Womens Health

Risk of False Alarm for Breast Cancer

Frederick R. Jelovsek

If you are a woman who gets a mammogram on a fairly regular basis, what is the chance that you will have a distressing false alarm? In other words, what is the chance that you will get a notice or call from your doctor asking you to have some more studies because the mammogram or the breast exam was not entirely normal?

In a recent study, Elmore JG et al: Ten-year risk of false positive screening mammograms and clinical breast examinations. N Engl J Med 1998; 338:1089-96., the investigators studied 2400 women ages 40-69 who had a total of 9762 screening mammograms and 10905 screening breast clinical physical exams over a 10 year period. This averaged 4 mammograms and 5 clinical breast exams during the study time.

Of the women screened, one third had abnormal testing results that required further evaluation.

Breast Cancer Detection

Study False Positive Rate
Over 10 years
Mammogram 23.8%
Breast exam 13.4%
Either 31.7%
After 10 exams*
Mammogram 49.1%
Breast exam 22.3%
* - Estimated by the authors

Not all of the suspicious studies lead to breast biopsy, however. The authors did estimate that in women who will not develop breast cancer, 18.6% will undergo biopsy by the time they have had 10 mammograms and 6.2% will undergo breast biopsy by the time they have had 10 breast exams over the age of 40.

Women need to be aware that there is this high of a rate of false alarms. Unfortunately using present technology this is a price we must pay to pick up breast cancers early. Physicians and scientists must continue working to lower these instances of false alarms.

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