Study: Harms of false-positives in mammography may be exaggerated

False-positive stereotactic vacuum-assisted breast biopsies (SVABs) may not negatively affect subsequent mammographic screenings, according to a recent study published in the Journal of the American College of Radiology (JACR). The harms of false-positives, according to reserachers from the Center for Biomedical Imaging at New York University School of Medicine, may be exaggerated.   

Between 2012 and 2014, researchers conducted a retrospective review of women who had SVABs, which included examining the age, clinical history, biopsy pathology and first post biopsy mammogram, according to study methods. In total, 395 SVABs with benign results were performed during the two-year period. A control group included 45,126 women who had a BI-RADS 1 or 2 mammogram and did not undergo a breast biopsy, researchers wrote. According to the study results, researchers concluded the following:  

• 191 of 395 (48.4 percent) women with benign biopsy results and 22,668 of 45,126 (50.2 percent) women who did not undergo a biopsy returned for an annual follow-up between nine and 18 months after their initial mammogram.

• 57 of the 395 (14.4 percent) women with benign biopsies and 3,336 of 45,126 (7.4 percent) of women who did not undergo a biopsy returned for annual follow-up exams more than 18 months after their initial mammogram.

• Older women (50 years or older), those with a personal history of breast cancer and women with post biopsy complications after having a benign SVAB were more likely to return for a follow-up screening.  

"Both mammographic recalls and image-guided breast biopsies, even when negative, are a necessary and useful element in the characterization of breast lesions identified on a mammogram," wrote lead author Alana Lewin, MD, a radiologist at New York University's School of Medicine, and colleagues. "Maintaining adherence to screening protocols after image-guided benign breast biopsy is vital to the identification of cancers that may arise in subsequent years."  

Because researchers found no major difference in both sets of patients, a false-positive biopsy—despite its emotional consequences on the patient—did not deter women from undergoing follow-up mammograms.  

"Our findings suggest that SVABs with benign results do not negatively impact screening mammography adherence," the authors wrote. "As demonstrated by our study, the previously purported 'harms' of false-positive mammography may be exaggerated."