False-Positive Mammograms Can Trigger Long-Term Distress
03/19/13
TUESDAY, March 19 (HealthDay News) -- Women who have a
false-positive mammogram result -- when breast cancer is first
suspected but then dispelled with further testing -- can have
lingering anxiety and distress up to three years after the
misdiagnosis, a new study finds.
The emotional fallout is probably so long-lasting, "because the
abnormal screening result is seen as a threat to your own
mortality," said study author Dr. John Brodersen, a researcher at
the University of Copenhagen in Denmark.
The report is published in the March-April issue of the
Annals of Family Medicine.
False-positive mammograms are often cited by public health
experts as a downside to mammography screening that needs to be
considered when making recommendations about who should be
screened, at what age and how frequently. They aren't uncommon: the
risk of a false positive for every 10 rounds of screening ranges
from 20 percent to 60 percent in the United States, Brodersen
said.
After an abnormal mammogram, doctors typically order additional
mammograms and, depending on those results, more tests such as an
ultrasound or MRI, and finally a biopsy.
Studies about the short-term and long-term consequences of
false-positive mammogram results have produced mixed findings,
which Brodersen said spurred him to conduct his study. He evaluated
more than 1,300 women, including 454 who had abnormal findings on a
screening mammogram and others who received normal results.
Of those 454 who first had abnormal results, 174 later found
they had breast cancer. Another 272 learned the result was a false
positive. (Eight others were excluded from the study due to unknown
conclusions or a diagnosis of cancer other than breast cancer.)
The women answered a questionnaire about their psychological
state, such as their sense of calmness, being anxious or not about
breast cancer and feeling optimistic or not about the future. They
repeated the questionnaire at 1, 6, 18 and 36 months after the
final diagnosis.
Six months after the final diagnosis, those with false positives
had negative changes in inner calmness and in other measures as
great as the women with breast cancer. Even at the three-year mark,
women with false-positives had more negative psychological
consequences compared with women with normal findings.
The differences among those with normal, false-positive and
breast cancer findings only began to fade at the three-year mark,
the study found.
Brodersen can't say if women who were more anxious about health
or life in general to begin with were more likely to have long-term
distress. "I have not investigated this aspect," he said.
Even without this information, the study is a good one, said
Matthew Loscalzo, the Liliane Elkins Professor in Supportive Care
Programs at the City of Hope Comprehensive Cancer Center in Duarte,
Calif.
"They looked at large enough numbers, so the data they are sharing is valid and should be taken very seriously," he said.
The finding that some women are still stressed three years later
does not surprise him, Loscalzo said. From his experience working
with patients, Loscalzo said, women who receive a false-positive
result do often feel at risk, even after getting the news they are
cancer-free.
Many, he said, will definitely worry: "Will the next one be a
breast cancer?"
In a statement released Monday, the American College of
Radiology said, in part: "Anxiety regarding inconclusive test
results is real and is only natural." However, the organization of
radiologists also cited what it said are study flaws. For instance,
the researchers did not take into account whether women with
false-positive results had a family history of breast cancer, or
whether some women were ordered to have more frequent mammograms,
both of which would likely raise anxiety levels.
Women who get an abnormal mammogram result need support,
Loscalzo said. Women who undergo additional testing after an
abnormal mammogram should ask to get their results as soon as
possible, he added. If they are feeling anxious, he suggests they
also tell their doctor they want to talk with a counselor, he
said.
More information
To learn more about mammography results, visit the
American Cancer Society.
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