When a mammogram shows an abnormal area that looks like a cancer but turns out to be normal, it’s called a false positive. Ultimately the news is good: no breast cancer. But the suspicious area usually requires follow-up with more than one doctor, extra tests, and extra procedures, including a possible biopsy. There are psychological, physical, and economic costs that come with a false positive.
When the American Cancer Society released updated breast cancer screening guidelines in October 2015, the anxiety caused by false positives was part of the reason the group recommended that women at average risk start regular annual screening at age 45 (instead of 40) and move to screening every 2 years at age 55.
A small study has found that people who attended an educational session about mammograms taught by a specially trained radiologist had less anxiety and more knowledge about mammograms.
The study was published online on Oct. 18, 2015 by the Journal of the American College of Radiology. Read the abstract of “Direct Interactive Public Education by Breast Radiologists About Screening Mammography: Impact on Anxiety and Empowerment.”
The researchers developed a 1-hour educational program on mammograms that included a presentation by a radiologist and a question-and-answer session. The researchers presented the program seven times as a lunch-and-learn session to a diverse group of organizations in the New York City area, including business, religious, and community groups. A total of 117 people attended the programs.
Before the mammogram educational program began, the researchers had each attendee fill out a survey that asked why people were anxious about mammograms:
- 56% were worried about unknown results
- 22% were concerned that the mammogram would be painful
- 15% were worried about how known risk factors might affect the likelihood of being diagnosed with breast cancer
- 13% were concerned about the general uncertainty of mammograms
- 9% were anxious about waiting for results
- 4% were worried about the possibility of more procedures
After the mammogram educational program, the researchers again had the attendees fill out a survey. This time the survey asked about why breast cancer screening is necessary, the differences between the need for more testing and a cancer diagnosis, the continued importance of physical exams, as well as anxiety levels. The results of these surveys showed that people who attended the educational program had a better understanding of why mammograms are useful, were more likely to get a mammogram, and were less anxious about the procedure.
"Our intention was to teach women what to expect from having a mammogram done and what to expect if you are called back for further testing,” said Lara Hardesty, M.D., of the University of Colorado Cancer Center and one of the paper’s authors. "This happens to 10% of women, and we wanted them to know that a positive screening mammogram doesn't mean you definitely have cancer."
"There is a major difference between the concepts of over-diagnosing and over-treating breast cancer," Hardesty continued. In her opinion, it remains essential to screen aggressively for breast cancer in hopes of catching the disease in an early, treatable stage.
At Breastcancer.org, we believe that if you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.
The Mayo Clinic, the American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, the National Cancer Institute, and the National Comprehensive Cancer Network all recommend that screening mammograms should start at age 40.
There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of your regular screening mammograms.
- If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
- If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
- If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.
- If you’re concerned about unknown results or being called back for more testing, talk to your doctor about what happens when mammogram results are unclear, as well as what to expect if you’re called back for more testing.
For more information on mammograms and other tests to detect and diagnose breast cancer, visit the Breastcancer.org Screening and Testing section.