Can a false-positive mammo trigger existential crisis?

Women who experience a false-positive screening mammogram incur long-term psychosocial harms, researchers reported March 18 in Annals of Family Medicine. Three years after a false-positive result, women recounted psychosocial consequences at a range between those with normal results and women with a breast cancer diagnosis. 

The concept of harms from screening mammography has been debated for two decades or longer. However, few studies have addressed or quantified the long-term psychosocial consequences. Existing data are sparse and conflicting.

John Brodersen, PhD, and Volkert Dirk Siersma, PhD, from the department of public health at University of Copenhagen, Denmark, designed a cohort study to measure long-term psychosocial consequences of a false-positive mammogram.

The researchers recruited 454 women with abnormal results, both false positive and true positive. For each woman, they also recruited two additional women with normal results screened on the same day at the same clinic.

All participants were asked to complete the Consequences of Screening in Breast Cancer, a validated questionnaire encompassing 12 psychosocial outcomes at baseline, one, six, 18 and 36 months. The first part of the questionnaire addressed anxiety, sense of dejection, negative impact on behavior, sleep, sexuality and degree of breast self-examination. The second part focused on existential values, impact on relationships within the social network, feeling less or more relaxed/calm and being less or more anxious about breast cancer.

“It is well known that a person’s values and perceptions of life can change as a result of trauma and existential crisis,” wrote Brodersen and Siersma.

Women in the three groups did not differ significantly in terms of social status, employment and whether they lived alone.

At baseline and before diagnosis, on the first part of the survey, women in the abnormal results groups reported greater negative psychosocial consequences than women with normal results. At one month, women with false-postive findings reported statistically greater negative consequences compared with the normal findings cohort but less-negative consequences than women diagnosed with breast cancer.

These trends continued over the three-year duration, according to the researchers. However, the difference in psychosocial outcomes between women with false positives and women with normal results generally mitigated over time.

Results for the second part of the survey mirrored the first. “Women with breast cancer experienced greater negative changes than women with false positives, who again experienced greater negative changes than women with normal findings.

“False-postive screening mammography causes long-term psychosocial harm,” concluded Brodersen and Siersma.