While breast cancer screenings can bring relief to many women who fear they are at risk, these exams can also be a source of anxiety when false positives occur. Many factors can cause an inaccurate report to be produced, but sometimes these errors can be tied to increased risk of breast cancer.
A new study, published in the journal Cancer Epidemiology, showed that false positive reports can be associated with a higher risk of developing malignancies. Dutch researchers, led by My von Euler-Chelpin, Ph.D., of the University of Copenhagen in Denmark, set out to see whether the increased chances of breast cancer were simply a result of misdiagnosis from physicians. Typically, clinical errors by doctors account for a small percentage of the greater risk, FierceMedicalImaging explained.
Euler-Chelpin and her team examined roughly 58,000 Danish women who had undergone mammograms between 1991 and 2005. They found that 4,473 exams resulted in false positives. By 2008, 295 of those women had been diagnosed with varying stages of breast cancer.
After re-reading the exams, the researchers discovered that doctors had missed the cancers in 72 cases the first time around. However, upon further review they found that women with false positives were still 27 percent more likely to be diagnosed with breast cancer later than women with negative test results. The risk was slightly higher in patients who had surgical biopsies that yielded negative findings.
While there is a clear association between false positive screenings and the future development of breast cancer, Euler-Chelpin and her colleagues could not determine a direct cause of the increased risk. However, she believed that this discrepancy underscores the importance of individualized screening programs for women.
Cutting down on false positives
Radiologist performance will always be questioned, despite the advancements in medical imaging. But their clinical capabilities improve when using digital breast tomosynthesis in combination with 2D full-field mammography for screenings, AuntMinnie.com reported.
According to a study published in Academic Radiology, the utilization of both technologies results in lower recall and higher cancer detection rates for radiologists. Led by Stephen Rose, M.D., of the TOPS Comprehensive Breast Center in Houston, researchers reviewed 10,878 exams that were conducted between May 2011 and January 2012 with the dual modalities. They analyzed the recall and detection rates of seven radiologists who performed retrospective readings with full-field mammography, and compared the results to the rates of 10 other radiologists who used full-field plus tomosynthesis in exams.
Out of the 10,878 cases that used combined digital imaging, 5.4 percent were recalled for additional exams. By comparison, the retrospective tests that only used mammography had 888 recalls, an 8.2 percent recall rate. The overall cancer detection rates were 5.4 per 1,000 for the dual modalities and 3.5 per 1,000 for mammography only. In addition, the combination of full-field mammograms and digital breast tomosynthesis found more invasive cancers than mammography alone, at 48 to 29.
"The recall rate for all screened women undergoing FFDM only during this period and interpreted by any radiologist in our practice was 7 percent," said Rose, quoted by AuntMinnie.com.
Rose and his colleagues concluded that adding DBT to 2D mammograms served as an effective measure to improving the accuracy of diagnostic radiology. By reducing instances of false positives and increasing detection rates, radiologists can ensure that patients receive the correct diagnosis to begin treatments for early stage cancers. The study from Rose highlights the significant positive impact that DBT can have on the performance of both radiologists and breast cancer screening programs.
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Ronny Bachrach
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