False-positive mammogram damage overlooked: Study

Incorrect results may cause anxiety, undermine quality of life, researchers say.

Women should be made aware of the potential downsides of breast cancer screenings, a team of Dutch doctors have urged, because false-positive results can prompt anxiety and seriously undermine a patient’s quality of life.

And during the time it takes to confirm the results, false-positive patients may undergo more diagnostic procedures than patients who actually do have breast cancer, the study authors noted in their report, which was published online recently in the British Journal of Surgery.

“Common sense tells us that early detection of breast cancer is good, and most screening programmes have been successful in reducing breast cancer deaths,” lead author Dr. Lideke van der Steeg, of the Department of Surgery at St. Elisabeth Hospital in Tilburg, said in a journal news release.

“However, while some women truly benefit from early detection, others experience harm and unnecessary anxiety. The women who received false-positives in our study experienced a significant reduction in their quality of life, especially if they were prone to anxiety, and the effects of this lasted at least a year,” said Dr. van der Steeg, who also is with the Centre of Research and Psychology in Somatic Diseases at Tilburg University in the Netherlands.

“In fact, women who had a tendency to be anxious fared much worse if they received a false-positive – which is estimated to happen in 60 percent of abnormal mammograms – than if they were actually diagnosed with breast cancer,” the study author said.

The investigators based their findings on surveys completed by 385 Dutch women who had received abnormal mammogram results. While 152 of the patients ultimately were found to actually have breast cancer, the remaining 233 women did not.

An examination of the patient medical records revealed that those with a false-positive reading were significantly younger than those with cancer (around 57 years old versus 60 years old, respectively).

More women who were mistakenly told that they had cancer had to endure a greater number of diagnostic procedures (such as biopsies) than those whose diagnosis turned out to be correct. For example, while just 14 per cent of those women who actually did have cancer had to undergo four post-screening diagnostic procedures, the same was true for 32 per cent of the false-positive group.

In fact, 55 per cent of the false-positive group had to return to the outpatient clinic within the first year after initial screening. Some had to do so as many as eight times, the authors noted.

Among the false-positive patients, the multiple visits and screenings were associated with high levels of anxiety, which the researchers considered a direct result of having to undergo so many subsequent screenings and diagnostic exams.

“The decision to participate in a screening program requires balanced information about the potential benefits and dangers,” Dr. van der Steeg said.

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