False-Positive Mammograms Leave a Long-Term Psychological Impact
A false-positive mammogram can cause long-term psychosocial harm, according to the results of a study published in the Annals of Family Medicine—in fact, three years later, women still suffer the psychological after-effects of the scare.
A mammogram is an X-ray of the breast. Screening mammography is performed in a woman without breast symptoms in order to detect breast cancer at an early stage when it is most easily treated. Different groups of experts have reached different conclusions about when mammographic screening should begin and how often it should be performed. The U.S. Preventive Services Task Force recommends that routine screening of average-risk women begin at age 50 and be performed every two years. The American Cancer Society recommends annual screening beginning at age 40.
Although screening mammography can reduce the risk of death from breast cancer (due to early detection), disease screening in healthy individuals can also lead to false-positive test results. A false-positive result suggests that cancer may be present even though the person is actually cancer-free. False-positive results can lead to anxiety and unnecessary additional testing.
To examine the impact of false-positive results, researchers conducted a cohort study with a 3-year follow-up. The study included 454 women ages 50 to 69 who had abnormal mammography results and 864 participants who had normal mammograms. The participants completed the Consequences of Screening in Breast Cancer—a validated questionnaire encompassing 12 psychosocial outcomes—at baseline, 1, 6, 18, and 36 months. The first component of the survey addresses eight types of psychosocial outcomes, such as self-image, anxiety, sexuality, dejection, and negative effects on behavior. The second component encompasses four scales: perceived changes resulting from the mammography, impact on social relationships, feeling less or more relaxed/calm, and anxiety.
The results indicated that three years after the false mammography results, women still exhibited greater psychosocial consequences compared with women who had normal mammograms. In fact, psychological testing at 6 months showed that women who received false-positive results remained as upset as women who had breast cancer—and reported changes in existential values and inner calmness as great as those reported by women with a diagnosis of breast cancer.
The researchers concluded that false-positive results on screening mammography cause long-term psychosocial harm that can last as long as three years. The frequency of false-positive mammography results ranges from 20 to 60 percent in the United States and Europe. Though screening for breast cancer may be beneficial, it can also result in psychological harm from false-positive results.
Brodersen J, Siersma VD. Long-Term Psychosocial Consequences of False-Positive Screening Mammography. Annals of Family Medicine. 2013; 11(2): 106-115.
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