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Medicine Science

Half of Women Will Get a False Positive 3D Mammogram, Study Finds (axios.com) 39

Posted by BeauHD from the way-too-common dept.
An anonymous reader quotes a report from Axios: Half of all women getting 3D mammograms will experience a false positive over a decade of annual screening, a study published Friday in JAMA Network Open found. False positives -- when a mammogram is flagged as abnormal, but there is no cancer -- have always been a problem. But 3D mammography has been aggressively marketed by hospitals, doctors and some patient groups for its ability to provide higher image quality images -- and previous studies have found they result in fewer false positives.

The researchers analyzed data from the Breast Cancer Surveillance Consortium on 3 million screening mammograms for more than 900,000 women ages 40-79. The screenings were performed between 2005 and 2018 at 126 radiology facilities. Researchers estimate over 10 years of getting 3D mammograms, 50% of women will experience at least one false-positive recall compared to 56% of women screened with 2D digital mammograms. Women with dense breasts or who were younger, as well as those who screened every year compared to once every two years, had a higher chance of a false positive. "Whenever you're called back for an additional workup, it's very stressful because women think they may have cancer," Diana Miglioretti, a lead author and professor and division chief of biostatistics at UC Davis Department of Public Health Sciences, told Axios.

"Often it may take days to even weeks to get that resolved," she said. "The main thing is we want to alleviate women's anxiety over these false positives and understand they are very common."
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Half of Women Will Get a False Positive 3D Mammogram, Study Finds More

Half of Women Will Get a False Positive 3D Mammogram, Study Finds

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  • Rather have... (Score:3)

    by Kelxin ( 3417093 ) on Friday March 25, 2022 @10:52PM (#62390701)
    False positives are better than false negatives. Anyone with a cancer diagnosis will tell you that.

    • It is better to have neither. False positives are so common for mammograms that many health experts say they aren't worth it for women with no risk factors.

      Most breast cancers that are detected and successfully treated are less than six months old. Giving tens of millions of women a mammogram every six months and then subjecting many of them to a battery of additional invasive procedures (including x-rays that can cause cancer, is a huge waste of time and medical resources.

      • It is better to have neither. False positives are so common for mammograms that many health experts say they aren't worth it for women with no risk factors.

        Most breast cancers that are detected and successfully treated are less than six months old. Giving tens of millions of women a mammogram every six months and then subjecting many of them to a battery of additional invasive procedures (including x-rays that can cause cancer, is a huge waste of time and medical resources.

        This! SO's been there and done that, and with no family history, the exams have been written off her medical to-do lists.

        This is not unlike the practice of the PSA tests for men to detect prostate cancer. A friend of the wife's husband got an elevated reading, and his wife insisted he get the operation. Completely wrecked the guy.Now he's impotent, incontinent, and as it turned out, completely unnecessary.

        The cynical part of me notes that some money was made, so the Medical community considers his sit

      • Yeah, but life isn't perfect.

        If we have to chose in cases like this then we should choose whatever method gives the lowest false negative.

        • Re: (Score:2)

          by Uecker ( 1842596 )

          You get the lowest false negative rate by declaring that all have cancer. (and before you respond, google ROC curve)

      • It is better to have neither.

        In an ideal world, yes.
        [Looks around. Sees non-ideal world]
        So? Practically, any test is going to have a non-zero rate for both false positives and false negatives. Doubly so for any biological test. Because biology is complicated, messy, and less than well understood.

        I'm sure it's scary getting a false positive. Not an ideal situation. But is it worse than the alternative of suddenly realising you've got a lump, and being told "it's inoperable ; make your will". You, personal

      • False positive leads to more testing, false negative leads to going on with life and finding out at a later stage that you're about to die because it wasn't caught earlier.

    • One thing that isn't mentioned in the article is the difficulty in reading images in women with dense breasts. Over 40% of women have what are classified as "dense breasts" which makes interpreting the results of x-ray images difficult. In 30 of the 50 US states, women with dense breasts are required to be informed about the difficulty in interpreting their imaging results and to discuss this difficulty with their primary care provider. Both Doctors and Patients Confused by Dense Breasts [acsh.org]

      Luckily, even when

    • Tough titties. *Yeaaaahh!*
    • False positives can be quite dangerous due to unnecessary mastectomies and other treatments. The arguments around this are endless and complex to interpret because cancer doesn't necessarily kill you while unnecessary treatments can. For example for breast cancer screening there's no benefit (risk reduction) for women aged 40-49 demonstrated across 10 randomised trials around the world, a small benefit (NNT = 270) for ages 50-59, and then it gets really complex because you start running into problems with

      • Re: (Score:2)

        by AmiMoJo ( 196126 )

        Would any doctor go a mastectomy based just on a scan? A biopsy is very low risk and provides a high degree of certainty.

        • Clearly "arglebargle_xiv" has a doctor who does just that. Probably why his family goes through generations so fast that he can count 14 generation back, when most families struggle to get to 7 generations. That sort of implies consistent breeding at legal minimum-age, at least for as long as there has been a legal minimum. (I get pretty fuzzy at 4 generations - I've never made any effort to investigate further.)

          Should we tell his doctor about Semmelweiss, or leave him to his Enlightenment sawbones practic

      • If you look closely enough, practically everyone has cancerous growths in their body (I've read estimates of 8 on average per person), which usually do get cleaned up by the immune system. Most can be only (or most easily) detected by blood tests and are perhaps often too small to be seen on scans like mammograms. But it does mean that practicality all people die with cancer, even if not of cancer..
    • No. Getting treated for non-existent cancer is terrible, life altering or life shortening. Many of the people who were supposedly cured of cancer, never had it in the first place.
  • If the only consequence is 10% overall additional scans, that isn't too bad, if the 3d scanning does better at avoiding false negatives, which can be quite dangerous. It could easily end up a statistical win. If the patients are informed that this happen often and not to be concerned until there is a second scan, the stress shouldn't be too high

    OTOH, a false positive that results in some more invasive test or treatement might not be a good tradeoff.

  • Worth it! (Score:4, Informative)

    by TheMiddleRoad ( 1153113 ) on Saturday March 26, 2022 @12:21AM (#62390785)

    Every single year, my wife had to go in for a second scan after every single mammogram.
    Then, after 7 years of this, they found something. She had very early breast cancer. They did surgery and radiation and she was done. Probably saved her life.
    So fine, it sucks, but worth it.

  • Isn't AI taking over the reading of x-rays and things such as mammograms? If not, I have a feeling in 20 years it will be and bad readings will be a thing of the past.
    • If AI were to take over routine screening examinations, and it cut the relative false positive rate by 20% (i.e., from 5% of scans to 4% of scans), would that be considered a success? Probably not.

      I don't know the situation in your area, but I believe that AI is used in my area for pre-screening the records : the AI classifies the specimens into "obvious, worrying features", "not obvious, or contradictory potentially worrying features", "dubious quality record", and "AI can't see anything worrying", then t

  • It reads like it's going to say that there's a problem with 3D mammograms, but in fact it confirms that they give fewer false positives (50% Vs 56% over 10 years).

    Oh, and - DUH! - if you have twice as many tests you have a higher chance of getting a false postive, who'd have thunk it? Eliminate false positives completely by not testing!

  • With todays available techn
    • (Oh my god, stupid mobile keyboards and /. for putting the submit button so low it border right above the onscreen keyboard) With todays technology it should be possible to go as low as 1% or lower over multiple checkups, hell it should really be zero. As with so many false positives, there will also be that much false negatives, which ofcourse is a much larger problem.
  • When, oh when, will this outrageous sexual inequality end ?

    Something must be done.

    • Re: (Score:2)

      by _merlin ( 160982 )

      Are you going for your regular prostate cancer screenings? What about testicular cancer? Men do get breast cancer [canceraustralia.gov.au], just nowhere near as frequently as women, probably due to having much less breast tissue - 116 cases in Australian men in 2012. Probably no worth widespread screening.

      • What about testicular cancer?

        I feel a great disturbance in the Force ... As if a million Slashdot reader's testicles suddenly swooped upwards, in fear.

        Personally, my attachment to my testicles is purely a matter of flesh and blood. If they went cancerous, then cut them off. I'd be more concerned about losing a toe.

  • 100% of those with a false positive result are relieved once proven negative, and still glad they took the test.

    100% of those with an actual positive result are happy that they had at least taken the test in the first place to give any chance of removal rather than allowing the cancer to grow rampantly.

    100% of those with a false negative would have preferred to have found it with a positive result, and probably wish for a false positive.

    It's all worth it for everyone no matter the result.

  • What an absolutely wretched use of statistics! First, the headline - "Half of Women Will Get a False Positive 3D Mammogram". That sounds really bad, until you learn that with the existing technology more than 50% of women will get a false positive. So the headline should read "3D Mammograms reduce the number of false positives."

    Next, what does the 50% statistic tell us about the rate of false positives? It feels like it's trying to insinuate that half of 3D mammograms result in false positives. But no

  • I am so afraid of serious health problems, so I regularly undergo medical examinations that will help me detect problems in time and start treatment. In addition, I regularly take supplements containing Delta 8 THC. I buy them from this online store via the link, so I recommend to check [diamondcbd.com] them out if you care about your health.

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