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False positive results: not as bad as you thought

by Lauren Dubinsky, Senior Reporter | April 24, 2014
A JAMA Internal Medicine study published earlier this week found that false-positive mammography results do lead to short-term anxiety for women, but women are still more likely to undergo future breast cancer screening.

Somewhere between 40 to 60 percent of women who have a mammogram done during a ten-year period will have a false-positive result. Because of that, women will have to undergo further testing — sometimes even a biopsy — to ensure that there is no cancer.

Previous studies have shown that the heightened anxiety and pain, and additional tests that are associated with false-positive results, adversely affect a woman's quality of life. "Most policy analyses of breast cancer screening have used assumptions about the harms of screening on health and overall well-being based on expert opinion rather than patient-reported outcomes," Anna Tosteson, principal author of the study, said in statement.

The Dartmouth Institute researchers set out to investigate this using data collected by the Digital Mammographic Imaging Screening Trial, which was conducted by the American College of Radiology Imaging Network.

A telephone survey was carried out with 22 sites where 1,226 women with both positive and negative mammogram results were randomly chosen. Follow-up interviews were conducted with 1,028 of the women — 534 with negative results and 494 with false positive results.

The women's attitudes toward future testing were measured depending on their intention to use breast screening in the future. Their preference to have a hypothetical test with a lower chance of a false-positive result was also measured.

The study found that anxiety was associated more with women who had false-positive results than those with negative results. However, false-positive results had no considerable influence on their overall health and well-being and they reported that they were even more likely to undergo future testing. Additionally, it did not increase their preference for a new mammogram with fewer false positives.

"With all the controversy about mammograms and whether they result in a net benefit or harm for women, it is important for women to be educated about possible screening outcomes," Tosteson said in a statement. "Our report can help those counseling women about breast cancer screening, and will also be useful to those developing mammography screening guidelines."

The American College of Radiology and the Society of Breast Imaging released comments about the study, stating that women who have a family history of breast cancer or those who have already underwent a biopsy because of suspicious test results may be more likely to experience anxiety. They believe that professionals should be better informed that women may be in need of more assistance after inconclusive results.

"These JAMA findings should, however, remind medical professionals that some women experience adverse effects of a false positive exam," the statement said. "The medical community should help identify which professionals can help these women cope with and overcome their concerns."

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