Factors associated with false-positive mammography at first screen in an Asian population

Abstract

IntroductionFalse-positive recall is an issue in national screening programmes. The aim of this study is to investigate the recall rate at first screen and to identify potential predictors of false-positive recall in a multi-ethnic Asian population-based breast cancer screening programme.MethodsWomen aged 50–64 years attending screening mammography for the first time (n = 25,318) were included in this study. The associations between potential predictors (sociodemographic, lifestyle and reproductive) and false-positive recall were evaluated using multivariable logistic regression models.ResultsThe recall rate was 7.6% (n = 1,923), of which with 93.8% were false-positive. Factors independently associated with higher false-positive recall included Indian ethnicity (odds ratio [95% confidence interval]: 1.52 [1.25 to 1.84]), premenopause (1.23 [1.04 to 1.44]), nulliparity (1.85 [1.57 to 2.17]), recent breast symptoms (1.72 [1.31 to 2.23]) and history of breast lump excision (1.87 [1.53 to 2.26]). Factors associated with lower risk of false-positive recall included older age at screen (0.84 [0.73 to 0.97]) and use of oral contraceptives (0.87 [0.78 to 0.97]). After further adjustment of percent mammographic density, associations with older age at screening (0.97 [0.84 to 1.11]) and menopausal status (1.12 [0.95 to 1.32]) were attenuated and no longer significant.ConclusionFor every breast cancer identified, 15 women without cancer were subjected to further testing. Efforts to educate Asian women on what it means to be recalled will be useful in reducing unnecessary stress and anxiety.

Cost effectiveness analysis of a polygenic risk tailored breast cancer screening programme in Singapore

“…While national mammography screening programmes have been widely implemented and shown to be cost effective in countries including the US [ 6 ], Australia [ 7 ], and South Korea [ 8 ], their respective guidelines for screening still vary. The current strategy in Singapore has its limitations, such as poor attendance, with only 66% of women aged 50 to 69 ever getting a mammogram in 2018; as well as high false positive rates and missed cases [ 9 , 10 ].…”

High-Throughput Proteomic Profiling of Nipple Aspirate Fluid from Breast Cancer Patients Compared with Non-Cancer Controls: A Step Closer to Clinical Feasibility

“…Ultimately a solid tissue biopsy is taken for histopathology to provide a definitive diagnosis, of which a recent study showed 93.8% of cases proved benign. This means that for a single breast cancer case identified by mammography, 15 women without cancer were subjected to unnecessary invasive procedures [ 6 ]. Moreover, as an independent diagnostic tool for early-stage disease or aggressive malignancies, imaging techniques are generally limited as they have a reduced threshold of detection in dense breasts and are less sensitive to small tumors [ 7 ].…”

Cost Effectiveness Analysis of a Polygenic Risk Tailored Breast Cancer Screening Programme in Singapore

“…The American Cancer Society advises annual mammography screening beginning from the age of 45 [9], while South Korea recommends mammography screening every two years from the age of 40 [10]. The current strategy in Singapore has its limitations, such as poor attendance, with only 66% of women aged 50 to 69 ever getting a mammogram in 2018 [11]. It was observed that half of these women do not come back for regular screening at two-year intervals.…”

“…It was observed that half of these women do not come back for regular screening at two-year intervals. This lukewarm response to mammogram screening may be due to the high potential for false-positive results and unnecessary biopsies [11]. Furthermore, the recommended screening commencement age of 50 may be inadequate as breast cancer can develop before that.…”