Psychologic distress in women with abnormal findings in mass mammography screening

Abstract

BACKGROUND This study was conducted to explore the psychologic morbidity of women recalled for diagnostic assessment during population‐based mammographic screening. METHODS This study prospectively attempted to measure physical, social, and emotional well‐being by the administration of a questionnaire before screening, at the time of recall; and 1 month later to women recalled and matched women with those not recalled. RESULTS Of the 224 women who were recalled for further diagnostic assessment and their matches, complete follow‐up was obtained on 182 pairs (81.3%). In contrast to those women not recalled, recalled women exhibited increased levels of concern at the time of recall. These levels had not decreased to the initial level after 1 month, even though breast carcinoma was not diagnosed. Similar negative short term effects also were evident in the areas of physical well‐being, social functioning, and anxiety and insomnia levels, although these were not sustained. CONCLUSIONS Women with normal results after mass mammographic breast screening experienced no increase in psychologic distress and a decrease in their concern regarding breast carcinoma. However, those women who were recalled to follow‐up after abnormal findings experienced an increase in their level of concern regarding breast carcinoma and this concern was sustained, as determined by repeat questionnaire, 1 month after a negative result had been determined. Cancer 1999;85:1114–8. © 1999 American Cancer Society.

Consequences of Screening in Breast Cancer (COS-BC): development of a questionnaire

“…The other part, which has only been used in two studies [8,10], consists of 10 items covering perceived positive aspects.…”

Moderators of Psychological Recovery from Benign Cancer Screening Results

“…This 12-item scale is a valid and reliable tool that was developed specifically for breast cancer screening settings [11][12][13] . A 5-point response scale, ranging from 0 ("not at all") to 4 ("quite a lot of the time"), was used, and the mean score for each subscale was computed.…”

“…Thus, a large number of women are told during diagnostic testing that they do not, in fact, have breast cancer. There is robust evidence showing that, despite alleviation of the immediate threat of cancer, women who receive a benign diagnosis report persistent anxiety and other manifestations of psychological distress particularly intensely during the first 3-4 months after the diagnostic procedure [4][5][6][7][8][9][10][11][12][13] . In fact, recent research has shown that, compared with control subjects, these women report distress up to 8 months after the benign outcome 4 .…”

Estrategias de afrontamiento y malestar emocional en mujeres con resultados dudosos de su mamografía de cribado

“…Probablemente conseguir un resultado normal es en un primer momento tranquilizador, pero si la mamografía es anormal, el diagnóstico puede aumentar la ansiedad (3)(4)(5)(6)(7)(8) especialmente en las mujeres a las que se les practica una biopsia, porque esta prueba se suele asociar con un problema serio de salud (9)(10)(11) . Aunque un resultado falso positivo ,es decir, una mujer que tiene una mamografía con sospecha de malignidad pero en la que luego se descarta clínicamente el diagnóstico de cáncer de mama (12) resulte finalmente un alivio, en ciertas situaciones pueden permanecer la preocupación y una alta percepción de riesgo (13) .…”

“…A este respecto, se ha encontrado, que las mujeres con resultados normales en la mamografía no vieron incrementado su malestar psicológico y disminuyó su preocupación con respecto al cáncer de mama. Sin embargo, aquellas mujeres a las que se les solicitó realizar un seguimiento de sus resultados anormales experimentaron un cierto nivel de preocupación con respecto al cáncer de mama que se mantuvo un mes después de que se confirmara el diagnóstico de benignidad (6) . Por el contrario, varios estudios han demostrado que los efectos emocionalmente negativos son de duración breve o inexistentes: encontrando que la frecuencia de la autoexploración mamaria después del cribado solo provocaba niveles de ansiedad en una pequeña minoría de mujeres a las que se les había practicado una biopsia abierta debido a lesiones benignas.…”