False positive mammogram worse than cancer for some women

Kathleen Blanchard's picture
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Some women with false positive mammogram report more anxiety and decreased quality of life than if they had breast cancer.

Findings from researchers have prompted urging that women receive more information about the potential for abnormal findings on mammograms that may not end up being the result of breast cancer.

Anxiety faced by women who received false positive mammogram results is described as "serious". Women who needed to undergo more testing, including biopsy, and ended up not having breast cancer “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", explain the researchers.

They add, "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 per cent of abnormal mammograms - than if they were actually diagnosed with breast cancer."

Lead author Dr Lideke van der Steeg from the Department of Surgery, St Elisabeth Hospital, Tilburg, and the Centre of Research and Psychology in Somatic Diseases, Tilburg University notes screening for breast cancer is important, but for some women it can cause harm.

The researchers spoke with 385 women with abnormal mammogram results. Of those, 152 actually had breast cancer, and the other 233 had false-positive results.

The findings, published in the British Journal of Surgery, revealed lower quality of life (QoL) was directly related to being called back for more breast cancer screening exams and diagnostic procedures.

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Data for the study was collected over a period of five years from three different hospital facilities. Women agreeing to participate in the study provided age, marital status, education and socioeconomic status by way of questionnaire.

For women with a tendency for anxiety, false positive mammogram accounted for 55% variance in QoL score that was determined with using the World Health Organization's Quality of Life instrument 100, which assesses physical health, psychological health, level of independence, social relationships and environment and spirituality. For women prone to being anxious, symptoms peaked at 3 months but remained the same at month 1 and 12.

There was a 46 per cent of the variance found in the group of women with breast cancer, who tended to be older and have larger tumors. Anxiety peaked at 6 months but remained the same at month 1 and 12.

The findings also found influence on QoL in the false positive group from a tendency toward anxiety. Additionally, a tendency toward anxiety did not influence QoL in the group of women with breast cancer, leading the researchers to believe quality of life declined for women given false positive mammogram results solely because they had to undergo more diagnostic tests.

"The decision to participate in a (breast cancer screening program) requires balanced information about the potential benefits and dangers," says Dr van der Steeg, who adds the positive benefits are often emphasized by government agencies and health care providers, “and are not always objective”.

The findings show mammogram screening can lead to anxiety and lower quality of life for women who have to undergo additional testing for abnormal findings that are not due to breast cancer.

DOI: 10.1002/bjs.7371

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