High Rate of “False Positives” in Mammograms Strikes Unnecessary Fear in Women

A fierce battle is going on right now between doctors who say annual mammograms should not continue, and breast cancer survivors who insist that having a routine annual mammogram allowed them to detect and treat their breast cancer before it was too late.

Why is there so much controversy? Well, it might have something to do with the unnecessary fear and dread that many women feel upon getting their mammogram results. A new study reveals that more than half of cancer-free women will be called back for further testing due to “false-positive” results, and of these women, about one in 12 will undergo a breast biopsy.
 
The study, which will be published in Annals of Internal Medicine, was led by Group Health Research Institute of Seattle for the Breast Cancer Surveillance Consortium.  It suggests undergoing mammogram and breast cancer screenings every other year instead of annually, as it will lower a woman's probability of a false-positive result by up to one third over the course of a decade.

Details of the Study

For the research, 170,000 women between the ages of 40 and 59 were examined.  From this group, around 4,500 women had invasive breast cancer.  The study found that women who started their yearly mammogram routine at the age of 40 instead of 50 are more likely to have false-positive results because an extra decade of testing has been added to the equation.  The results of the research could provide important information about the potential harms of undergoing regular mammography, and it provides an estimate of the risks involved with false-positive test results.
 
In addition to causing inconvenience for the patient, follow-up calls requesting a second mammogram also adds anxiety as the patient laments over the chance that they might have breast cancer.  Having a second mammogram could also cause physical side effects.  A false-positive test result may increase the chance of a doctor recommending a surgical biopsy or fine needle aspiration, which can lead to unnecessary pain, scarring and medical complications resulting from these procedures. 

A second report that was also published in the same issue of Annals, and also used data from the Breast Cancer Surveillance Consortium, examined the data of over 330,000 women between the ages of 40 and 79.  This report studied the accuracy of film mammography and compared it to digital mammography, which has become increasingly more common.

A personalized recommendation could help reduce the number of false-positives, as well as health care costs associated with inefficiency.  If a doctor examined his or her patient's mammogram history and found no signs of abnormal growth, then further investigation would help the doctor make an informed decision on performing a follow up mammogram. 

While the debate between those who recommend annual mammograms and those who don't continues, recent studies have shown that perhaps a general rule is not the best approach, and not all women should undergo annual mammograms.