Psychological consequences of false-positive screening mammograms in the UK

Evid Based Med. 2013 Apr;18(2):54-61. doi: 10.1136/eb-2012-100608. Epub 2012 Aug 2.

Abstract

Objectives: To identify the psychological effects of false-positive screening mammograms in the UK.

Methods: Systematic review of all controlled studies and qualitative studies of women with a false-positive screening mammogram. The control group participants had normal mammograms. All psychological outcomes including returning for routine screening were permitted. All studies had a narrative synthesis.

Results: The searches returned seven includable studies (7/4423). Heterogeneity was such that meta-analysis was not possible. Studies using disease-specific measures found that, compared to normal results, there could be enduring psychological distress that lasted up to 3 years; the level of distress was related to the degree of invasiveness of the assessment. At 3 years the relative risks were, further mammography, 1.28 (95% CI 0.82 to 2.00), fine needle aspiration 1.80 (95% CI 1.17 to 2.77), biopsy 2.07 (95% CI 1.22 to 3.52) and early recall 1.82 (95% CI 1.22 to 2.72). Studies that used generic measures of anxiety and depression found no such impact up to 3 months after screening. Evidence suggests that women with false-positive mammograms have an increased likelihood of failing to reattend for routine screening, relative risk 0.97 (95% CI 0.96 to 0.98) compared with women with normal mammograms.

Conclusions: Having a false-positive screening mammogram can cause breast cancer-specific distress for up to 3 years. The degree of distress is related to the invasiveness of the assessment. Women with false-positive mammograms are less likely to return for routine assessment than those with normal ones.

Publication types

  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Biopsy / adverse effects
  • Biopsy / psychology
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / psychology
  • False Positive Reactions
  • Female
  • Humans
  • Mammography / adverse effects
  • Mammography / psychology*
  • Middle Aged
  • Stress, Psychological / etiology
  • United Kingdom