Many women find mammograms difficult to face. Symptom-free routine exams are uncomfortable and there’s always the fear of the outcome. When suspicious symptoms lead to a mammogram, anxiety is heightened even more.
Sometimes mammograms are read incorrectly or further examination reveals a false-positive result (an indication of abnormality when none actually exists). Relief and rejoicing are usually expected when a positive finding is proven to be false but a Swedish study finds the stress and anxiety generated by a false-positive mammogram can linger as long as a year.
Anetta Bolejko led the study from Malmö, Sweden, that tracked the psychosocial consequences of false-positive screening results of mammography. Bolejko, of the Skåne University Hospital’s Department of Medical Imaging and Physiology, says her study indicates the need for support and comfort from healthcare providers when a woman is called back for further investigation of a seemingly positive screening outcome.
Swedish Consequences of Screening - Breast Cancer
Bolejko’s study involved a group of 399 women who were called back to medical facilities after an abnormality was detected on their mammograms. The women, who all volunteered for the study, completed the Swedish Consequences of Screening - Breast Cancer questionnaire during their recall visit before follow-up diagnostics revealed no indication of breast cancer. Their initial mammography readings were updated to false-positive.
An additional 499 women, matched in age to the 399 in the study group, served as a control group and answered the same questionnaire. Each of these women had negative mammograms from the beginning but completed the questionnaire at the same intervals over the following year as the false-positive group.
Psychosocial Distress Indicators
All women in both groups of study completed the questionnaire when they arrived for their first follow-up visit and again six and 12 months later. The questionnaire measured psychosocial stress for five indicators:
- Anxiety
- Behavioral concerns
- Existential values
- Sense of dejection
- Sleep quality
Highly Stressful Year
The first questionnaire, completed before the false-positive women knew they were cancer-free, revealed:
- 83% reported anxiety
- 67% experienced behavioral difficulties such as problems concentrating
- 88% a sense of dejection
- 53% had problems sleeping
These findings indicate five times more psychosocial distress in the false-positive group than in the negative control group.
Throughout the following year, the false-positive study group reported twice as many psychosocial concerns than those in the negative control group.
Surprise Findings
Bolejko expressed surprise that such a great degree of psychosocial distress lingered as long as a year after women learned their initial mammograms were a false positive. A final false-positive diagnosis was expected to bring relief, not lingering distress. She said, “This means that we think that early recall should be applied cautiously because it seems to create confusion and maintain psychosocial distress."
Who Gets False-Positive Readings
Data from the National Cancer Institute indicates women most likely to get a false-positive screening result:
- Are young,
- Have had previous breast biopsies,
- Have a family history of breast cancer, and/or
- Are taking estrogen for conditions such as menopause.
Sources:
- Bolejko, Anetta, Peter Hagell, Christine Wann-Hansson, and Sophia Zackrisson. "Prevalence, Long-term Development, and Predictors of Psychosocial Consequences of False-Positive Mammography among Women Attending Population-Based Screening." Cancer Epidemiology, Biomarkers & Prevention (2015). Web. 9 Sep. 2015.
- "Mammograms." National Cancer Institute. US Department of Health and Human Services, 25 Mar. 2014. Web. 9 Sep. 2015.