False-Positive Mammogram Findings do not Discourage Future Testing

False-positive mammography results are associated with short-term anxiety in women who have been recalled for more testing, but women with false-positive results are still more likely to undergo future testing, according to a study published online in JAMA Internal Medicine.

Researchers from the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, NH, conducted the Digital Mammographic Imaging Screening Trial to determine how false-positive results affect women and their feelings towards future breast cancer screening.

A telephone survey was conducted shortly after screening at 22 sites. A total of 1,028 (534 with negative results, 494 with false-positive results) of 1,226 randomly selected women responded to the survey.

According to the findings, anxiety was reported more often among women who had false-positive test results than those who did not (35 percent versus 32.7 percent, respectively); 50.6 percent of the women who received a false-positive result reported feeling moderate or higher anxiety. Some women, 4.6 percent, reported extreme anxiety. However, more women who had false-positive results (25.7 percent) than those who had negative results (14.2 percent) responded that they would be “more likely” to undergo future breast cancer screening.

“Our finding of time-limited harm after false-positive screening mammograms is relevant for clinicians who counsel women on mammographic screening,” co-author Anna N.A. Tosteson, ScD, said in a release.

The American College of Radiology (ACR) and the Society of Breast Imaging (SBI) released comments about the JAMA study, stating that anxiety regarding inconclusive test results is real and only natural. Experts in breast imaging continue to work on minimizing the number of false-positives, but also ensuring that follow-up exams are as minimally invasive as possible. The majority of women who are recalled following a mammogram only need to undergo a second mammogram or an ultrasound, ACR and SBI said in a related release. Only about one to 2 percent of women must go on to have a more invasive needle biopsy.

“Like similar previous studies, Tosteson et al published online April 21, 2014 in the Journal of the Medical Association (JAMA), proves that patients experience short-term anxiety regarding test results and that those feelings rapidly decline over time,” the release said. “The study also shows that there are no measurable effects to women’s health from experiencing a false-positive exam as some have previously claimed.”

ACR and SBI pointed out that women who have a family or personal history with breast cancer are more likely to experience anxiety. This knowledge can be used by physicians when they are discussing results with their patients.

The JAMA findings should remind medical professionals that some women experience adverse effects of a false-positive exam, the ACR and SBI said. In these scenarios, the medical community should help identify which professionals can help these women cope with their concerns.