Psych Effects Linger After False-Positive Mammograms
(COPENHAGEN, Denmark) — Mammograms can detect breast cancer early, and save lives. But they can also lead to false alarms that take a heavy psychological toll, a new study found.
The Danish study of more than 1,300 women found that those who received “false-positive” results on their screening mammograms reported symptoms of anxiety and depression that still lingered three years later, long after a cancer diagnosis had been ruled out. Their psychological well-being was more closely matched to that of breast cancer patients than healthy women.
“It is comparable to a life crisis, like getting divorced or the death of a close family member,” study author Dr. John Brodersen of the University of Copenhagen’s department of public health said of mammogram false positives. “People don’t trust their body anymore; they interpret their body systems differently; they go to the doctor more frequently [to] search for security to know they are healthy. These women are turned from healthy people to people [at] risk, to people who are close to being sick.”
Women who had false positives were also more likely to report disturbances in sleep and sexuality, according to the study, published Monday in the journal Annals of Family Medicine.
One in eight American women will battle breast cancer in her lifetime, according to the American Cancer Society. In 2013, roughly 232,340 women will be newly diagnosed with invasive breast cancer. Nearly 40,000 women will die from the disease.
The U.S. Preventive Services Task Force recommends biennial mammograms for women between the ages of 50 and 74. The test, an X-ray of the breast, is often the first step in diagnosing breast cancer. But it can also lead to unnecessary tests and procedures, such as biopsies and lumpectomies, not to mention stress.
“Any abnormal finding sends a woman into a tailspin,” Lillian Shockney, a breast cancer nurse at Johns Hopkins Hospital in Baltimore, told ABC News. “It’s awful. But she would rather know if she has something ominous in her breast or not.”
A 2012 study of 100,000 women suggested the risks of mammogram false positives may even outweigh the benefits. It’s estimated that for one woman’s life to be saved, 2,000 women have to be screened, leading to 200 false positives and 10 unnecessary surgeries.
“The default is to assume that screening must be good; catching something early must be good,” study author James Raftery, professor of health technology assessment at the University of Southampton, U.K., told ABC News at the time. But “breast cancer screening was introduced because it was assumed to benefit women’s health overall. And the side effects are pretty damn serious.”
Breast cancer screening guidelines have been a topic of ongoing debate among researchers, with some studies supporting more frequent screening for women over 40 and others suggesting a minimal role for mammography in the reduction of breast cancer mortality overall.
In June 2012, the American Medical Association came out in support of routine mammography for women starting at age 40, bucking the USPSTF recommendation. And in Janurary 2013, a review of Medicare data found that more then $410 million was spent on screening women 75 and older — another group for whom mammography is not recommended.
But Americans appear to like their screening, according to a 2011 Gallup poll that found that 58 percent of responders were satisfied with the current level of screening and 31 percent wished there was more. A mere 7 percent thought there was too much.
Brodersen hopes his study will highlight the risks of overscreening.
“We are producing a need for health care that is unnecessary,” he said. “Please stop screening every year from age 40 to death. Trust the USPSTF recommendation.”
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