False-Positive Mammogram Linked to Higher Risk of Breast Cancer, Death

Women who have a false-positive mammogram result may have a higher risk of later developing breast cancer and dying from it, according to a study published in JAMA Oncology.

Researchers found a 1.6-fold higher risk of breast cancer and a 1.8-fold higher risk of breast cancer death among women with a false-positive mammogram than among women without a false-positive result.

This population-based study included 45,213 women without breast cancer who had a false-positive mammogram from 1991 to 2017. These women were matched to 452,130 control individuals based on age, calendar year of mammography, and screening history.

The 20-year cumulative incidence of breast cancer was 11.3% among patients with a false-positive mammogram and 7.3% for those without a false-positive result (hazard ratio [HR], 1.61; 95% CI, 1.54-1.68).

The association between a false-positive result and breast cancer risk was significantly higher in:

• Patients who were 60 to 75 years of age (HR, 2.02; 95% CI, 1.80-2.26) than in patients who were 40 to 49 years (HR, 1.38; 95% CI, 1.23-1.56)
• Patients who underwent a biopsy at recall (HR, 1.77; 95% CI, 1.63-1.92) than in those who did not (HR, 1.51; 95% CI, 1.43-1.60)
• Patients with lower breast density (HR, 4.65; 95% CI, 2.61-8.29) than in those with higher breast density (HR, 1.51; 95% CI, 1.43-1.60).

Patients with a false-positive mammogram also had a higher risk of all-cause death (HR, 1.07; 95% CI, 1.04-1.11) and breast cancer-specific death (HR, 1.84; 95% CI, 1.57-2.15) than patients without a false-positive result.

“[T]o our knowledge, this is the first study to show that women with a false-positive result are at increased risk of death from breast cancer,” the researchers wrote. “This increased breast cancer mortality was most probably associated with the increased breast cancer incidence, as the prognosis of patients with breast cancer did not differ based on whether or not they had false-positive results before.”

“We note 3 results of our cohort study with clear clinical implications,” the researchers added. “First, besides having a biopsy, age at a false-positive mammography result and mammographic breast density should be considered in individualizing surveillance programs among women with a false-positive result. Second, close and intensive surveillance within the next 2 screening rounds may be of particular value. Third, long-term awareness of the disease should be promoted among women with a false-positive result to help address the increased risk of breast cancer incidence and mortality among these women.”

Reference

Mao X, He W, Humphreys K, et al. Breast cancer incidence after a false-positive mammography result. JAMA Oncol. Published online November 2, 2023. doi:10.1001/jamaoncol.2023.4519

This article originally appeared on Cancer Therapy Advisor