Receiving news that a mammogram result is positive is understandably alarming, but receiving a false-positive result can also induce anxiety. However, researchers publishing in JAMA Internal Medicine say women’s anxiety over such false-positive results is temporary and does not negatively impact a woman’s well-being overall.
The researchers, led by Anna Tosteson of the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire, note that between 40-60% of women who experience routine screening mammography during a 10-year period will encounter a false-positive mammogram.
When this result occurs, the women must undergo additional testing, which sometimes includes a biopsy, in order to certify that there is no cancer.
The researchers say they anticipated that the increased anxiety and pain of extra tests would affect quality of life for such women, however, their study suggests otherwise.
To investigate the impact a false-positive mammogram has, they used data from the Digital Mammographic Imaging Screening Trial (DMIST), conducted by the American College of Radiology Imaging Network (ACIRN).
After studying personal anxiety and standard measures of overall health and well-being, the researchers measured the women’s attitudes toward future screening, as well as whether they would prefer to have an imaginary new mammogram that had a lower chance of a false-positive outcome.
In total, 1,226 randomly selected women with positive and negative mammogram results were enrolled in the study, and follow-up interviews were taken from 1,028 of the women. Of these, 494 had false-positive results, the team notes.
Of the women with a false-positive result, 50.6% reported their anxiety as moderate or higher, and 4.6% reported their anxiety as extreme.
However, the researchers say this anxiety did not affect the women’s plans to undergo screening again during the next 2 years.
In detail, 25.7% of women with false-positive results said they were “more likely” to have future breast cancer screening done, compared with 14.2% of the women with negative results.
So, women who received a false-positive result were more likely to plan to use breast cancer screening in the future, and the researchers say the women’s results did not increase how much they preferred the new “hypothetical” mammogram with fewer false positives.
Commenting on their findings, Tosteson suggests they may provide clinicians with an opportunity to educate women further:
“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. Women need to make informed decisions that are based on their own risks and preferences.”
She adds that their findings could help those who counsel women about breast cancer screening, as well as those who develop screening guidelines for mammography.
“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,” she says.
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