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False-Positive Screening Mammograms: Effect of Immediate versus Later Work-up on Patient Stress¹

¹ From the School of Medicine, Department of Radiology (K.K.L.) and the Department of Human and Community Development (J.O., R.A.P.), University of California, Davis, 4860 Y St, Ste 3100, Sacramento, CA 95817. Received January 14, 2000; revision requested February 28; final revision received June 7; accepted July 14. Supported in part by the Breast Cancer Fund of the State of California through the Breast Cancer Research Program of the University of California (grant 1KB-0134). Address correspondence to K.K.L. (e-mail: kklindfors@ucdavis.edu).

PURPOSE: To compare the stress experienced by women who had false-positive screening mammograms and had undergone immediate on-site diagnostic imaging evaluation with that experienced by those who had been recalled for subsequent imaging.

MATERIALS AND METHODS: A retrospective survey was mailed to women with false-positive screening mammograms that had proved negative or benign at diagnostic imaging. The women were divided into (a) those who had undergone diagnostic imaging during the same appointment as their screening examination and (b) those who had returned at a later date for work-up. The survey included questions about stress that was related to the screening and diagnostic experiences, how subjects had been notified about screening results, and their breast health histories.

RESULTS: From the group that had undergone immediate work-up (n = 100), 50 eligible surveys were received; 71 were received from women who had undergone later work-ups (n = 176). The self-reported overall stress was significantly greater (P = .027) in the group recalled for subsequent diagnostic imaging. Among all respondents, stress from a false-positive screening result was greatest in women younger than 50 years of age with a positive first-degree family history of breast cancer.

CONCLUSION: Providing immediate on-site diagnostic evaluation can reduce the stress of a false-positive screening mammogram.

Index terms: Breast • Breast neoplasms, diagnosis, 00.30 • Breast radiography, 00.11

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