Several large studies, including a review by the U.S. Preventive Services Task Force in 2009 and a study on the causes of death in the United Kingdom in 2013, have questioned the value of screening mammograms.
Doctors who question the value of mammograms say that while mammograms do save lives, for each breast cancer death prevented, three to four women are overdiagnosed. Overdiagnosis means either:
- a screening mammogram finds a suspicious area that would have been eventually diagnosed as cancer by other means, without any effect on prognosis
- a screening mammogram finds a suspicious area that never would have affected a woman’s health if it hadn’t been found or treated
False positive results from screening mammograms also have helped fuel the debate about the value of breast cancer screening. When a mammogram shows an abnormal area that looks like a 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 more than one doctor, extra tests, and extra procedures, including a possible biopsy. There are psychological, physical, and economic costs that come with a false positive.
These studies and the resulting stories in the media have fueled an ongoing debate about the value of screening mammograms.
A study has found that while false positive results do cause anxiety and stress, the anxiety is short-term and doesn’t affect women’s overall health and well-being.
The research was published online on April 21, 2014 by JAMA Internal Medicine. Read the abstract of “Consequences of False-Positive Screening Mammograms.”
To understand how much a false positive mammogram affected women’s quality of life, the researchers randomly selected 1,028 women who had mammograms at 22 screening centers in the United States and conducted a telephone survey on anxiety shortly after the women were screened and then 1 year after the mammogram:
- 534 women had negative mammogram results
- 494 women had false positive mammogram results
About 50% of the women with false positive results said their anxiety levels were moderate or higher and 4.6% said their anxiety levels were extreme shortly after their mammograms. But 1 year after the mammograms, there were no differences in the anxiety levels of women who had negative results and women who had false-positive results. False positive results seemed to have no effect on quality of life in the long run.
Getting a false positive results also didn’t affect how likely the women were to get another mammogram in the next 2 years. More women who got false positive results said they were likely to have a mammogram in the future:
- 25.7% of women who got false positive results said they would have a mammogram in the future
- 14.2% of women who got negative results said they would have a mammogram in the future
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 should 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, including fear of a false positive, 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 on mammograms, visit the Breastcancer.org Mammograms page.
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