Are Pricey Computer-Aided Mammograms Worth It?

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Mammograms Every Other Year OK for Women Over 50: Study

Title: Mammograms Every Other Year OK for Women Over 50: Study
Category: Health News
Created: 3/18/2013 4:35:00 PM
Last Editorial Review: 3/19/2013 12:00:00 AM

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False-Positive Mammograms Can Trigger Long-Term Distress

For some, anxiety persisted up to 3 years after being declared cancer-free, study finds

By Kathleen Doheny

HealthDay Reporter

TUESDAY, March 19 (HealthDay News) -- Women who have a false-positive mammogram result -- when breast cancer is first suspected but then dispelled with further testing -- can have lingering anxiety and distress up to three years after the misdiagnosis, a new study finds.

The emotional fallout is probably so long-lasting, "because the abnormal screening result is seen as a threat to your own mortality," said study author Dr. John Brodersen, a researcher at the University of Copenhagen in Denmark.

The report is published in the March-April issue of the Annals of Family Medicine.

False-positive mammograms are often cited by public health experts as a downside to mammography screening that needs to be considered when making recommendations about who should be screened, at what age and how frequently. They aren't uncommon: the risk of a false positive for every 10 rounds of screening ranges from 20 percent to 60 percent in the United States, Brodersen said.

After an abnormal mammogram, doctors typically order additional mammograms and, depending on those results, more tests such as an ultrasound or MRI, and finally a biopsy.

Studies about the short-term and long-term consequences of false-positive mammogram results have produced mixed findings, which Brodersen said spurred him to conduct his study. He evaluated more than 1,300 women, including 454 who had abnormal findings on a screening mammogram and others who received normal results.

Of those 454 who first had abnormal results, 174 later found they had breast cancer. Another 272 learned the result was a false positive. (Eight others were excluded from the study due to unknown conclusions or a diagnosis of cancer other than breast cancer.)

The women answered a questionnaire about their psychological state, such as their sense of calmness, being anxious or not about breast cancer and feeling optimistic or not about the future. They repeated the questionnaire at 1, 6, 18 and 36 months after the final diagnosis.

Six months after the final diagnosis, those with false positives had negative changes in inner calmness and in other measures as great as the women with breast cancer. Even at the three-year mark, women with false-positives had more negative psychological consequences compared with women with normal findings.

The differences among those with normal, false-positive and breast cancer findings only began to fade at the three-year mark, the study found.

Brodersen can't say if women who were more anxious about health or life in general to begin with were more likely to have long-term distress. "I have not investigated this aspect," he said.

Even without this information, the study is a good one, said Matthew Loscalzo, the Liliane Elkins Professor in Supportive Care Programs at the City of Hope Comprehensive Cancer Center in Duarte, Calif.

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False-Positive Mammograms Can Trigger Long-Term Distress

Title: False-Positive Mammograms Can Trigger Long-Term Distress
Category: Health News
Created: 3/19/2013 10:35:00 AM
Last Editorial Review: 3/19/2013 12:00:00 AM

View the original article here

Mammograms Every Other Year OK for Women Over 50: Study

Researchers found similar risk for advanced disease as with yearly screening, but some experts disagree

By Kathleen Doheny

HealthDay Reporter

MONDAY, March 18 (HealthDay News) -- Some women 50 and older may be able to have a mammogram every other year without increasing their risk of developing an advanced breast cancer, according to a large new study on nearly 1 million women.

The findings are published online March 18 in JAMA Internal Medicine.

The study conclusions drew mixed reactions, including criticism for its methods, from other experts. Debate about who should get screened with mammography, and how often, has been ongoing.

In the new research, women aged 50 to 74 who got a screening mammogram every other year had a risk of developing advanced-stage breast cancer that was similar to that of women in the same age range who got the test every year.

The researchers evaluated nearly 12,000 women with breast cancer and more than 922,000 without, said researcher Dr. Karla Kerlikowske, a professor of medicine, epidemiology and biostatistics at the University of California, San Francisco School of Medicine.

The investigators considered whether the women had high breast density and whether they were taking combination hormone therapy with estrogen and progestin, both considered risk factors for breast cancer. Dense breasts have more glandular tissue and less fatty tissue.

"If you undergo [mammography every two years], you are not any more likely to end up with some advanced breast cancer than if you have annual screenings," Kerlikowske said of this group of women.

Screening every two years -- or biennially -- was also associated with a lower risk of having a false-positive result, the researchers found. False-positives -- suspicions of cancer that turn out not to be after more testing -- can cause more expense and distress, experts note.

However, for women aged 40 to 49 who have extremely dense breasts, the researchers found biennial mammograms were linked with nearly a twofold increased risk of advanced-stage cancers and large tumors, and also a high risk of false-positive results.

In 2009, the U.S. Preventive Services Task Force, an independent panel of experts, issued its guidelines that women 50 to 74 at average risk should get a mammogram every two years. Women 40 to 49, the task force said, should talk with their doctor about the risks and benefits of screening.

The task force guidelines are at odds with those of many other organizations, including the American Cancer Society, which recommends annual screening beginning at age 40.

The task force guidelines consider only a woman's age, according to Kerlikowske. Her team decided to study the benefits and harms of screening based not just on age but also on breast density and hormone therapy use.

Women in the study were 40 to 74. Most diagnosed with breast cancer during the years studied, 1994 to 2008, were 50 or older. They typically had dense or very dense breasts.

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For Older Women, Mammograms Every 2 Years Found as Good as Annual Test

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