Women's Experiences of Inaccurate Breast Cancer Screening Results: A Systematic Review and Qualitative Meta-synthesis

Abstract

Background: Adjunct screening with ultrasound has the potential to detect breast cancers that may not be visible on screening mammography. The use of adjunct ultrasonography is thought to be a safe and inexpensive approach to improving the sensitivity of screening with mammography alone, but potentially at the expense of increasing the rate of false-positive findings. The objective of this review was to examine women's experiences of inaccurate breast cancer screening results and how they affect perceptions of breast cancer screening technologies.

Methods: This report synthesizes 16 primary qualitative studies, which together involved 690 participating women, to examine women's experiences of inaccurate breast cancer screening results. Qualitative meta-synthesis was used to integrate findings across primary research studies.

Results: The experience of a false-positive result caused short-term anxiety until the negative result was confirmed. It also led to reoccurring anxiety during future screening. The anxiety experienced in the face of a false-positive result was magnified in high-risk women, who often reflected on the previous breast cancer experiences of family members while awaiting further results. Despite this increased anxiety, women who had experienced a false-positive result were generally not deterred from future screening. Rather, the experiences heightened their awareness of breast cancer and led to a desire for more examinations and more technologies. Women who had experienced false-negative results struggled to restore trust in screening but recognized that some breast cancers were identified through mammography. They were willing to see themselves as exceptions to an otherwise beneficial service.

Conclusions: Qualitative studies provide some insight into how breast cancer screening inaccuracy affects women, including their faith in the screening technology. Although women suffered marked anxiety from experiencing false-positive mammography tests and loss of confidence from false-negative results, these feelings generally did not diminish women's belief in the value of mammography screening. In many cases, the experiences reinforced the importance of risk reduction as well as screening.

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