If you’ve ever been called back after a screening mammogram, for either a follow-up diagnostic mammogram, or even worse, for a biopsy, it can be extremely nerve-wracking, to say the least. But what happens when you learn that your results are negative? This finding is called a “false-positive,” and while the results are reassuring, most women can relate to a simultaneous feeling of… Well… Frustration.
According to a recent study published in The Annals of Internal Medicine1, a large percentage of women are actually less likely to return to regular breast cancer screening after false-positive mammography results.
“False-positive results are a frustrating reality for both patients and radiologists,” explains Dr. Jason McKellop, a breast imager and Medical Director of Breastlink Tarzana. “When scouring screening mammograms for breast cancer, breast imagers typically cast a wider net than is necessary, in order to catch as much disease as possible, and to avoid the even more dreaded, false-negative result. For this reason, the majority of cases called back from screening mammography are in fact benign.”
The above-mentioned article also cites a 2022 report that suggests that after 10 years of annual screening, 50-60% of women can expect to have at least one false-positive recall, and 7-12% will have at least one false-positive biopsy recommendation.
According to Dr. McKellop, “the reasons for this are multi-fold.” He explains, “mammograms, are not as ‘black and white’ as they are widely perceived. Breast cancers are subtle findings on x-ray and can often blend into the normal anatomical structures of the breast, obscuring their presence from even the most scrutinizing eye. Because of this, there is a wide degree of overlap between normal anatomy and diseased anatomy. Indeed, the picture is not so ‘black and white’ at all, rather an unforgiving shade of gray. Because of this overlap, benign things can be easily interpreted as suspicious, and vice versa - suspicious things may be misinterpreted as benign.”
That being said, mammograms are still the gold standard for early detection of breast cancer. In fact, another study published in 20212, found that women who had been regular with their scheduled screening mammography appointments before a cancer diagnosis saw a substantial reduction in the risk of dying from the disease.
This study was conducted by a multinational team of researchers who analyzed data from almost 550,000 women eligible for mammography screening. The results ultimately showed that women who maintain their regular screening mammogram schedules are more likely to survive than women who delay or abandon screenings.
If you’re still not convinced to return to your regularly scheduled mammograms, let’s turn to one more study.3 This one is based on a large population-based cohort study with a long follow-up and it shows that women with a false-positive mammography result had an elevated incidence of breast cancer and mortality for up to 20 years.
“It is quite interesting to note that women who have been called back for false positive findings have a higher lifetime risk of developing breast cancer than those who have not,” Dr. McKellop says. “While the reasons for this are not entirely clear, it stands to reason that a peculiarity in a false-positive mammogram finding may be associated/correlated with ultimately developing breast cancer.”
What all of this research and all of these studies point to is one crucial takeaway: regular screening mammograms save lives.
Dr. McKellop emphasizes this, saying, “Despite the limitations of mammography, the benefits of a screening program far outweigh the harms of being called back for what ultimately are deemed falsely-positive results. Some studies have shown up to a 30% reduction in breast cancer related mortality by simply adhering to an annual screening mammography schedule.”
At our RadNet and Breastlink centers, not only do we provide the most advanced technology in our screening mammograms, but we offer patients the opportunity to take your screening one step further with the addition of Artificial Intelligence. The Enhanced Breast Cancer Detection (EBCD) program combines artificial intelligence (AI) technology with a rigorous clinical review process to deliver greater accuracy in breast care. The AI helps radiologists detect subtle lesions in your mammogram during the review process. Since first introducing the program in January, 2023, over 400 breast cancers have been detected at an earlier stage using the EBCD review process and it has also been shown to lower recall rates.
So, should you ever be recalled after a mammogram, either for a second diagnostic mammogram or for a biopsy, and the results end up being negative, you should definitely feel relieved. You can absolutely feel frustrated (who wouldn’t?). But please, don’t doubt that returning for your regular screening isn’t worth it – because it really is.
Sources:
- https://www.auntminnie.com/clinical-news/womens-imaging/article/15682928/women-less-likely-to-return-to-mammo-after-falsepositive-results? braze_int_id=64e76011840a460001420e39&braze_ext_id=643033b619ef38833c612a45
- https://pubs.rsna.org/doi/10.1148/radiol.2021203935?_gl=1*lscg8g*_gcl_au*NjAzMTk1MTQyLjE3MjU2NDc2NzY.*corpRollup_ga*ODc3NjUzMzA2LjE3MjU2NDc2NzU.*corpRollup_ga_EQ32SZ84M3*MTcyODA3MzE4NS4yLjAuMTcyODA3MzE4NS42MC4wLjA.
- https://jamanetwork.com/journals/jamaoncology/fullarticle/2811409#:~:text=Question%20What%20are%20the%20long%2Dterm%20outcomes%20for,biopsy%20was%20performed%20during%20recall%20or%20not.
Add new comment