False-Positive Mammograms: A 20-Year Game of Risk

Inaccurate Mammogram Predictions Increase Risk of Future Breast Cancer Diagnosis

False-positive mammogram increases risk of future breast cancer

False-positives on a screening mammogram, when the test suggests something abnormal that turns out to be non-cancerous, may not be as harmless as previously believed. In fact, a large new study published in JAMA Oncology suggests that women who receive false-positive results may face an increased risk of breast cancer for up to 20 years. Talk about a rollercoaster ride of emotions!

So, what does this mean exactly? Well, let’s delve into the study. Researchers analyzed nearly 500,000 Swedish women who underwent mammography screenings between 1991 and 2017, including over 45,000 women who received a false-positive result. Over the course of 20 years, it was found that 11% of women in the false-positive group developed breast cancer, compared to 7% of women without a false-positive. That’s definitely a cause for concern!

But here’s where it gets interesting. Age and breast density play a crucial role in this game of risk. Older women (age 60 and up) and women with low breast density, meaning they have more fat tissue than fibrous and glandular tissue, have the highest likelihood of future breast cancer following a false-positive mammogram. In fact, among women aged 60 to 75, those with a false-positive had double the risk of developing breast cancer compared to those without a false-positive. And if you have low breast density and a false-positive mammogram, you’re nearly five times more likely to join the breast cancer club. It’s like getting a golden ticket to an unwelcome factory tour!

Now, before you start panicking, let’s talk about what these findings mean for women. Despite the distressing experience of a false-positive result, experts emphasize the importance of continuing to receive regular breast cancer screenings. As study leader Xinhe Mao suggests, “It’s important for these women to maintain long-term awareness of breast cancer.” So, don’t jump off the mammography train just yet!

But why are false-positives more common in women with dense breasts? Well, it’s all about the difficulty of distinguishing between normal and abnormal tissue on the initial mammogram. Women with dense breasts often get called back for additional testing simply because it’s like looking for a needle in a haystack. On the other hand, when women have low breast density, the callback may indicate a truly suspicious finding, such as a tiny tumor or a “proliferative” breast condition—abnormal-looking cells which, although non-cancerous, come with their own elevated risk of breast cancer.

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So, what’s the takeaway from all of this? Susan Brown, senior director of health information and publications at Susan G. Komen, emphasizes the importance of personalized risk assessment and screening plans. It’s not a one-size-fits-all situation. Discussing your personal risk factors with your doctor is key to making informed decisions.

Now, before we wrap up, let’s address the elephant in the room—the study was conducted in Sweden, where mammography screenings take place every two years. In the United States, we often recommend yearly screenings. Can the findings be applied to the U.S.? Well, Mao and her team believe that the overall pattern remains consistent, though the breast cancer risk associated with false-positives may be slightly lower due to different screening intervals. Phew, that’s a relief!

In conclusion, the game of risk that follows a false-positive mammogram is no laughing matter. But armed with this knowledge, women can make empowered choices about their breast health. So, keep rolling the dice, ladies, but don’t forget to stay vigilant and prioritize regular screenings. You’ve got this!

More information

The American Cancer Society has a primer on mammography screening.

SOURCES: Xinhe Mao, MSc, researcher, medical epidemiology and biostatistics, Karolinska Institute, Stockholm, Sweden; Susan Brown, MS, RN, senior director, health information and publications, Susan G. Komen, Dallas; JAMA Oncology, Nov. 2, 2023, online