Do false-positive stereotactic-guided breast biopsies impact future screening adherence?

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 - Breast screening

False-positive stereotactic vacuum-assisted breast biopsies (SVABs) do not negatively affect a patient’s future screening mammography adherence, according to a new study publishing by the Journal of the American College of Radiology.

The authors reviewed data from more than 900 SVABs performed from 2012 to 2014. Biopsies that resulted in recommended surgical excision were excluded, leaving 395 false-positive SVABs. Screening adherence of those patients was compared with a control group of more than 45,000 women who had a mammogram and did not undergo a biopsy.

Overall, 48.4 percent of patients with false-positive SVABs and 50.2 percent of the control group returned as recommended for annual follow-up. In addition, 14.4 percent of patients with false-positive SVABs and just 7.4 percent of the control group returned for a subsequent mammogram in less than 18 months.

“Stereotactic-guided biopsies lack the speed and efficiency of ultrasound-guided biopsies and may result in relatively decreased patient comfort,” wrote lead author Alana A. Lewin, MD, department of radiology at the New York University School of Medicine in New York City, and colleagues. “In designing our study, we set out to determine whether this specific form of breast biopsy might affect patient screening adherence.”

The authors emphasized that this does not mean false-positive exams have no impact on patients—their impact, in fact, is quite significant. “Breast biopsies with benign results may cause psychological distress to patients,” they wrote. “Surveys have shown that women with false-positive mammograms are more likely to be worried about breast cancer and have exaggerated perceptions of personal breast cancer risk.”

The data also found that “women in older age groups” and women with a personal history of breast cancer were more likely to return for routine screening.

Lewin et al. noted that their study did have limitations. It was retrospective, for instance, and considered data from a single institution. Also, it is possible that some patients counted as nonadherent simply went elsewhere for their next round of screening.