Anxiety experienced with a false-positive mammogram is temporary and does not negatively affect a womans overall well-being, according to a study.
Researchers with the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, N.H., reported the findings April 21 on the website of JAMA Internal Medicine.
Anywhere from 40% to 60% of women who undergo routine screening mammography during a 10-year period will experience a false-positive mammogram, according to background information in the study. Such mammograms require additional testing, sometimes involving a biopsy, to confirm that cancer is not present. Researchers have suspected that increased anxiety, pain and the bother of additional tests might adversely affect the quality of life for women who experience false-positive screening mammograms.
In this study, researchers used data collected by the Digital Mammographic Imaging Screening Trial, which was conducted by the American College of Radiology Imaging Network, to study the impact a false-positive mammogram has on womens lives.
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, principal author Anna N. A. Tosteson, ScD, said in a news release. The DMIST study did not support these assumptions, and gave us evidence that a false-positive mammogram experience has a limited impact on womens overall well-being.
The researchers studied personal anxiety and a standard measure of overall health and well-being often used by health economists to evaluate the effectiveness of health interventions. Attitudes toward future screening were measured by womens intention to use breast screening in the future; and by how much they would prefer to have a hypothetical new type of mammography, which the researchers described as having a lower chance of a false-positive result but requiring overnight travel to use.
While false-positive mammograms were associated with a temporary increase in womens anxiety, they had no measurable influence on overall health and well-being. Additionally, a false positive actually increased a womans intention to use breast cancer screening in the future, and did not increase how much she preferred the new mammogram with fewer false positives.
Another analysis showed that womens anticipated anxiety about future false-positive mammograms rather than actually experiencing a false-positive was associated with a strong preference for the new type of mammogram.
Tosteson said the studys findings suggest an opportunity to educate women about the false-positive mammogram experience. 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, Tosteson said in a news release. Women need to make informed decisions that are based on their own risks and preferences. Our report can help those counseling women about breast cancer screening, and will also be useful to those developing mammography screening guidelines.
She stresses that further evaluation is needed, and that several groups sponsored by the National Cancer Institute are actively studying mammography screening, including the PROSPR (Population-based Research Optimizing Screening through Personalized Regimens) Network and the Breast Cancer Surveillance Consortium.
Study abstract: http://archinte.jamanetwork.com/article.aspx?articleid=1861037