title: Increased Risk of Developing Breast Cancer after a False-Positive Screening Mammogram.
abstract: BACKGROUND
  Women with a history of a false-positive mammogram result may be at increased risk of developing subsequent breast cancer.
  
  
  METHODS
  Using 1994 to 2009 Breast Cancer Surveillance Consortium data, we included women ages 40 to 74 years with a screening mammogram that resulted in a false-positive with recommendation for additional imaging, false-positive with recommendation for biopsy, or true-negative with no cancer within one year following the examination. We used partly conditional Cox proportional hazards survival models to assess the association between a false-positive mammogram result and subsequent breast cancer, adjusting for potential confounders. Adjusted survival curves stratified by breast density and false-positive result were used to evaluate changes in risk over time.
  
  
  RESULTS
  During 12,022,560 person-years of follow-up, 48,735 cancers were diagnosed. Compared with women with a true-negative examination, women with a false-positive with additional imaging recommendation had increased risk of developing breast cancer [adjusted HR (aHR) = 1.39; 95% confidence interval (CI), 1.35-1.44] as did women with a false-positive with a biopsy recommendation (aHR = 1.76; 95% CI,1.65-1.88). Results stratifying by breast density were similar to overall results except among women with almost entirely fatty breasts in which aHRs were similar for both the false-positive groups. Women with a false-positive result had persistently increased risk of developing breast cancer 10 years after the false-positive examination.
  Women with a history of a false-positive screening mammogram or biopsy recommendation were at increased risk of developing breast cancer for at least a decade, suggesting that prior false-positive screening may be useful in risk prediction models.
authors.affiliation: Department of Radiology and Department of Epidemiology, The University of North Carolina, Chapel Hill, North Carolina. Louise_Henderson@med.unc.edu.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Henderson
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Hubbard
authors.affiliation: Department of Surgery and Office of Health Promotion Research, University of Vermont, Burlington, Vermont.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Sprague
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, California. General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, California.
authors.forename: Karla
authors.initials: K
authors.lastname: Kerlikowske
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D016016:Proportional Hazards Models; D014481:United States / Q000453:epidemiology