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False Alarm Can Be Worse Than Breast Cancer

January 17, 2011
Written by: , Filed in: Breast Imaging
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For some anxiety-prone women, a false positive mammogram result can be worse than actually having breast cancer, according to a study published online last month in the British Journal of Surgery.

Researchers from The Netherlands studied 385 women with abnormal mammogram results. Of those, 152 were subsequently diagnosed with breast cancer, but the other 233 had false positive results, meaning they did not have cancer.

The researchers followed each women for a year after her diagnosis. Questionnaires assessed the subjects’ personalities, including their tendencies toward anxiety, as well as their quality of life (QoL), measured by the World Health Organization Quality of Life assessment instrument 100, which covers physical health, psychological health, level of independence, social relationships, environment, and spirituality.

“Common sense tells us that early detection of breast cancer is good, and most screening programs have been successful in reducing breast cancer deaths,” said lead author Lideke van der Steeg, MD, PhD, of the department of surgery at St. Elisabeth Hospital in Tilburg and the Centre of Research and Psychology in Somatic Diseases at Tilburg University. Dr. van der Steeg was quoted in a news release.

“However, while some women truly benefit from early detection, others experience harm and unnecessary anxiety,” Dr. van der Steeg continued. “The women who received false positives in our study experienced a significant reduction in their quality of life, especially if they were prone to anxiety, and the effects of this lasted at least a year.

“In fact, women who had a tendency to be anxious fared much worse if they received a false positive—which is estimated to happen in 60 percent of abnormal mammograms—than if they were actually diagnosed with breast cancer.”

On average, the women whose mammogram results turned out to be false positives experienced significantly more diagnostic procedures, including such invasive procedures as biopsies, than the women with breast cancer before each received a final diagnosis. Of the false positive patients, 32 percent required four or more procedures, compared with 14 percent of the women with breast cancer.

Of the women who received false positives, 55 percent returned to the outpatient clinic in the first year after the screening that produced the false positive—some as many as eight times.

So, what should be done about this? Dr. van der Steeg’s suggestion is simple: give women more information about screening mammograms, including an honest assessment of the possible negative aspects as well as the positives:

Women deserve more balanced information to help them to choose whether or not to accept a breast screening invitation. This should not only cover the supposed benefits, but explain the potential side effects of a false positive, such as the increased feelings of anxiety and reduced QoL found by our study.

Related seminar: Breast Imaging and Digital Mammography

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One Response to “False Alarm Can Be Worse Than Breast Cancer”

  1. Pamela on January 21st, 2011 at 11:24 am

    Yes, more explanation about the possibility of a false positive result is the answer. I have noticed over my 26 years of reading mammograms that if there is a false positive workup, it is often two years or more before the patient returns for another screening mammogram.