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Author: By knowing what to expect, women may experience less
anxiety related to screening
PHILADELPHIA, October 18, 2011 - A new article being published
in Annals of Internal Medicine, the flagship journal of the
American College of Physicians, shows that false-positive recalls
will occur for the majority of women undergoing annual mammography
screening over a 10-year period. Mammography screening has been
shown to reduce deaths from breast cancer, but controversy remains
about the best time to begin screening and how often to get
In 2009, the U.S. Preventative Services Task Force recommended
that the decision to start regular mammography before the age of 50
years should be an individual one and that physicians should take
patient context into account, including the patient's values
regarding specific benefits and harms. The Task Force also
recommended that women aged 50 to 74 years and younger women who
opted for screening should have screening once every two years
versus every year.
A potential harm of shorter interval breast cancer screening is
the risk of false-positive results. To compare the cumulative
probability of false-positive results and stage of cancer diagnosis
after 10 years of screening with either an annual or a biennial
schedule, researchers studied seven mammography registries in the
Breast Cancer Surveillance Consortium, the most comprehensive
breast cancer registry in the world. The researchers concluded that
after 10 years of annual screening, more than half of women will
have at least one false-positive recall, and 7 to 9 percent will
have a false-positive biopsy recommendation. Biennial screening
reduces false-positive recalls by about one-third, but is
associated with a small increase in the probability of late-stage
Using data from the same registry, researchers studied screening
records for women aged 40 to 79 who underwent digital (n=213,034)
versus film-screen mammography (n=638,252) to determine if one
method was better than the other at detecting cancer. The
researchers found that digital and film-screen mammography were
equally effective for women age 50 to 79, but for women age 40 to
49-especially those with dense breasts-digital was a bit more
likely to find a cancer. However there was also had an increased
risk for false positive results for these younger women.
"We conducted these studies to help women understand that having
a false positive result is part of the process for mammography
screening," said Rebecca Hubbard, PhD, Assistant Investigator at
Group Health Center for Health Studies, Seattle, WA, and co-author
of both studies. "We hope that by helping women know what to expect
in terms of false-positive results, they'll be less likely to
experience anxiety when they are called back for a repeat screening
The study authors recommend that women and their doctors develop
a screening plan based on the patient's individual risk factors for
breast cancer, and tolerance for false-positive recalls.
About Annals of Internal MedicineAnnals of Internal Medicine is one of the five most widely
cited peer-reviewed medical journals in the world, with a current
impact factor of 16.2. The journal has been published for 82 years.
It accepts only 7 percent of the original research studies
submitted for publication. Follow Annals on Twitter and Facebook.