False positive results from screening mammograms help fuel the debate about the value of breast cancer screening. When a mammogram shows an abnormal area that looks like cancer but turns out to be normal, it’s called a false positive.
Ultimately the news is good: no breast cancer. But the suspicious area usually requires follow-up with one or more doctors, extra tests, and extra procedures – possibly including a biopsy – not to mention the stress and worry about the results. There are psychological, physical, and economic costs that come with a false positive.
A Danish study has found that the negative psychological effects of a getting a false positive mammogram result linger for at least 3 years after women learned they didn’t have breast cancer.
The study was published in the March/April 2013 issue of Annals of Family Medicine. Read “Long-Term Psychosocial Consequences of False-Positive Screening Mammography.”
The study looked at 454 women who had abnormal mammogram results and 864 women who had normal mammogram results. The women were ages 50 to 69.
All the women answered the first part of the Consequences of Screening in Breast Cancer (COS-BC) survey right after they got their mammogram results and, in the case of the women with abnormal results, before they had any more testing or doctor’s visits regarding the abnormal results. The women filled out the second part of the survey 1, 6, 18, and 36 months after they learned the final results of their mammograms (either a breast cancer diagnosis or a false positive).
The COS-BC survey is a two-part survey that asks about the psychological and social effects of abnormal and false-positive mammogram results. The first part of the survey asks about self-image, anxiety, sleep, sexuality, feelings of sadness, and any negative effects on behavior. The second part of the survey asks women to rate changes in thoughts about the future, feelings of pessimism, effects on relationships, and feelings of calmness.
Looking at answers from the first part of the COS-BC survey, the researchers found that women who initially had abnormal mammogram results had more negative affects right after getting their results than women who had normal results.
Looking at answers to part two of the survey, the researchers found that 1 month after final diagnosis, women with normal mammogram results had fewer negative effects compared to women who had false positive results and women who had been diagnosed with breast cancer.
Answers to the surveys given 6, 18, and 36 months after final diagnosis showed that women who had normal mammogram results had the fewest negative effects. Women who had false positive results had more negative effects than the women with normal results, but fewer negative effects than women who were diagnosed with breast cancer.
“There’s no doubt that getting a mammogram is anxiety-provoking for any woman,” said Marisa Weiss, M.D., chief medical officer of Breastcancer.org. “Getting called back to check out an ‘abnormal’ finding is worse. With breast cancer being one of women’s top anxieties, it doesn’t take much to trigger a cascade of negative reactions. It’s also no surprise that the anxiety persists. Living through a false positive sensitizes you to the issue and makes you feel vulnerable. But any study looking at the negative impact of false positives must account for how horrible it feels to be diagnosed late because of false negative results.”
While the results of this study are troubling, it’s important to know several things:
- The researchers don’t really spell out what type of additional tests the women who got abnormal mammogram results had. Were they only called back for more mammograms? Or did they have to have an ultrasound or MRI? Were biopsies done? It makes sense that women who had to have more tests plus a biopsy would be more anxious and stressed than women who only had to have another mammogram.
- If you’re routinely getting screening mammograms, the number of false positives you get will DECREASE because the radiologist will have earlier results with which to compare. So getting regular mammograms helps reduce the number of false positives.
- Each woman should be aware of her own breast cancer risk, beyond just family history. By “personalizing” the screening process – knowing your breast density, your family history, your history of biopsies and benign breast disease, among other factors – can help doctors know which women are at risk for false positive mammogram results and tailor screening to meet their specific needs.
If you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.
There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of your regular screening mammograms.
- If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
- If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
- If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.
For more information, visit the Breastcancer.org Mammograms pages.