7 to 9 percent of those who have false negative also have biopsy, new study shows
Article Source: msnbc.com
from:msnbc.com1 in 2 will have false alarm from yearly mammogram
Seeded on Mon Oct 17, 2011 6:12 PM EDT (msnbc.com)
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Been there with the wife. Very frustrating and scary for nothing. Somebody made a bunch of money.
Do enough mamograms and the radiation from them will give you cancer.
I hope you don't fly. You are exposure to more radiation on a single flight than a bunch of mammograms. Your comments are way out of line. I hope you haven't scared anyone out of a potentially life saving mammogram. Mammograms saved my life!
Not directly to your boobs!
In this case "false alarm" means you get called back for more testing. A mammogram is a screening tool. It does not make the diagnosis of cancer, a biopsy does that. If only 7% to 9% of biopsies are negative that is not necessarily a bad thing although it is more than just an inconvenience. If 100% of biopsies were positive it would very likely mean that some early cancers were not being biopsied. The problem I have with a lot of mammography clinics is the fact that they will tell the patient to return later for more studies even if the patient is still in the clinic. Also, the patient is frequently not told enough about what the problem might be. This causes undue stress and anxiety that could be alleviated in just a few minutes most of the time.
I don't think the article was saying that 7% to 9% of biopsies were negative, I think the article is saying that 7% to 9% of women have negative biopsies in a 10 year period. Having just gone through this process myself (including the biopsy that was negative, thank goodness), any resentment I feel over "unnecessarily" going through the anxiety and procedure itself is vastly outweighed by the relief at the negative result and thankfulness that so many women's lives are saved by these screening procedures catching their cancers early. A screening tool will have false positives and that's to be expected--I'd be much more concerned about a high rate of false negatives.
No wonder women have to pay more for health insurance. Thats 50% getting un needed expenses
What if a woman's doctor followed the every-other-year recommendation and the woman had a false NEGATIVE at her mammogram? Then she would be waiting two years for another test and would suffer from the cancer progressing. What would her stress level be then?
Yep, I'd rather have false positives and get double-checked.
boy, that would have to be a lot of mammograms...I think the average radiation dose is 0.1 mSv. To put it in persepective, thats 1/30th of the radiation you are exposed to during a transcontinental flight, or 1/30th the dose you are exposed to just living in North America per year.
Even if you had mammograms every year from 40 to 90 it would be similiar to a round trip flight from boston to LA
Did you know that when they call you back for follow-up testing, insurance covers NONE of the cost? I have good insurance that covers every other little thing, but just because they got forced to cover the first mamm at 100% (which is only the RIGHT thing to do), they stuck me with a $1,000 bill for ultrasound follow-up. Totally mainstream insurance, I assume it's the standard thing now. How rotten is that?
You have CRAPPY insurance. I would have filed an appeal. Was it because the ultrasound found nothing?
Well, if you get cancer, and have one breast removed, you still pay full price for future mammograms...I know that one for a fact, and I still HAPPILY pay it...
Wow. My insurance covered the additional "pictures", the ultra sound and biopsy-all negative. And I have run of the mill group insurance. Didn't pay one dime.
I had the same thing happen to me. Got stuck with the bill for a second mammogram and an ultrasound because they coded them diagnostic, not preventive. My insurance covers 100% of preventive but since it wasnt preventive, I had to pay out of pocket. If you ask me, these call backs for ultrasounds are just a way for them to make more money.
My call back and additional testing found my cancer. I would pay the extra money knowing that it is best to double check anything that looks suspicious.
really, its just tough to tell on mammogram if the lesion is fluid filled or not. Ultrasound is better for that--if it is fluid filled its less likely to be cancer, and saves you from a biopsy
I agree though, that insurance not covering it is wrong
My first mammogram I had was not covered because I was 24 at the time. Even today at 40 mammograms are a waste of time for me. The denser the breast tissue the less they are able to see. Throughout all the ultrasounds, un-seeing mammograms and the thousands of out of pocket... I will continue to go.
I had my first "pre-cancerous" lump removed at the age of 24. Now that I'm older my insurance covers any needed tests every year. I have had more false alarms over the years from doctors feeling something. But every dollar I have spent and every hour I have wasted is worth it. The knowledge that I am OK is worth it.
Here is a tip for ladies that need to get their mammograms.
Get a group of friends together that all need to get their mammograms every year. All of you take off work for eachothers mammogram appointments. One person can be the designated driver (change every appt unless one person is a non-drinker). If you have to get "smooshed" then go get "smashed". Make it a day out for margaritas. Everyone attends the appointment then goes out for drinks and lunch afterward. It's kinda like a "smooshed" club. At least it is one way to maybe look forward to getting them done and celebrating that your friends are taking care of themselves.
Good comments Paddleboard. One other "trick" that a doctor told me about that often gets insurance companies to agree to cover a mammogram that they might not cover. He asks his younger patients, "Have you noticed any breast lumps? If you have, your insurance company might be persuaded to approve a mammogram."
This is a tough one for me. I am five years into breast cancer-actively treating most of this time-and the mammogram I got after finding the lump on my own was characterized as "clear" and "no abnormalities". Luckily my Drs. and I could feel the lump and moved forward with additional screening and tests. It was/is cancer for me. Best way is to do self-exams.
Even after the additional tests that found my cancer and knowing EXACTLY where it was, my lump couldn't be felt.
Some of the rarer forms of breast cancer do not form lumps and do not show on mammograms. In addition to mammograms and self checks, they really need to warn us about other possible cancer symptoms - redness, dimpling, swelling, pain, inturned nipples. I am still very pro-mammograms, but doctors need to get the word out about these other symptoms, too.
Mammograms and their new partners, ultrasounds are necessary evils for every woman. I willingly go every year, though not happily. What has to change is that most of the time you go for the tests and you are told "go home". If we call you it means we have found something. No news is good news". Seriously folks, if we can figure out how to put a man on the moon, surely some genius among us should be able to tell a woman the results of her tests the same day. I keep waiting and hoping.
Please, please start having mammograms at 40 and have them yearly. I was diagnosed in May 2011 with breast cancer. I am 49 yrs old. If I had waited until 50 or only had a mammogram every other year, my cancer would have been more advanced. I am lucky, my cancer is stage 1a. I am pretty sure I will be cured. It makes me furious to hear that we should wait to have mammograms because of false positives or it's not cost effective to start them at 40. Are you kidding? One life IS worth the cost. I am a poster child for starting mammograms at 40 and having them yearly.
Wendy -
I agree, this headline should read "Mammograms help diagnose 50% cancers accurately." Better a false positive followed up by a biopsy than never knowing until it is too late!
That is great for people that have insurance and can afford to do something about it if something is found. Why would people who cannot afford to pay for everything want to know they have cancer. Seems like mental torture to me.
Use the machine to test for testicular cancer and those false positives will rapidly vanish as MEN demand and get more accurate and less painful examinations!!
50 percent over ten years?
So basically 10*(0.05)=50% is what they're suggesting. Over ten years, with each year having a 5% false-positive rate. More ominously, what's the false negative rate (aka, how many people are told no breast cancer when they really have one)
Would one prefer a test with a lower false positive rate in exchange for a low negative rate? Also, if you're a doctor and you have an ambiguous case, do you do worst-case assumption (raising the false positive rate) or go with false negative, which could potentially kill someone?
There is no conspiracy. Equipment isn't cheap, techs aren't cheap, the training required to operate the instrumentation isn't cheap and the training and experience to interpret the output isn't cheap either. One of these days, they'll outsource pathology/interpretation of results overseas...
By the way, the article's summary uses "false negative" inaccurately. People who are false negative will be told the test is negative, and probably won't have the biopsy.
"More than half of healthy women who have an annual mammogram will get at least one false positive result over a 10-year period, and 7 to 9 percent will undergo a biopsy that doesn't turn out to show cancer, U.S. researchers said Monday."
This result suggests that of the 7 to 9 percent of women overall underwent a biospy that showed a negative result for cancer. Unless they meant 7 to 9 percent of the false-positives opted for a biopsy. Which means 3.5% of women who had mammograms over a ten year period had an un-necessary biopsy.
My
wife had mammograms every year. When they found cancer the tumor was at a size
that indicate it was more than a year old.
False negative the year before. So
we have a silly discussion going on. If
you want early detection you have to have frequent test and yes there are false
positives. Same situation with Prostate
cancer. I had two biopsies a year
apart. Second one caught it early.
I had a lumpectomy as a result of my mammogram - benign. However, while they were putting in the wire before the surgery, I was given eight (8!) mammograms. I won't get another mammogram ever again - I'll admit that I do not know much about radiation exposure during mammograms, but getting "zapped" eight times in one day freaked me out, especially since my doctor told me that the reason why I was getting a lumpectomy was because they weren't 100% sure of the result, and although they were 90% certain that it was benign, they wanted to "cover their tailpipes," because they were worried that I might sue if they did nothing and it turned out to be cancer.
Patients need to learn about medical radiation AND environmental radiation exposure levels so they can make informed decisions.
Some medical tests use relatively low levels of radiation (x-rays, mammograms), some are higher (CT scans and angiograms), and some use magnetic detection (MRI's) rather than radiation.
Still, the potential risks usually do not outweigh the potential benefit of a test ordered by a competent physician.
I was diagnosed this year with Stage 4 breast cancer; it has already spread to my shoulder. No cure;no surgery or radiation. Hopefully it will be controlled with hormone pills since the cancer is estrogen/progesterone receptive.
I have had yearly mammograms for over 30 yrs (I'm 65).
My advice is-if your mammogram is suspicious,see a surgeon who has a lot of experience with breast cancer. The best diagnostic is an MRI;that shows ALL areas where there are suspicious tissues.
And remember 8-12 % of breast cancers DO NOT SHOW ON A MAMMOGRAM!
I had my first mammogram in my mid-thirties and they saw something that did not look right and had me come back in for a second mammogram a couple of weeks later. It turned out that a mole that was on my breast was giving a false positive reading. The technician placed a band aid on it and it did not show. A few years later another spot showed, this time they had me go right down to radiology to have an ultra sound; this showed a definite lump and I was scheduled for a needle biopsy. Fortunately, this too was negative. I hate to think if I had waited until I was 50, things could have been much different. My husband was more freaked out about all of this than I was, but then again, his mother died from undiagnosed breast cancer in the late 1960's because they didn't have the testing that we do now.
This article is stupid. Catching breast cancer early, regardless of the risk of any false positive, is the only thing that matters. Any woman after 40 who fails to get a yearly mammogram is asking for trouble. Doing it every two years only lets the cancer for those who have it grow another year. Better to have a false positive rather than an undiagnosed cancer. These guys have no common sense.
And the problem is? I see no problem with this whatsoever. It makes more sense to be 50% at risk then 100% at risk? And even if a biopsy is done and turns out negative...wouldn't this be called "health care management"? The problem here is the insurance companies are trying to curtail its use because they don't want to pay for it, AND that's because they are over charging for such a simple diagnostic tool..
Ok lets eliminate false positives altogether by not doing ANY mama-grams. The radiologist spotted SOMETHING abnormal on the Xray. Wouldn't you want to have that checked out??
The article is about routine mammography not for follow ups on something suspicious.
What's suggested in the study is to switch to biannual routine screening to reduce the false positives. Using the same warped logic, lets completely eliminate false positives by never doing routine screening.
I'm saying the false positive is really a 'positive abnormality', just not cancer. Is a garbage study....
Because of false positives and unnecessary harm that is done!
Indiscriminately telling every woman with boobies to have them scanned leads to inevitable harm in some with no physical benefit for that individual. Ultimately it should be up to the woman with guidance from her doctor.
The establishment has knon about this since about 2002 and the false results are higher then this report.Also studies have found that those women with a high genetic disposition for breast cancer are having their DNA scrambled enough by radiation to cause their cancer.
Worry and anguish is temporary. Death is sorta permanent, last I checked. We pay these morons?
I had a false positive the first time I had a mamogram--it really sucked, but I hasnt stopped me from getting one each year. Just dont let anyone but your doctor or radiologist tell you anything about the results. The clerk behind the desk told me that it looked like cancer and even gave me a quadrant and how big it was. I couldnt feel anything, so needless to say I was really freaked out. Turns out she was reading my resutts upside down and backwards, and it was just dense breast tissue. I never did feel any type of a lump. I told my doctor about the impromptu diagnosis, and he said he would look into it, but the person who gave me my results didnt even apologize.
Task Force recommendations and Susan G. Komen-based foundations are meant to be a launching pad for questions & answers between patients and doctors. Each women should ask her doctor about her situation, based on her health and history. This is a chance to have a list of questions about what's affordable for you, what options are available and what the evidence proves is necessary or unnecessary.
http://whatstherealcost.org/video.php?post=five-questions