Association Between False-Positive Results and Return to Screening Mammography in the Breast Cancer Surveillance Consortium Cohort
Menée aux Etats-Unis à partir de données de 3 529 825 mammogrammes de dépistage réalisés entre 2005 et 2017 auprès de 1 053 672 femmes âgées de 40 à 73 ans et sans diagnostic préalable de cancer du sein, cette étude évalue l'association entre des résultats faussement positifs et la probabilité de participer à un dépistage ultérieur par mammographie
Background: False-positive results on screening mammography may affect women’s willingness to return for future screening.
Objective: To evaluate the association between screening mammography results and the probability of subsequent screening.
Design: Cohort study.
Setting: 177 facilities participating in the Breast Cancer Surveillance Consortium (BCSC).
Patients: 3 529 825 screening mammograms (3 184 482 true negatives and 345 343 false positives) performed from 2005 to 2017 among 1 053 672 women aged 40 to 73 years without a breast cancer diagnosis.
Measurements: Mammography results (true-negative result or false-positive recall with a recommendation for immediate additional imaging only, short-interval follow-up, or biopsy) from 1 or 2 screening mammograms. Absolute differences in the probability of returning for screening within 9 to 30 months of false-positive versus true-negative screening results were estimated, adjusting for race, ethnicity, age, time since last mammogram, BCSC registry, and clustering within women and facilities.
Results: Women were more likely to return after a true-negative result (76.9% [95% CI, 75.1% to 78.6%]) than after a false-positive recall for additional imaging only (adjusted absolute difference, −1.9 percentage points [CI, −3.1 to −0.7 percentage points]), short-interval follow-up (−15.9 percentage points [CI, −19.7 to −12.0 percentage points]), or biopsy (−10.0 percentage points [CI, −14.2 to −5.9 percentage points]). Asian and Hispanic/Latinx women had the largest decreases in the probability of returning after a false positive with a recommendation for short-interval follow-up (−20 to −25 percentage points) or biopsy (−13 to −14 percentage points) versus a true negative. Among women with 2 screening mammograms within 5 years, a false-positive result on the second was associated with a decreased probability of returning for a third regardless of the first screening result.
Limitation: Women could receive care at non-BCSC facilities.
Conclusion: Women were less likely to return to screening after false-positive mammography results, especially with recommendations for short-interval follow-up or biopsy, raising concerns about continued participation in routine screening among these women at increased breast cancer risk.
Primary Funding Source: National Cancer Institute.
Annals of Internal Medicine , résumé, 2023