News | Mammography | February 09, 2017

False Positive Mammograms More Likely to Cause Delay of Next Screening

Study finds women who receive a true negative result are significantly more likely to come back for their next screening than women who receive a false positive

screening mammograms, false positive, true negative, screening behavior, Firas M. Dabbous, Cancer Epidemiology Biomarkers & Prevention

February 9, 2017 — A new study published in Cancer Epidemiology: Biomarkers & Prevention found that women who had a false positive result from a screening mammogram were more likely to delay or forgo their subsequent screening mammogram than women who had a true negative result.

Women who have a false positive result from a screening mammogram often experience emotional, physical and economic stress, according to Firas M. Dabbous, Ph.D., manager of patient-centered outcomes research at the Russell Institute for Research & Innovation at the Advocate Lutheran General Hospital in Park Ridge, Ill, and author of the study. "We wanted to know whether having a false positive screening mammogram also causes women to delay coming back for their next screen," he said.

For this study, Dabbous and colleagues obtained data for women who received mammography screening through a large healthcare organization with multiple facilities in the greater metropolitan Chicago area. Among the 741,150 screening mammograms from 261,767 women included in the analysis were 12.3 percent that yielded a false positive result; the remaining 87.7 percent yielded true negative results.

The researchers found that women who had a false positive result were significantly less likely to have a subsequent screening mammogram in the database than women who had a true negative result; 22.1 percent of women who had a true negative and 15 percent of women who had a false positive had at least one subsequent screening mammogram in the database.

Among the women with more than one screening mammogram in the database, those who had a true negative result from the first mammogram were 36 percent more likely to have returned for a subsequent screen in the next 36 months compared to women who had a false positive result.

When delay in having a subsequent screen was defined as any mammogram performed more than 12 months after the first screening mammogram, the median delay was found to be significantly higher for women who had a false positive result compared with those who had a true negative result. The median delay was 13 months for those who had a false positive result compared with three months for those who had a true negative result.

The researchers then reanalyzed the data using different statistical methods to eliminate the chance for bias in the methods. Using propensity scoring matching, they found that women who had a true negative result were 34 percent more likely to return for a subsequent screen than those who had a false positive result, and that the median delays in returning for a subsequent screen were six months and 13 months, respectively.

In addition, the researchers found that the four-year cumulative risk of a late stage at diagnosis was 0.4 percent for those who had a false positive screening mammogram compared with 0.3 percent for those who had a true negative result. This difference was statistically significant.

"This [the fact that having a false positive screening mammogram caused women to delay coming back for their next screen] suggests that we need to more actively encourage women who have a false positive result from a screening mammogram to adhere to routine screening mammography recommendations because it has been shown to reduce breast cancer mortality," said Dabbous.

"Because we obtained the same conclusion using two different statistical approaches to analyze the data, we have a high degree of confidence in the results," he continued. "We believe that the delay in subsequent screening for women who have an initial false positive result increases the probability that they will subsequently receive a later-stage breast cancer diagnosis compared with women who first have a true negative result from a screening mammogram."

According to Dabbous, the main limitation of the study is the lack of ability to follow the women who did not show up for their next screen in this healthcare system because some may have received subsequent mammograms at different institutions. However, he noted that the results were similar when restricted to those who remained in the system and so the researchers are confident that this limitation did not bias the results.

The study was supported by a grant from the Agency for Health Research and Quality. Dabbous declares no conflicts of interest.

For more information: www.cebp.aacrjournals.org

References

Dabbous, F.M., Dolecek, T.A., Berbaum, M.L., Friedewald, S.M., et al. "Impact of a False-Positive Screening Mammogram on Subsequent Screening Behavior and Stage at Breast Cancer Diagnosis," Cancer Epidemiology: Biomarkers & Prevention. Published online Feb. 9, 2017. DOI: 10.1158/1055-9965.EPI-16-0524

Related Content

Examples of the imaging performance of XPCI-CT (b,e) compared to conventional specimen radiography (a,d) and benchmarked against histopathology (c,f). he top row focuses on the similarity between the XPCI-CT slice in (b) and the histological slice in (c). Arrow 1 indicates margin involvement, arrow 2 a variation in density in the internal structure of the tumour mass, arrow 3 tumour-induced inflammation. All this is confirmed by the histological slice in (c), and hardly visible in the conventional image in

Examples of the imaging performance of XPCI-CT (b,e) compared to conventional specimen radiography (a,d) and benchmarked against histopathology (c,f). he top row focuses on the similarity between the XPCI-CT slice in (b) and the histological slice in (c). Arrow 1 indicates margin involvement, arrow 2 a variation in density in the internal structure of the tumour mass, arrow 3 tumour-induced inflammation. All this is confirmed by the histological slice in (c), and hardly visible in the conventional image in (a). The bottom row focuses on the detection of small calcifications, a key feature in DCIS. These are undetectable in (d), detected in (e), enhanced in the maximum intensity projection (MIP) image at the bottom of (f), and confirmed by histopathology in the top part of (f). The scale bar [shown in (b) and (e)] is the same for all images apart from (f), which has its own scale. Red arrows in (e) and (f) indicate the microcalcifications. Image courtesy of Professor Alessandro Olivo

News | Breast Imaging | February 22, 2021
February 22, 2021 — A new X-ray imaging scanne
Axial FLAIR MR image shows T2 prolongation in bilateral middle cerebellar peduncles (arrows). Findings were associated with restricted diffusion and areas of T1 hypointense signal without enhancement or abnormal susceptibility. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

Axial FLAIR MR image shows T2 prolongation in bilateral middle cerebellar peduncles (arrows). Findings were associated with restricted diffusion and areas of T1 hypointense signal without enhancement or abnormal susceptibility. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Coronavirus (COVID-19) | February 22, 2021
February 22, 2021 — According to an...
F-18 FES PET images of patients with ER+/PR+/HER2- invasive ductal carcinoma. Left panel: Progressive disease seen at the 8-week time-point in a patient on sequential therapy. Right panel: Stable disease through all 3 time-points, remaining on study therapy for 6.7 months until disease progression on combined vorinostat aromatase inhibitor therapy. Image created by Lanell M Peterson, Research Scientist, University of Washington Medical Oncology, Seattle WA.

F-18 FES PET images of patients with ER+/PR+/HER2- invasive ductal carcinoma. Left panel: Progressive disease seen at the 8-week time-point in a patient on sequential therapy. Right panel: Stable disease through all 3 time-points, remaining on study therapy for 6.7 months until disease progression on combined vorinostat aromatase inhibitor therapy. Image created by Lanell M Peterson, Research Scientist, University of Washington Medical Oncology, Seattle WA.

News | Molecular Imaging | February 22, 2021
February 22, 2021 — Molecular imaging
Example MR images from paediatric brain tumour patients. This first column shows T1-weighted images following the injection of gadolinium contrast agent. The second column shows T2-weighted images and the final column shows apparent diffusion coefficient maps calculated from diffusion-weighted images. (a–c) are taken from a patient with a Pilocytic Astrocytoma, (d–f) are from a patient with an Ependymoma and (g–i) were acquired from a patient with a Medulloblastoma.

Example MR images from paediatric brain tumour patients. This first column shows T1-weighted images following the injection of gadolinium contrast agent. The second column shows T2-weighted images and the final column shows apparent diffusion coefficient maps calculated from diffusion-weighted images. (ac) are taken from a patient with a Pilocytic Astrocytoma, (df) are from a patient with an Ependymoma and (gi) were acquired from a patient with a Medulloblastoma. Image courtesy of Nature Research Journal

News | Pediatric Imaging | February 17, 2021
February 17, 2021 — Diffusio...
A comparison of standard mammography imaging (left) in a woman with dense breasts and a breast MRI imaging study (right) showing a clearly defined cancer and is extremely hard to detect on the mammograms.

A comparison of standard mammography imaging (left) in a woman with dense breasts and a breast MRI imaging study (right) showing a clearly defined cancer and is extremely hard to detect on the mammograms. Images from Christiane Kuhl, M.D.

Feature | MRI Breast | February 17, 2021 | By Dave Fornell, Editor
Dense breast tissue can hide cancers i
T1 structural images for the two sequences, MPRAGE and MPRAGE+PMC. The top row shows the MPRAGE sequence, while the bottom row shows the images that were generated with the MPRAGE+PMC sequence. Columns represent two different participants, one with minimal head motion (left, Low-Mover) and another with a large quantity of motion (right, High-Mover). Pial and white matter (WM) surface reconstruction from Freesurfer are also shown.

T1 structural images for the two sequences, MPRAGE and MPRAGE+PMC. The top row shows the MPRAGE sequence, while the bottom row shows the images that were generated with the MPRAGE+PMC sequence. Columns represent two different participants, one with minimal head motion (left, Low-Mover) and another with a large quantity of motion (right, High-Mover). Pial and white matter (WM) surface reconstruction from Freesurfer are also shown.

News | Magnetic Resonance Imaging (MRI) | February 17, 2021
February 17, 2021 — A new paper,...
Immunotherapy-based precision medicine clinical trials being developed

Getty Images

News | Prostate Cancer | February 16, 2021
February 16, 2021 — Black men die more often of prostate cancer yet, paradoxically, have greater survival benefits fr
The research collaboration agreement covers a joint clinical retrospective study on liver fibrosis severity in Non-Alcoholic Steato-Hepatitis (NASH) patients
News | Artificial Intelligence | February 10, 2021
February 10, 2021 — Median Technologies announced the company has signed a research collaboration agreement with the
Screening strategy based on baseline breast density at age 40 may be effective and cost-effective for reducing breast cancer mortality

Getty Images

News | Breast Density | February 10, 2021
February 10, 2021 — A mammography screenin...
Unhealthy lifestyles, various diseases, stress, and aging can all contribute to an imbalance between the production of ROS and the body's ability to reduce and eliminate them. The resulting excessive levels of ROS cause "oxidative stress".

Unhealthy lifestyles, various diseases, stress, and aging can all contribute to an imbalance between the production of ROS and the body's ability to reduce and eliminate them. The resulting excessive levels of ROS cause "oxidative stress". Graphic courtesy of National Institutes for Quantum and Radiological Science and Technology

News | Magnetic Resonance Imaging (MRI) | February 10, 2021
February 10, 2021 — Oxygen is essential for human life, but within the body, certain biological environmental conditi