Effect of false-positive mammograms on return for subsequent screening mammography

Pinckney, Richard G; Geller, Berta M; Burman, Marcia; Littenberg, Benjamin

doi:10.1016/S0002-9343(02)01438-9

« Previous Next »The American Journal of Medicine
Volume 114, Issue 2 , Pages 120-125, 1 February 2003

Effect of false-positive mammograms on return for subsequent screening mammography

Richard G Pinckney, MD, MPH
- Division of General Internal Medicine (RGP, BL), University of Vermont College of Medicine, Burlington, Vermont, USA
- Requests for reprints should be addressed to Richard G. Pinckney, MD, MPH, Division of General Internal Medicine, University of Vermont College of Medicine, Arnold 3, 1 South Prospect Street, Burlington, Vermont 05401, USA
Berta M Geller, EdD
- Office of Health Promotion Research (BMG), University of Vermont, Burlington, Vermont, USA
Marcia Burman, MD
- Deceased. Formerly with the Department of Medicine, University of Washington, Seattle, Washington. This research was supported in part by the National Cancer Institute cooperative agreement U01-CA70013.
Benjamin Littenberg, MD
- Division of General Internal Medicine (RGP, BL), University of Vermont College of Medicine, Burlington, Vermont, USA

Received 22 December 2000; received in revised form 30 May 2002; accepted 16 August 2002.

Abstract

Purpose

There has been concern that false-positive mammograms may deter women from future screening mammograms. We sought to determine whether false-positive mammograms affected follow-up for rescreening.

Methods

We studied a cohort of 41,844 women in the Vermont Mammography Registry. We measured the proportion of women returning for the next screening mammogram for 30 months following an initial screening mammogram, and compared rates of follow-up screening at 18 and 30 months in women with false-positive and true-negative initial mammograms. We adjusted for potential confounders using multivariable logistic regression models.

Results

Of the 2469 women aged 50 years or older with false-positive mammograms, 67.2% (n = 1660) returned at 18 months for rescreening, compared with 63.9% (16,948/26,521) of the women with true-negative mammograms (P = 0.001). Similarly, 86.8% (2143/2469) of the women with false-positive mammograms returned at 30 months for rescreening, compared with 84.7% (22,466/26,521) of the women with true-negative mammograms (P = 0.005). After adjusting for age, use of hormone replacement therapy, prior mammography, prior false-positive mammography, and education, women with false-positive mammograms were more likely to return at 18 months (odds ratio [OR] = 1.40; 95% confidence interval [CI]: 1.30 to 1.51) and at 30 months (OR = 1.30; 95% CI: 1.18 to 1.44).

Conclusion

Despite previous concerns, false-positive screening mammograms did not discourage women from returning for subsequent screening mammography. However, other deleterious effects of false-positive results still warrant improvements in the accuracy of breast cancer screening.

Keywords: False-positive reactions, Mammography, Screening, Breast cancer