Programme no. 234-OP
Impact of diagnostic invasiveness on the psychosocial consequences of false-positive mammography: cohort study
Bruno Heleno*1, John Brodersen2, Volkert Siersma3
1Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark, 2Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark, 3Research Unit for General Practice and Section of General Practice, Department of Public Health,University of Copenhagen,Copenhagen,Denmark
* = Presenting author
Objectives: To assess whether women with false-positive mammography managed with work-up that involved a biopsy (invasive group) had worse psychosocial consequences than women managed only with additional imaging (non-invasive group).
Background: The psychological consequences of false-positive mammography are among the important harms of mammography screening. It is possible that increasingly invasive diagnostic procedures after a positive mammography lead to worse psychosocial consequences. However, there is little direct evidence supporting this claim. Of the studies that looked into psychosocial consequences of mammography screening, few stratified the analysis by type of diagnostic testing and their results seem conflicting.
Results: There were 272 women with false-positive mammography in the cohort. The psychosocial consequences of women managed invasively and non-invasively were similar during the 36 months of follow-up. In 60 comparisons (12 scales and 5 time-points) the differences between the groups were never statistically significant (P<0.01) and the point estimates for the differences were always close to zero.
Material/Methods: Subgroup analysis of a cohort study of 454 women with abnormal screening mammography and 908 matched controls with normal results. Using a condition-specific questionnaire (Consequences of Screening in Breast Cancer), we assessed 12 psychosocial outcomes at 5 time points (0, 1, 6, 18 and 36 months after final diagnosis) and compared two groups of women with false-positives (non-invasive and invasive groups).
Conclusion: There was no evidence that increased invasiveness of diagnostics was associated with worse psychosocial consequences.
Points for discussion: It is reasonable to pool subgroups of women with false-positive in a single analysis. The invasiveness of subsequent diagnostic procedures does not help to identify women at higher risk of adverse psychosocial consequences of false-positive mammography.