Blog | Wednesday, April 23, 2014

QD: News Every Day--False-positive mammograms may not increase long-term anxiety


False-positive mammograms were associated with increased short-term anxiety but not long-term anxiety, and such results increased women’s intention to undergo future breast cancer screening, a study found.

Researchers conducted a telephone follow-up survey among 1,000 women as part of a quality-of-life sub-study. Randomly selected women with positive and negative mammograms requiring follow-up testing or referral without a cancer diagnosis were assessed for their willingness to undergo future mammographic screening. They were also presented with a hypothetical scenario in which they could travel and stay overnight to undergo a new type of mammography that would identify as many cancers with half the number of false-positive results.

Results appeared online April 21 at JAMA Internal Medicine.

Women’s plans to undergo mammography within the next 2 years did not differ by screening outcome. But, 25.7% of women who had a false-positive mammogram characterized themselves as “more likely” to undergo future breast cancer screening compared with 14.2% of those who had a negative mammogram. However, there were no differences in women’s attitudes toward the anticipated anxiety they would feel if they were to have a positive mammogram in the future.

Women’s experience of a false-positive mammogram did not influence their willingness to travel to avoid a false-positive mammogram in the future, with the vast majority of women in both groups being willing to travel up to 4 hours to avoid such a result. A small minority in each group were willing to travel and stay overnight to avoid a false-positive mammogram (10.5% in the negative and 9.9% in the false-positive group). When women were asked to choose between a new type of mammography that would avoid breast compression and one that would avoid false-positive mammograms, most (81.6%) chose the latter.

The authors wrote: “The fact that women’s anticipated anxiety about future false-positive mammograms was a correlate of willingness to travel and stay overnight to avoid such a result, but the actual experience of a false-positive mammogram was not, further highlights opportunities to educate women about screening outcomes.”

In an editorial, Kurt Kroenke, MD, MACP, wrote, “These adverse consequences would be less concerning if false-positive mammograms were an uncommon event. However, the cumulative probability of a woman receiving at least 1 false-positive mammogram within 10 years is 61.3% with annual and 41.6% with biennial screening. The cumulative probability of biopsy recommendations based on a false-positive mammogram is 7% with annual and 4.8% with biennial screening. This increase in likelihood of a false-positive mammogram over the screening life span of a woman amplifies the adverse consequences at a population level.”