Women with certain mammography screens eventually judged to be fake were still during significantly increasing odds for building invasive breast cancer within a successive 10 years, a investigate involving 1.3 million women showed.
The 10-year breast cancer risk was aloft by 39% in women who had false-positive mammograms and additional breast imaging as compared with women who had true-negative mammograms, Louise M. Henderson, PhD, of a University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill, and co-authors reported in a Dec emanate of Cancer Epidemiology, Biomarkers Prevention.
Moreover, a risk boost reached 76% in a branch of women who had breast biopsies after false-positive mammograms, and was eccentric of breast density, a famous risk for breast cancer.
The reasons for a organisation sojourn unclear, though a formula advise that a story of false-positive screening mammography should be incorporated into breast cancer risk-prediction models, a researchers said.
“Now that we have this information, a wish is that we can supplement it into existent risk-prediction models to urge their ability to distinguish between women who will go on to rise breast cancer and those who won’t,” Henderson told MedPage Today.
The regard is not new though a vast studious race and length of follow-up in a new investigate boost a turn of certainty that a organisation is genuine and not a possibility finding, pronounced Richard Wender, MD, arch of cancer control during a American Cancer Society.
“The energy of this investigate to uncover a organisation is really strong, quite when we mix it with a formula of a other studies that have been done,” pronounced Wender. “I consider we can now contend with certainty that women who have had a prior false-positive mammogram are during rather aloft risk for breast cancer.”
In comprehensive terms, a bulk of a increasing risk is small, about 2% during a follow-up duration contra 1% for women who had true-negative mammographic results. “A tiny though genuine increase,” pronounced Wender.
The investigate did not yield an reason for a association, though a “leading hypothesis” is that proliferative changes on mammography might paint an early idea to elaborating breast cancer before sincere cancer exists, he added.
About 16% of initial mammograms and 10% of second and successive mammograms furnish secretly certain results. Women who have annual mammograms have a 61% accumulative probability of during slightest one false-positive outcome for each 10 mammograms. The odds of a false-positive outcome declines to 42% for women who bear mammographic screening ever other year.
Previous studies have yielded opposing information per a risk of breast cancer after a false-positive mammogram, a authors noted. Most of a progressing studies were conducted in Europe, that has reduce reported rates of false-positive mammograms. The only investigate conducted in a U.S. showed an increasing risk of destiny breast cancer in postmenopausal though not premenopausal women.
Increased firmness of breast hankie is compared with an increasing risk of breast cancer and false-positive mammography. Previous studies had not looked during intensity differences in breast cancer risk by breast-tissue firmness after false-positive mammograms, a authors continued.
In an bid to enhance on information performed from prior studies, Henderson and colleagues queried a Breast Cancer Surveillance Consortium to brand women who underwent mammograms from 1994 to 2009. Using information from 7 participating registries, investigators evaluated breast cancer risk after false-positive mammograms, holding into comment opposite recommendations (workup with additional imaging or involving breast biopsy) and breast density.
“We hypothesized that there would be a larger boost in breast cancer risk among women with a story of false-positive biopsy recommendation formula compared with those with a false-positive additional imaging recommendation and that this organisation would be eccentric of breast density,” a authors wrote.
Data research enclosed 1,297,906 women ages 40 to 74 with no family story of breast cancer who underwent a sum of 2,207,942 screening mammograms. The formula showed 159,448 false-positive mammograms and a radiologist recommendation for additional imaging, 22,892 false-positive mammograms and a recommendation for biopsy, and 2,025602 true-negative mammograms.
Women 40 to 49 accounted for a largest suit of false-positive mammograms with additional imaging (34.8%) or biopsy recommendation (33.1%). False-positive mammograms with additional imaging or biopsy also occurred some-more mostly among pre- and perimenopausal women and compared with a organisation who had true-positive formula (38% to 39% contra 30%).
False-positive mammographic commentary were numerically some-more common in women with heterogeneously or intensely unenlightened breasts though not significantly aloft as compared with women who had true-negative formula (54% to 55% contra 45%).
Among women with true-negative mammographic results, 43,105 breast cancers occurred during 11,034,496 person-years of follow-up, translating into a rate of 3.91/1,000 person-years. That compared with a rate of 5.51/1,000 for women who had false-positive mammograms and a recommendation for additional suppose and 7.01/1,000 in a branch who had false-positive formula and a biopsy recommendation. Stratification by breast firmness showed a identical rate pattern, lowest in a true-negative organisation and top in a false-positive with biopsy group.
During a initial year of follow-up, about 20% of women with false-positive and true-negative mammograms had successive screening mammograms. Rates were identical during 3, 4, and 5 years, suggesting that women with false-positive formula were not screened some-more mostly as compared with women who had true-negative results, a authors noted.
An practiced research showed that women with a false-positive mammogram and additional imaging had a jeopardy ratio for breast cancer of 1.39 contra women with true-negative results. False-positive mammography with biopsy was compared with a jeopardy ratio of 1.76 compared with women who had true-negative mammograms. Analyses by breast firmness yielded identical jeopardy ratios for women with heterogeneously or intensely unenlightened breasts.
Even in a deficiency of a transparent reason for a finding, a investigate creates a clever box that “we should accept that a false-positive mammogram is a risk cause for presaging destiny risk of breast cancer,” Wender told MedPage Today.
“In clinical terms, that means women who have a false-positive mammogram need to be quite observant about gripping adult with unchanging mammographic screening. The clinicians caring for these women should have a approach to lane women who have had a false-positive and make certain that each bid is done to keep adult to date with mammography.”
Henderson and co-authors disclosed no applicable relations with industry.
F. Perry Wilson, MD, MSCE Assistant Professor, Section of Nephrology, Yale School of Medicine