Effect of abnormal screening mammogram on quality of life

Background: Screening for breast cancer reduces breast cancer-related mortality. Advantages of screening are explained clearly, but its disadvantages are underrepresented in consent folders. Methods: In September 2002 a prospective, longitudinal study started concerning quality of life (QoL) in women with breast disease. Between September 2002 and January 2007, 385 women with an abnormal screening mammogram were included. Of these, 152 women were diagnosed with breast cancer (BC group) and 233 had a false-positive result (FP group). Questionnaires concerning anxiety (State and Trait Anxiety Inventory) and QoL (World Health Organization Quality of Life assessment instrument 100) were completed before diagnosis, and 1, 3, 6 and 12 months later. Results: The BC group was significantly older (60.2 versus 57.3 years; P < 0.001); significantly more histological biopsies were needed in the FP group (P < 0.001). Almost 60 per cent of the FP group revisited the outpatient clinic in the first year. Trait anxiety had a profound influence on QoL. Women in the FP group with a high score on trait anxiety had lowest QoL on all measurements (P < 0.001). They also reported more feelings of anxiety compared with women in the FP group with a lower trait anxiety score, and women in the BC group with a low trait anxiety score (P < 0.001). Conclusion: Women with a false-positive diagnosis of screen-detected breast cancer had a low QoL and feelings of anxiety, especially when they scored high on trait anxiety. This effect lasted for at least 1 year.