Diagnostic invasiveness and psychosocial consequences of false-positive mammography

Ann Fam Med. 2015 May-Jun;13(3):242-9. doi: 10.1370/afm.1762.

Abstract

Purpose: We undertook a study to assess whether women with false-positive mammography have worse psychosocial consequences if managed with a workup that involves a biopsy (invasive group) than if managed with only additional imaging (noninvasive group).

Methods: We performed subgroup analysis of a cohort study of 454 women with abnormal screening mammography and 908 matched control women with normal results. Using a condition-specific questionnaire (Consequences of Screening in Breast Cancer), we assessed 12 psychosocial consequences at 5 time points (0, 1, 6, 18, and 36 months after final diagnosis) and compared the 2 groups of women with false-positives (invasive and noninvasive management groups).

Results: Among the 252 women with false-positive mammography eligible for this study, psychosocial consequences were similar for those managed invasively and those managed noninvasively during the 36 months of follow-up. In 60 comparisons (12 scales and 5 time points), differences between the groups were never statistically significant (P <.01) and the point estimates for the differences were always close to zero. The psychosocial consequences of women with false-positive results, regardless of management, fell between those of women with normal mammography and those of women determined to have breast cancer.

Conclusions: We found no evidence that use of more invasive diagnostics was associated with worse psychosocial consequences. It is therefore reasonable to pool subgroups of women with false-positives in a single analysis. The invasiveness of subsequent diagnostic procedures does not help to identify women at higher risk for adverse psychosocial consequences of false-positive mammography.

Keywords: biopsy; biopsy/adverse effects; breast cancer; false-positive reactions/adverse effects; fine-needle/adverse effects; mammography/adverse effects; mass screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biopsy, Fine-Needle
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / psychology*
  • Cohort Studies
  • Early Detection of Cancer
  • False Positive Reactions*
  • Female
  • Humans
  • Mammography / psychology*
  • Mass Screening
  • Middle Aged
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Time Factors