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Radiology. 2016 Aug;280(2):379-86. doi: 10.1148/radiol.2016151174. Epub 2016 Feb 15.

Risk of Breast Cancer in Women with False-Positive Results according to Mammographic Features.

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From the Departments of Epidemiology and Evaluation (X.C., I.T., M.P., L.D., M. Sala), Obstetrics and Gynecology (M.V.), and Image Diagnostics (A.R.), IMIM (Hospital del Mar Medical Research Institute), Pg. Marítim 25-29, 08003 Barcelona, Catalonia, Spain; Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain (X.C., I.T. L.D., M.B., M. Sala); Cancer Registry of Norway, Oslo, Norway (M.R.); Cancer Prevention and Monitoring Program, Catalan Institute of Oncology, Barcelona, Catalonia, Spain (C.V.); Clinical Epidemiology and Cancer Screening, Parc Taulí University Hospital, Sabadell, Catalonia, Spain (M.B.); Radiology Department, Hospital de Santa Caterina, Girona, Catalonia, Spain (J.F.); Epidemiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain (M.J.Q.); Direction General of Public Health, Department of Health, Government of Cantabria, Santander, Cantabria, Spain (M. Sánchez); Principality of Asturias Breast Cancer Screening Program, Principality of Asturias, Oviedo, Spain (C.N.); Catalan Cancer Plan, Department of Health, Catalonia, Spain (J.A.E.); Spanish Cancer Research Network (RTICC), Carlos III Health Institute, Madrid, Spain (J.A.E.); and Breast Cancer Screening Program of Tarragona, The Foundation League for the Research and Prevention of Cancer, Tarragona, Catalonia, Spain (F.S.).


Purpose To assess the risk of breast cancer in women with false-positive screening results according to radiologic classification of mammographic features. Materials and Methods Review board approval was obtained, with waiver of informed consent. This retrospective cohort study included 521 200 women aged 50-69 years who underwent screening as part of the Spanish Breast Cancer Screening Program between 1994 and 2010 and who were observed until December 2012. Cox proportional hazards regression analysis was used to estimate the age-adjusted hazard ratio (HR) of breast cancer and the 95% confidence interval (CI) in women with false-positive mammograms as compared with women with negative mammograms. Separate models were adjusted for screen-detected and interval cancers and for screen-film and digital mammography. Time without a breast cancer diagnosis was plotted by using Kaplan-Meier curves. Results When compared with women with negative mammograms, the age-adjusted HR of cancer in women with false-positive results was 1.84 (95% CI: 1.73, 1.95; P < .001). The risk was higher in women who had calcifications, whether they were (HR, 2.73; 95% CI: 2.28, 3.28; P < .001) or were not (HR, 2.24; 95% CI: 2.02, 2.48; P < .001) associated with masses. Women in whom mammographic features showed changes in subsequent false-positive results were those who had the highest risk (HR, 9.13; 95% CI: 8.28, 10.07; P < .001). Conclusion Women with false-positive results had an increased risk of breast cancer, particularly women who had calcifications at mammography. Women who had more than one examination with false-positive findings and in whom the mammographic features changed over time had a highly increased risk of breast cancer. Previous mammographic features might yield useful information for further risk-prediction models and personalized follow-up screening protocols. (©) RSNA, 2016 Online supplemental material is available for this article.

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