False-positive mammography results are linked to an increased risk of future breast cancer

Study Reveals the Reason Why Many Women Don't Return for Mammogram Screenings But many people who get a false-positive don't return for screenings

False-positive mammography results are linked to an increased risk of future breast cancer

• A new study found women were less likely to return for another mammogram if they received a false-positive result in the past.
• About 10% of screening mammograms require some kind of follow-up, though most of these cases aren’t cancer.
• Experts urge people to stay up-to-date with screening mammography, especially since women who have received a false-positive result are at a higher risk for future breast cancer.

Receiving a false-positive mammogram result could discourage women from returning for future screenings, according to a new study.

Researchers found that women were less likely to get another mammogram if, in the past, they had been asked to come back for additional imaging after a false-positive result. This was especially true among women who received false-positive results on two consecutive screening mammograms.

The research was published in the Annals of Internal Medicine on September 3.

Mammography is used to help detect breast cancer; however, sometimes the tests can pick up on abnormal tissue that isn’t actually cancerous. About 10% of screening mammograms require diagnostic workup after the fact, and most people who get called back for additional imaging don’t have breast cancer.

These false-positive results can, of course, cause anxiety and can waste a person’s time and money if they undergo unnecessary testing.

But researchers are concerned that people could be putting their health at risk if they choose not to come back for future breast cancer screenings after receiving one or multiple false-positive results—especially since research has shown false-positive mammography results are associated with an increased risk of breast cancer in the future.

“Women should be aware that a screening test often requires further diagnostic evaluation to confirm that a finding is normal,” lead study author Diana Miglioretti, PhD, cancer center researcher and division chief of biostatistics at UC Davis, told Health. “This is a standard part of the screening process.”

Here’s what experts had to say about false-positive mammogram results and what to do if you receive one.

False-Positive Mammograms Linked to Fewer Future Screenings

To investigate how false-positive mammogram results affected patients, Miglioretti and her team analyzed data from more than one million women at health facilities participating in the Breast Cancer Surveillance Consortium. Collectively the patients had more than 3.5 million screening mammograms between 2005–2017, and were between the ages of 40 and 73.

The researchers found that 77% of women who received a negative result from their mammogram returned for future screening.

But that percentage dropped to 61% when women received a false-positive finding that required another mammogram within six months to confirm the results. If doctors recommended a biopsy after a false-positive result, 67% of women returned for subsequent mammography.

The greatest dip was seen amongst those who received false-positive results on two consecutive mammograms recommending follow-up—only 56% returned for their next screening mammogram.

Migliorettii and her team also examined demographic data and found that Asian and Hispanic women were least likely to return for future screening mammograms after a false-positive result.

Mammograms and the Risk of False-Positive Results 

A mammogram is an imaging exam that uses X-rays to take pictures of breast tissue—when doctors examine these images, they can see if someone has a tumor or small deposits of calcium that can be indicative of breast cancer. Mammograms can also be used to diagnose a person with breast cancer if that person has a lump or some other sign of the disease.

During a mammogram, a machine compresses the breast in order to spread the tissue. This helps doctors spot any alterations in how that breast tissue looks normally, said Lumarie Santiago, MD, professor of breast imaging at the University of Texas MD Anderson Cancer Center.

“These alterations can be due to the presence of breast cancer or benign entities such as a cyst, which is a structure filled with fluid,” Santiago told Health.

However, a mammogram can only identify a tissue abnormality; it can’t determine whether that abnormality is cancerous or benign. Alterations on the scan could also just be normal breast tissue that was overlapped instead of dispersed.

In these situations, these alterations on the screening mammogram are flagged as a positive result, but may not necessarily be breast cancer, Santiago explained.

“Additional testing is required when a new mass is identified in a screening mammogram, but if the testing demonstrates the mass to be a cyst, the screening mammogram would be considered to be a false-positive result,” she said.

False-positive mammogram results are more common in people who:

• Are younger
• Have dense breasts
• Have a family history of breast cancer
• Take estrogen
• Have previously had a breast biopsy

Navigating a False-Positive Mammogram

Even though false-positive results can happen with mammography, it’s still crucially important that people continue to get them, experts said.

The U.S. Preventive Services Task Force recommends that women get screened for breast cancer every other year from ages 40 to 74.

“It’s important for women who receive false-positive results to continue screening every one to two years, as a false-positive—particularly if it leads to a diagnosis of benign breast disease—is associated with a small increase in developing breast cancer in the future,” said Miglioretti.

In fact, consistent participation in screening mammography has a significant impact on a woman’s risk of death from breast cancer—a medical record with multiple scans of a person’s breast tissue makes it easier for doctors to detect any subtle changes or issues and lowers the risk of false positives.

And routine mammography can help establish and identify patients who are at a higher risk of developing breast cancer, Douglas Marks, MD, breast oncologist and associate professor at the NYU Grossman Long Island School of Medicine, told Health.

“Repeat breast imaging and benign breast biopsies are commonly identified when reviewing the history of a patient who ultimately is diagnosed with breast cancer,” he said.

If someone does receive a false-positive result from their mammogram, they should continue to undergo any recommended testing to ensure the cause of the abnormality is addressed. The false-positive result might also provide more information about a person’s breast health as they continue to participate in future screening mammography.

“False-positive mammograms should be discussed with the patient’s physician,” said Marks. “While discouraging, they should not prompt discontinuation or delay of future scheduled imaging. It is important to note that sometimes false-positive mammograms may still be informative.”

This story originally appeared on: Health News - Author:Lauryn Higgins