Increased Risk of Developing Breast Cancer after a False-Positive Screening Mammogram

Abstract

Background: Women with a history of a false-positive mammogram result may be at increased risk of developing subsequent breast cancer.

Methods: Using 1994 to 2009 Breast Cancer Surveillance Consortium data, we included women ages 40 to 74 years with a screening mammogram that resulted in a false-positive with recommendation for additional imaging, false-positive with recommendation for biopsy, or true-negative with no cancer within one year following the examination. We used partly conditional Cox proportional hazards survival models to assess the association between a false-positive mammogram result and subsequent breast cancer, adjusting for potential confounders. Adjusted survival curves stratified by breast density and false-positive result were used to evaluate changes in risk over time.

Results: During 12,022,560 person-years of follow-up, 48,735 cancers were diagnosed. Compared with women with a true-negative examination, women with a false-positive with additional imaging recommendation had increased risk of developing breast cancer [adjusted HR (aHR) = 1.39; 95% confidence interval (CI), 1.35-1.44] as did women with a false-positive with a biopsy recommendation (aHR = 1.76; 95% CI,1.65-1.88). Results stratifying by breast density were similar to overall results except among women with almost entirely fatty breasts in which aHRs were similar for both the false-positive groups. Women with a false-positive result had persistently increased risk of developing breast cancer 10 years after the false-positive examination.

Conclusion/impact: Women with a history of a false-positive screening mammogram or biopsy recommendation were at increased risk of developing breast cancer for at least a decade, suggesting that prior false-positive screening may be useful in risk prediction models.