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False-Positive Mammograms Can Cause Long-term Harm, Study Finds
Women who receive a false-positive mammogram result often suffer from long-lasting psychological effects, according to a new study. However, one doctor says that the risk of these effects are outweighed by the benefits of screening.
By Amir Khan
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MONDAY, March 18, 2013 —Getting a false-positive mammogram result instead of an actual cancer diagnosis may seem like a cause for celebration, but according to a new study by researchers from the University of Copenhagen in Denmark, false positives can have long-term psychological effects that leave many women irrevocably changed.
False-positives are common, with some estimates putting the likelihood of a woman getting a false test result indicating cancer at 61 percent over 10 years of screening, according to Susan G. Komen For The Cure.
Researchers looked at 1,310 women, and gave them a questionnaire asking them to rate their stress, anxiety, sense of dejection and other psychological factors. 454 of the women had an abnormal finding during a mammogram, and researchers found that even after three years of being declared free of any suspected cancer, the women were suffering from psychological effects that mirrored those of women who were diagnosed with cancer.
“It is well known that a person’s values and perceptions of life can change as a result of trauma and existential crisis,” the researchers wrote in the study. “Women with false positives reported changes just as great in existential values and inner calmness as women with breast cancer.”
The National Cancer Institute recommends that all women age 40 and over have a mammogram every one to two years. However, while frequent screening raises the risk for false-positives, Elisa Port, MD, co-director of the Dubin Breast Center of the Tisch Cancer Institute at Mount Sinai, said that false positives are a small price to pay for a better chance at catching breast cancer early.
“There is no question that the more you look the more you’re going to find,” she said. “However, that doesn’t change the fact that the risk of dying from breast cancer when you do annual mammograms decreases by 15 percent.”
Port acknowledged the stress that accompanies false-positives, and said that while it is impossible to avoid false-positives completely, going to a center that specializes in mammograms will help reduce the risk.
“Go to a center where mammography is performed regularly in high volume by radiologists who only do breast radiology,” she said. “Experienced breast radiologists are more likely to test better and read your results better.”
In the end, the researchers wrote in the study that it’s clear that false-positive test results should not be taken lightly.
“For cancer screening, including screening mammography, this balance between benefits and harms is delicate,” they wrote. “Having a false positive is not harmless and causes undesirable outcomes in the long run.”
Shawn Farley, director of public affairs from the American College of Radiology, agreed, saying that although researchers are working to eliminate false-positives, they are an unfortunate part of testing. However, he said, doctors need to understand that and be ready to provide emotional support if needed.
"Anxiety regarding inconclusive test results is real and is only natural," he said via email. "Attention to women's feelings associated with test results is, and should be, a concern for those who provide this care."
And while Port agreed that doctors should be aware of their patients emotional state and recommend counseling when needed, ultimately, patients themselves need to be able to deal with the results of any test they undergo, she said.
“Every test you do has the potential to result in a false positive,” she said. “People need to be able to deal with the findings.”
Most importantly, she said, women shouldn't avoid mammograms over fears of false positives.
“You can’t have it both ways,” she said.
Video: Consequences of False Positive Mammogram Results
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