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False-positive mammograms may cause long-term psychosocial effects
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False-positive screening results from a mammogram caused women to experience long-term psychosocial consequences, especially among women scheduled for early recall, according to a study conducted in Sweden.
Anetta Bolejko, PhD, of the department of medical imaging and physiology at Skåne University Hospital in Malmö, Sweden, and colleagues sought to identify the prevalence, longitudinal development and predictors of psychosocial adverse effects associated with false-positive results of mammography screening.
Anetta Bolejko
“Our results show that psychosocial consequences of false-positive screening mammograms are common and can persist over time, with approximately one-third of women experiencing psychosocial consequences up to 1 year after the diagnostic work-up,” Bolejko said in a press release. “This is important because women invited to attend mammographic screening should be informed about the potential benefits and harm of the program and the risk of long-term, psychosocial consequences of false-positive screening mammography should be acknowledged.”
The researchers identified 399 Swedish women with a false-positive mammogram — or, a negative breast cancer diagnosis following a recall examination — that took place between September 2009 and December 2010 and compared them with 499 age-matched controls who had a negative mammogram.
All women responded to the Consequences of Screening–Breast Cancer questionnaire at baseline, 6 months and 12 months. Researchers assessed five of the questionnaire scales — including sense of dejection, anxiety, behavioral, sleep and existential values — as outcome measures.
Women who had a false-positive result had a higher prevalence of psychosocial consequences on all five scales than the matched controls (P < .001). The prevalence of consequences decreased between baseline and 6 months (P < .001) but appeared stable between 6 months and 12 months.
Early recall frequently predicted long-term consequences in each of the five scales. At 6 months, the ORs for psychosocial consequences due to early recall ranged from 3.21 (95% CI, 1.68-6.14) for behavioral consequences to 10.31 (95% CI, 5.01-21.23) for a sense of dejection. At 12 months, the ORs for consequences due to early recall ranged from 3.05 (95% CI, 1.55-6.04) for behavioral consequences to 3.67 for a sense of dejection (95% CI, 1.95-6.91) and sleep (95% CI, 1.82-7.4) scales.
Long-term consequences for all five outcomes also appeared more common among foreign-born women (OR range, 2.35-3.71), those who reported a lack of social support (OR range, 1.13-1.25) and women dissatisfied with information at recall (OR range, 2.28-2.56).
“We were surprised to find that women who are frequently monitored by additional clinical mammography (early recall) following a false-positive screening mammogram experienced psychosocial consequences,” Bolejko said in the release. “This means that we think that early recall should be applied cautiously because it seems to create confusion and maintain psychosocial distress.”
The findings may be limited because although the researchers analyzed the extent of the psychosocial consequences, they did not analyze the relevance of the consequences.
“Our results show that psychosocial consequences of false-positive mammograms are common and can persist over time,” the researchers concluded. “This argues for an intervention to prevent the development of such consequences.” – by Anthony SanFilippo
Disclosure: The researchers report no relevant financial disclosures.
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