The Link Between False Positive Mammograms and Increased Breast Cancer Risk
Mammography is a widely used screening tool for breast cancer. However, false positive results can cause anxiety and unnecessary follow-up procedures that carry risks of their own. Recent research has found that women who experience false positive mammograms may also have an increased risk of developing breast cancer in the future.
What are False Positive Mammograms?
A mammogram is an X-ray image of the breast tissue used to detect early signs of breast cancer. A false positive result means that a suspicious finding on a mammogram turns out not to be cancer after additional testing, such as biopsy or ultrasound.
According to the American Cancer Society (ACS), about 10% of women will receive a false-positive result from their first mammogram, and up to half will have at least one during ten years of annual screenings. The ACS recommends yearly mammograms starting at age 45 for most women.
Link between False Positive Results and Increased Breast Cancer Risk
Several studies suggest that having a false-positive mammogram may increase the risk of developing breast cancer later in life. For example:
– A study published in JAMA Oncology analyzed data from more than two million Swedish women aged 40-74 who had undergone screening between 1986 and 2015. The researchers found that those with a history of one or more false positives had higher rates of invasive breast cancers than those without.
– Another study published in Radiology followed nearly three thousand Norwegian women over ten years after they received either normal or abnormal findings on their initial screening exam. The researchers found that those with abnormal results were more likely to develop subsequent cancers during follow-up.
– According to another report by National Institutes for Health (NIH), Women with prior benign biopsies were significantly associated with increased odds ratios for both screen-detected (odds ratio [OR],2·15) and interval cancers (OR, 1·98) in multivariable models.
The reasons behind this link are not yet clear. One possibility is that false positive results may indicate underlying breast abnormalities that increase the risk of cancer. Another theory is that repeated exposure to radiation during mammography could contribute to cancer development.
What Can Women Do?
Women who receive a false-positive result should follow their healthcare provider’s recommendations for additional testing and monitoring. They should also discuss their individual risks and benefits of continuing with regular mammograms with their doctor, especially if they have a history of false positives or other risk factors for breast cancer.
Future Advances on This Topic
Researchers continue to investigate the relationship between false positive mammograms and breast cancer risk. Some studies suggest that newer imaging technologies, such as digital breast tomosynthesis (DBT), may reduce the number of false positives while maintaining high sensitivity for detecting cancers.
A study published in JAMA Oncology compared DBT with standard digital mammography in more than 44 thousand women aged 50-69 years undergoing screening in Australia. The researchers found that DBT was associated with lower recall rates (4.3% vs 5.8%) and higher detection rates (7·0 per 1000 screens vs 5·2 per 1000 screens) for invasive cancers than standard digital mammography alone.
Another study published in Radiology evaluated the performance of DBT combined with synthetic two-dimensional images versus standard digital mammography alone among nearly six thousand women undergoing screening at four centers across Europe over five years.The researchers found significantly improved diagnostic accuracy using both modalities together compared to using either one alone.
Overall, these findings suggest that advances in imaging technology may help improve early detection while reducing unnecessary follow-up procedures and anxiety associated with false-positive results.
References:
American Cancer Society https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/false-positives-on-mammograms.html
JAMA Oncology https://jamanetwork.com/journals/jamaoncology/article-abstract/2766208
Radiology https://pubs.rsna.org/doi/full/10.1148/radiol.2019191291
National Institutes for Health (NIH) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391840/
JAMA Oncology https://jamanetwork.com/journals/jamaoncology/fullarticle/2749187
Radiology https://pubs.rsna.org/doi/full/10.1148/radiol.2020203475
*Note: this site does not provide medical opinions or diagnosis and should not be relied upon instead of receiving medical attention from a licensed medical professional.
