False-Positive Mammogram Results May Turn Out Not to Be: Study

THURSDAY, April 5 (HealthDay News) — Women who have a
false-positive result on their mammogram may be at higher long-term risk
of developing breast cancer than those whose initial test is negative,
according to a new Danish study.

However, the link between false-positive results and an increased risk
of breast cancer was weaker among women who had been screened from the
early 2000s on, the researchers found.

Experts have long known that screening mammograms, done in healthy
women to detect breast cancer early, are bound to lead to some
false-positive test results. These are results that seem to detect cancer
but turn out to be false upon further testing.

However, few studies have followed these women with false-positive
results long-term to evaluate what happens, said My von Euler-Chelpin, an
associate professor of epidemiology at the University of Copenhagen, who
led the study. The new findings were published online April 5 in the
Journal of the National Cancer Institute.

“Some earlier research has found similar results, but to my knowledge
there has been no study with such a long follow-up as this one,”
Euler-Chelpin said.

For the study, the investigators evaluated 58,000 Danish women, aged 50
to 69. They looked at those with negative mammogram results and those
that turned out to be — with further testing such as ultrasound and
biopsies — false positives. They looked at both invasive breast cancer
and the early cancer known as ductal carcinoma in situ.

The average follow-up time was nearly 11 years. Women who had received
false-positive results in the mid-1990s had about a 1.5 to 1.6 times
higher risk of eventually developing breast cancer compared to those who
had negative initial mammograms. This increased risk persisted even at six
or more years, the researchers found.

For the false-positive group that underwent their mammograms in the
year 2000 or later, the link with the increased risk was not significant
from a statistical point of view, the study authors noted. “The excess
risk might still be there,” von Euler-Chelpin said. It could be, she said,
that there were not enough cases to detect accurately any increase in
risk.

Why would the women with false-positive results be at higher risk? “The
reason for this is not known, but misclassification is a possibility,”
von Euler-Chelpin said. That is, the women actually had breast cancer but
the tests did not detect it.

Whether the findings would apply to U.S. women is not clear, said Dr.
Stephanie Bernik, chair of surgical oncology at Lenox Hill Hospital in New
York. She reviewed the findings but was not involved in the study.

The research seems to suggest that ”screening has gotten so much
better [that] we are more accurate,” Bernik said. “We are better at
figuring out who needs a biopsy and who doesn’t,” she added.

“In the past, false positives [in the study] were clearly an indication
of an increased risk of getting breast cancer,” Bernik said of the study
findings. “Now, it is less clear,” she said of the more recent findings,
since 2000.

The Danish researchers encourage women with false-positive tests to
continue to get regular follow-up screenings as recommended by their
doctors.

In the United States, Bernik said, a woman who has had a false-positive
mammogram result is often, but not always, advised to get another
mammogram in six months. It depends on what the doctors see on the
mammogram and other information. Women should follow their doctors’
advice on the follow-up schedule, she said, as every case is different.

Bernik finds that among her patients, women who have had a previous
false-positive result — and had further testing that ruled out cancer —
often say they are tempted to ignore recommendations to get further
testing when they get a repeat mammogram result that calls for further
testing. That is a mistake, she tells them.

“Women can’t rely on the fact they had a false-positive test in the
past to forgo additional studies going forward,” Bernik said. “You have to
treat each new finding as its own entity.”

More information

To learn more about mammograms and false-positive results, visit the U.S. National Cancer Institute.

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