Do False-Positive Mammography Results Reduce the Likelihood of Future Breast Cancer Screening?

By: Chris Schimpf, MSW
Posted: Tuesday, October 8, 2024

False-positive mammography results may reduce the chances that women will return for future breast cancer screening, according to research published in the Annals of Internal Medicine. Diana L. Miglioretti, PhD, of the University of California, Davis, School of Medicine, and colleagues found in their large cohort study that women who underwent mammograms and received false-positive results were less likely to return, especially if they received false positives on two sequential mammograms or the recall led to recommendations for short-interval follow-up or biopsy.

“The decrease in subsequent screening after a false-positive biopsy recommendation is especially concerning because having a benign biopsy finding is associated with increased risk for invasive breast cancer and advanced cancer,” the investigators noted. “Health-care providers should educate their patients about the importance of false-positive results, especially benign biopsy findings.”

A total of 1,053,672 women aged 40 to 73 without breast cancer diagnoses were included in the study, drawn from 177 facilities participating in the Breast Cancer Surveillance Consortium. The participants underwent a total of 3,529,825 screening mammograms between 2005 and 2017, of which 3,184,482 were true negatives and 345,343 were false-positive recalls with either recommendation for immediate additional imaging only, short-interval follow-up, or biopsy.

The researchers reported that participants were 76.9% more likely to return after a true negative (95% confidence interval = 75.1%–78.6%) than after a false-positive recall for additional imaging only (adjusted absolute difference = –1.9 percentage points), short-interval follow-up (–15.9 percentage points), or biopsy (–10.0 percentage points). They also noted that Asian and Hispanic/Latinx women had the largest decreases in probability of returning after a false positive with a recommendation for short-interval follow-up (–20 to –25 percentage points) or biopsy (–13 to –14 percentage points) vs a true negative. Finally, among women who underwent two screening mammograms within 5 years, a false-positive result on the second was associated with a decreased probability of returning for a third regardless of the first screening result.

Disclosure: For full disclosures of the study authors, visit acpjournals.org.

Annals of Internal Medicine

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