Breast cancer detection risk in screening mammography after a false-positive result

  1. Castells, X. 1
  2. Román, M. 1
  3. Romero, A. 1
  4. Blanch, J. 1
  5. Zubizarreta, R. 2
  6. Ascunce, N. 3
  7. Salas, D. 45
  8. Burón, A. 1
  9. Sala, M. 1
  1. 1 Mar Teaching Hosp, Dept Epidemiol & Evaluat, Inst Municipal Invest Med Parc Salut Mar, Barcelona 08003, Spain
  2. 2 Hlth Off, Publ Hlth & Planning Directorate, Galician Breast Canc Screening Program, Santiago De Compostela 15703, Galicia, Spain
  3. 3 Inst Salud Publ, Navarra Breast Canc Screening Program, Pamplona 31003, Spain
  4. 4 Gen Directorate Publ Hlth, Valencia, Spain
  5. 5 Ctr Publ Hlth Res CSISP, Valencia, Spain
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Revista:
Cancer Epidemiology

ISSN: 1877-7821

Año de publicación: 2013

Volumen: 37

Número: 1

Páginas: 85-90

Tipo: Artículo

DOI: 10.1016/J.CANEP.2012.10.004 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Cancer Epidemiology

Resumen

Background: False-positives are a major concern in breast cancer screening. However, false-positives have been little evaluated as a prognostic factor for cancer detection. Our aim was to evaluate the association of false-positive results with the cancer detection risk in subsequent screening participations over a 17-year period. Methods: This is a retrospective cohort study of 762,506 women aged 45-69 years, with at least two screening participations, who underwent 2,594,146 screening mammograms from 1990 to 2006. Multilevel discrete-time hazard models were used to estimate the adjusted odds ratios (OR) of breast cancer detection in subsequent screening participations in women with false-positive results. Results: False-positives involving a fine-needle aspiration cytology or a biopsy had a higher cancer detection risk than those involving additional imaging procedures alone (OR = 2.69; 95% CI: 2.28-3.16 and OR = 1.81; 95% CI: 1.70-1.94, respectively). The risk of cancer detection increased substantially if women with cytology or biopsy had a familial history of breast cancer (OR = 4.64; 95% CI: 3.23-6.66). Other factors associated with an increased cancer detection risk were age 65-69 years (OR = 1.84; 95% CI: 1.67-2.03), non-attendance at the previous screening invitation (OR = 1.26; 95% CI: 1.11-1.43), and having undergone a previous benign biopsy outside the screening program (OR = 1.24; 95% CI: 1.13-1.35). Conclusion: Women with a false-positive test have an increased risk of cancer detection in subsequent screening participations, especially those with a false-positive result involving cytology or biopsy. Understanding the factors behind this association could provide valuable information to increase the effectiveness of breast cancer screening. (C) 2012 Elsevier Ltd. All rights reserved.

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