Effect of abnormal screening mammogram on quality of life

Steeg, Alida F. W. van der; Keyzer-Dekker, Claudia M. G.; Vries, Jolanda De; Roukema, Jan A.

doi:10.1002/bjs.7371

Cited by 56 publications

(56 citation statements)

References 23 publications

(28 reference statements)

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“…Ancelle-Park, R (F) 1 , Armaroli P (I) 2 , Ascunce N (E) 3 , Bisanti, L (I) 4 , Bellisario C (I) 2 , Broeders M (NL) 5 , Cogo C (I) 6 , De Koning H (NL) 7 , Duffy S W (UK) 8 , Frigerio A (I) 2 , Giordano L (I) 2 , Hofvind S (N) 9 , Jonsson H (S) 10 , Lynge E (DK) 11 , Massat N (UK) 8 , Miccinesi G (I) 12 , Moss S (UK) 8 , Naldoni C (I) 13 , Njor S (DK) 11 , Nyströ m L (S) 14 , Paap E (NL) 5 , Paci E (I) 12 , Patnick J (UK) 15 , Ponti A (I) 2 , Puliti D (I) 12 , Segnan N (I) 2 , Von Karsa L (D) 16 , Tö rnberg S (S) 17 , Zappa M (I) 12 , Zorzi M (I) …”

Section: Euroscreen Working Groupmentioning

confidence: 99%

False-Positive Results in Mammographic Screening for Breast Cancer in Europe: A Literature Review and Survey of Service Screening Programmes

Hofvind

Ponti

Patnick³

et al. 2012

J Med Screen

118

100

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Objective To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment. Methods A literature review was conducted to identify studies of the cumulative risk of a false-positive result in European screening programmes (390,000 women). We then examined aggregate data, cross-sectional information about further assessment procedures among women with positive results in 20 mammographic screening programmes from 17 countries (1.7 million initial screens, 5.9 million subsequent screens), collected by the European Network for Information on Cancer project (EUNICE). Results The estimated cumulative risk of a false-positive screening result in women aged 50-69 undergoing 10 biennial screening tests varied from 8% to 21% in the three studies examined (pooled estimate 19.7%). The cumulative risk of an invasive procedure with benign outcome ranged from 1.8% to 6.3% (pooled estimate 2.9%). The risk of undergoing surgical intervention with benign outcome was 0.9% (one study only). From the EUNICE project, the proportions of all screening examinations in the programmes resulting in needle biopsy were 2.2% and 1.1% for initial and subsequent screens, respectively, though the rates differed between countries; the corresponding rates of surgical interventions among women without breast cancer were 0.19% and 0.07%. Conclusion The specific investigative procedures following a recall should be considered when examining the cumulative risk of a false-positive screening result. Most women with a positive screening test undergo a non-invasive assessment procedure. Only a small proportion of recalled women undergo needle biopsy, and even fewer undergo surgical intervention.

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Section: Euroscreen Working Groupmentioning

confidence: 99%

False-Positive Results in Mammographic Screening for Breast Cancer in Europe: A Literature Review and Survey of Service Screening Programmes

Hofvind

Ponti

Patnick³

et al. 2012

J Med Screen

118

100

View full text Add to dashboard Cite

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“…The NHS BSP also aims to minimise the number of open biopsies that prove to be entirely benign in order to contain the costs of the programme and to limit patient anxiety associated with false positive results. 3 A core biopsy graded as B3 (lesion of uncertain malignant potential)4 for screen detected lesions can prove difficult to manage. Options for further management include repeat core biopsy and diagnostic open (surgical) biopsy.…”

mentioning

confidence: 99%

Lesions of uncertain malignant potential (B3) on core biopsy in the NHS Breast Screening Programme: is the screening round relevant?

Hunt

Steel

Porter

et al. 2012

annals

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INTRODUCTION Most women who have screening mammography and undergo subsequent open biopsy following an indeterminate core biopsy result are eventually found to have benign disease. However, a significant number have malignant disease and the rate of malignancy in such cases may be influenced by various factors. This study examined the effect of the type of screening round (prevalent or incident) on the likelihood of breast cancer being present. METHODS A total of 199 women who had NHS breast screening mammograms and subsequent indeterminate (B3) core biopsy results followed by excision biopsy over an 11-year period in a single breast screening unit were reviewed. RESULTS The rate of malignancy following excision of a lesion graded as B3 on core biopsy was 21% for women in the prevalent screening round compared to 33% in subsequent rounds (Fisher's exact test, p=0.038). CONCLUSIONS The incidence of malignancy associated with a B3 core biopsy result appears to be related to the screening round in which the lesion is detected, being approximately 50% higher in the subsequent incident rounds compared to the initial prevalent round. This finding may be useful in formulating management plans for women who have an indeterminate biopsy result.

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“…15,16 Higher recall and false positive rates also increase anxiety among referred women and increase workup costs. 26 Several authors have focused on the issue of increasing medical malpractice claims regarding mammography in the United States. 10,11 One explanation for the high number of claims seems to be the public's high expectations of mammography performance.…”

Section: Discussionmentioning

confidence: 99%

Malpractice claims following screening mammography in The Netherlands

Smallenburg

Setz-Pels

Groenewoud

et al. 2012

Intl Journal of Cancer

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Although malpractice lawsuits are frequently related to a delayed breast cancer diagnosis in symptomatic patients, information on claims at European screening mammography programs is lacking. We determined the type and frequency of malpractice claims at a Dutch breast cancer screening region. We included all 85,274 women (351,009 screens) who underwent biennial screening mammography at a southern breast screening region in The Netherlands between 1997 and 2009. Two screening radiologists reviewed the screening mammograms of all screen detected cancers and interval cancers and determined whether the cancer had been missed at the previous screen or at the latest screen, respectively. We analyzed all correspondence between the screening organization, clinicians and screened women, and collected complaints and claims until September 2011. At review, 20.9% (308/1,475) of screen detected cancers and 24.3% (163/670) of interval cancers were considered to be missed at a previous screen. A total of 19 women (of which 2, 6 and 11 women had been screened between 1997 and 2001 (102,439 screens), 2001 and 2005 (114,740 screens) and 2005 and 2009 (133,830 screens), respectively) had contacted the screening organization for additional information about their screen detected cancer or interval cancer, but filed no claim. Three other women directly initiated an insurance claim for financial compensation of their interval cancer without previously having contacted the screening organization. We conclude that screening-related claims were rarely encountered, although many screen detected cancers and interval cancers had been missed at a previous screen. A small but increasing proportion of women sought additional information about their breast cancer from the screening organization.Many countries have introduced screening mammography programs with the aim to reduce breast cancer mortality. 1 Essential for reducing morbidity and mortality is the early detection of breast cancers, as a diagnostic delay lowers breast-conserving treatment options and worsens prognosis. 2,3 Unfortunately, a delayed diagnosis resulting from a missed cancer at screening is not rare. Certain cancers are just not visible at screening mammography, whereas others are misinterpreted or overlooked. 4,5 Interpretation of mammograms is one of the most difficult tasks in radiology and the sensitivity of screening mammography for breast cancer detection ranges from 70% to 80%. 6,7 Nevertheless, the public's expectations of the efficacy of screening mammography are high, and diagnostic errors can have major legal consequences for the screening radiologist.An Italian study observed, over a period of 12 years, a marked rise in malpractice claims related to diagnostic mammography in symptomatic women. 8 In the United States, a delay in breast cancer diagnosis is nowadays the most prevalent and the second most expensive condition resulting in malpractice lawsuits. 9,10 The most common defendant in these lawsuits is the interpreting radiologist and as a consequence the ...

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Effect of abnormal screening mammogram on quality of life

Abstract: Women with a false-positive diagnosis of screen-detected breast cancer had a low QoL and feelings of anxiety, especially when they scored high on trait anxiety. This effect lasted for at least 1 year.

Cited by 56 publications

References 23 publications

False-Positive Results in Mammographic Screening for Breast Cancer in Europe: A Literature Review and Survey of Service Screening Programmes

False-Positive Results in Mammographic Screening for Breast Cancer in Europe: A Literature Review and Survey of Service Screening Programmes

Lesions of uncertain malignant potential (B3) on core biopsy in the NHS Breast Screening Programme: is the screening round relevant?

Malpractice claims following screening mammography in The Netherlands

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