High rate of false-positives with annual mammogram
During a decade of receiving mammograms, more than half of cancer-free women will be among those summoned back for more testing because of false-positive results, and about one in 12 will be referred for a biopsy.
Simply shifting screening to every other year lowers a woman's probability of having one of these false-positive episodes by about a third from 61 percent to 42 percent over the course of a decade.
A new study delving into false-positives in mammography looked at nearly 170,000 women between the ages of 40 and 59 from seven regions around the United States, and almost 4,500 women with invasive breast cancer. Because of the added decade of testing alone, it found, women who start mammograms at 40 instead of 50 are more likely to have false-positive results that lead to more testing.
"This study provides accurate estimates of the risk of a false-positive mammography and breast biopsy for women undergoing repeat mammography in community practice, and so provides important information about the potential harms of undergoing regular mammography," said co-author Karla Kerlikowske, a professor of medicine at the UCSF School of Medicine.
The study will be published in Annals of Internal Medicine. The research was led by Group Health Research Institute of Seattle for the Breast Cancer Surveillance Consortium.
"Recalls'' for a second mammogram for what turn out to be non-cancer results, known as false positives, may cause inconvenience and anxiety. Recommendations for fine-needle aspiration or surgical biopsy are less common, but can lead to unnecessary pain and scarring. The additional testing also contributes to rising medical costs.
Kerlikowske is the lead author of an additional report to be published in the same issue of Annals that for the first time in the United States examines the accuracy of film mammography against digital, which has increasingly replaced older film screening.
That study looked at nearly 330,000 women between the ages of 40 and 79. The data was pooled from the Breast Cancer Surveillance Consortium, a collaborative network of mammography registries in the United States.
The researchers found that overall cancer detection rates were similar for both methods. However, digital screening may be better for women between the ages of 40 and 49 who are more likely to have extremely dense breasts associated with lower cancer detection. The study also found new evidence that digital mammography is better at detecting estrogen receptor-negative tumors, particularly in women aged 40 to 49 years.
Breast cancer may not be detected, the researchers caution, if a radiologist fails to identify a visible breast lesion or if a tumor is obscured by normal breast tissue. Additionally, an imperceptible tumor may grow quickly and be discovered through a clinical exam prior to the next mammogram.
Digital mammography was developed in part to improve the detection of breast cancer in dense breasts by improving the ability to distinguish normal dense breast tissue from isodense invasive cancer.
The authors note that for every 10,000 women 40 to 49 who are given digital mammograms, two more cases of cancer will be identified for every 170 additional false-positive examinations.
Healthy women will undergo 12 screening mammograms in their lifetimes if they follow U.S. Preventive Services Task Force guidelines that recommend biennial screening starting at age 50 and continuing until age 74. This is controversial, with many practitioners recommending annual mammograms.
If women start biennial screening at 40, they will undergo 17 exams; those who start annual screenings at age 40 will undergo 34 exams.
For the false-positive study, the researchers found that after a decade of annual screening, a majority of women will receive at least one false-positive result, and 7 to 9 percent will receive a false-positive biopsy recommendation.
"We conducted this study to help women know what to expect when they get regular screening mammograms over the course of many years,'' said study leader Rebecca Hubbard, PhD, an assistant investigator at Group Health Research Institute. "We hope that if women know what to expect with screening, they'll feel less anxiety if or when they are called back for more testing. In the vast majority of cases, this does not mean they have cancer.''
The researchers say that screening every other year would likely lessen the probability of false-positive results "but could also delay cancer diagnosis.'' However, for those diagnosed with cancer, the authors found women screened every two years were not significantly more likely to be diagnosed with late-stage cancer compared to those screened at one-year intervals.
The study stresses the importance of radiologists being able to review a patient's previous mammograms because it "may halve the odds of a false-positive recall.''
Provided by University of California, San Francisco
- Researcher calls for mammograms to be tailored to patient Sep 30, 2011 | not rated yet | 0
- Yearly mammograms from age 40 save 71 percent more lives, study shows Jan 27, 2011 | not rated yet | 0
- Mammography use among women younger than 40 years old differ between minority populations Dec 08, 2009 | not rated yet | 0
- Adding ultrasound screening to mammography brings benefits, risks May 13, 2008 | not rated yet | 0
- Adding ultrasound to mammography may improve breast cancer detection in high-risk women May 13, 2008 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
In a new study described in the journal Oncogene, researchers reveal how a key player in cell growth, immunity and the inflammatory response can be transformed into a primary contributor to tumor growth.
Cancer 3 hours ago | not rated yet | 0 |
A new study conducted using extensive medical records of over one million Israeli adolescents before military service shows clearly how exposure to the Israeli sun of young, light-skinned children increases substantially ...
Cancer 5 hours ago | not rated yet | 0
A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...
Cancer 9 hours ago | not rated yet | 0
Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...
Cancer 10 hours ago | not rated yet | 0
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
Cancer May 19, 2013 | not rated yet | 0
New research from the University of Southampton has shown that blind and visually impaired people have the potential to use echolocation, similar to that used by bats and dolphins, to determine the location of an object.
42 minutes ago | not rated yet | 0 |
While the effects of acute stroke have been widely studied, brain damage during the subacute phase of stroke has been a neglected area of research. Now, a new study by the University of South Florida reports that within a ...
25 minutes ago | not rated yet | 0 |
A new report suggests that improved health care and significant reductions in drug costs might be attained by breaking up the age-old relationship between physicians and drug company representatives who promote the newest, ...
28 minutes ago | not rated yet | 0
Food microbiology laboratories continue to submit false negative results and false positive results on a routine basis. A retrospective study of nearly 40,000 proficiency test results over the past 14 years, presented today ...
14 minutes ago | not rated yet | 0
Posterior fossa subdural hematoma (PFSDH) is a serious and rare condition in newborns, generally occurring after difficult deliveries. But with appropriate treatment, there's an excellent chance of good long-term outcomes ...
17 minutes ago | not rated yet | 0
National guidelines recommend that at-risk women be screened for elevated cholesterol levels to reduce their chances of developing cardiovascular disease. But who is 'at risk?' The results of a study by investigators ...
27 minutes ago | not rated yet | 0