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Increased patient concern after false-positive mammograms

Clinician documentation and subsequent ambulatory visits

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Abstract

OBJECTIVE: To measure how often a breast-related concern was documented in medical records after screening mammography according to the mammogram result (normal, or truenegative vs false-positive) and to measure changes in health care utilization in the year after the mammogram.

DESIGN: Cohort study.

SETTING: Large health maintenance organization in New England.

PATIENTS: Group of 496 women with false-positive screening mammograms and a comparison group of 496 women with normal screening mammograms, matched for location and year of mammogram.

MEASUREMENTS AND MAIN RESULTS: 1) Documentation in clinicians’ notes of patient concern about the breast and 2) ambulatory health care utilization, both breast-related and non-breast-related, in the year after the mammogram. Fifty (10%) of 496 women with false-positive mammograms had documentation of breast-related concern during the 12 months after the mammogram, compared to 1 (0.2%) woman with a normal mammogram (P=.001). Documented concern increased with the intensity of recommended follow-up (P=.009). Subsequent ambulatory visits, not related to the screening mammogram, increased in the year after the mammogram among women with false-positive mammograms, both in terms of breast-related visits (incidence ratio, 3.07; 95% confidence interval [CI], 1.69 to 5.93) and non-breast-related visits (incidence ratio, 1.14; 95% CI, 1.03 to 1.25).

CONCLUSIONS: Clinicians document concern about breast cancer in 10% of women who have false-positive mammograms, and subsequent use of health care services are increased among women with false-positive mammogram results.

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Authors and Affiliations

  1. Received from Harvard Pilgrim Health Care and Harvard Medical School, Boston, Mass

    Mary B. Barton MD, MPP, Sara Moore MPH, Sarah Polk MS, Ernest Shtatland PhD & Suzanne W. Fletcher MD, MSc

  2. the University of Washington School of Medicine, Seattle, Wash

    Joann G. Elmore MD, MPP

Authors
  1. Mary B. Barton MD, MPP
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  2. Sara Moore MPH
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  3. Sarah Polk MS
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  4. Ernest Shtatland PhD
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  5. Joann G. Elmore MD, MPP
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  6. Suzanne W. Fletcher MD, MSc
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Corresponding author

Correspondence to Mary B. Barton MD, MPP.

Additional information

This study was supported by the Thomas O. Pyle fellowship and a project grant from the Harvard Pilgrim Health Care Foundation and by the American Cancer Society. Dr. Elmore was the recipient of a Robert Wood Johnson Generalist Faculty Arward.

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Barton, M.B., Moore, S., Polk, S. et al. Increased patient concern after false-positive mammograms. J GEN INTERN MED 16, 150–156 (2001). https://doi.org/10.1111/j.1525-1497.2001.00329.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2001.00329.x

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