participate at the discretion of the radiologist performing the biopsy. Those approached either consented or declined a research biopsy. 2449 patients underwent USG breast biopsy and 1309 were deemed eligible for a research biopsy. Of the eligible population, 886 (67.7%) were approached for participation, and 423 (32.3%) were not. Of those approached, 564 (63.7%) consented for a research biopsy, while 322 (36.3%) declined. Patients older than 70 years of age and patients who both used a primary language other than English and had non-commercial health insurance were less likely to be approached for biobank participation (p = 0.01 and p = 0.002, respectively). Among those approached, non-Hispanic White patients were more likely to provide their consent compared to patients from other racial and ethnic groups (p = 0.014). Among these groups, non-Hispanic Black patients were particularly less likely to consent to a research biopsy (p = 0.005). Our findings highlight the need for targeted interventions to increase participation across diverse patient subgroups.