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Study: Mammography False Positives Can Harm

March 19, 2013
Written by: , Filed in: Breast Imaging
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The latest dispatches from the mammography wars:

  • If women age 50 to 74 get mammograms every two years instead of annually, they decrease their risk of false positive results without increasing their risk of advanced breast cancer.
  • A false positive mammography result can cause significant psychosocial harm for at least three years.

The first finding comes from a study published online Monday in JAMA Internal Medicine, based on U.S. Breast Cancer Surveillance Consortium data from 11,474 women with breast cancer and 922,624 without, gathered from 1994 through 2008.

The researchers uncovered no increased risk of advanced-stage or large tumors for women 50–74, regardless of breast density or use of hormone therapy. They found the 10-year cumulative risk of a false positive result in that age group was 49.8 percent with annual screening, 30.7 percent with biennial screening, and 21.9 percent with triennial screening.

For women age 40 to 49 with extremely dense breasts, the picture was different. Those women faced an increased risk of advanced or large tumors with biennial compared to annual screening. Their cumulative 10-year risk of a false positive result was 65.5 percent with annual screening. The authors wrote:

Women aged 49 to 49 years with extremely dense breasts who choose to undergo mammography should consider annual screening to decrease the risk of advanced-stage disease but should be informed that annual screening leads to a high cumulative probability of a false-positive mammography result because of the additional screening examinations.

An article in the March-April issue of the Annals of Family Medicine presents evidence that false positives are nothing to take lightly. Researchers recruited 454 women in Denmark whose screening mammography results had come back as abnormal. The researchers matched each of those women with two other women who had normal results from a screening the same day at the same clinic.

Each woman completed a questionnaire covering 12 psychosocial outcomes at 1, 6, 18, and 36 months after final diagnosis (true or false positive) or receipt of a “normal” screening result. Not surprisingly, women diagnosed with breast cancer reported the most negative psychosocial consequences—feelings of dejection or anxiety, problems with sleeping or sexuality, and so on—and women with “all clear” screening results reported the fewest negative consequences.

Women who received false positives fell in the middle, meaning that they did suffer significant negative effects. Those findings persisted throughout the study period—three years after diagnosis or receipt of a normal result.

The article concludes, starkly:

False-positive screening mammography causes long-term psychosocial harm.

It’s the sort of harm that some downplay because it’s not physical. But emotional injuries can cripple too. Anyone who has ever grieved knows that truth.

Related seminar: Chicago International Breast Course and The Society for the Advancement of Women’s Imaging

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One Response to “Study: Mammography False Positives Can Harm”

  1. Radiology Daily»AlertArchive » Complaint Alleges Carelessness By Radiologist on March 20th, 2013 at 10:38 am

    […] do the American College of Radiology and the Society of Breast Imaging think of the study, which we mentioned Tuesday, that found persistent negative psychosocial effects from false positive mammography reports? Not […]