Search

Objective: We aimed to explore whether the type of mammographic feature prompting a false-positive recall (FPR) during mammography screening influences the risk and timing of breast cancer diagnosis, particularly if assessed with invasive procedures. Study design: We included information on women screened and recalled for further assessment in Spain between 1994 and 2015, with follow-up until 2017, categorizing FPRs by the assessment (noninvasive or invasive) and mammographic feature prompting the recall. Main outcome measures: Breast cancer rates in the first two years after FPR (first period) and after two years (second period). Results: The study included 99,825 women with FPRs. In both periods, the breast cancer rate was higher in the invasive assessment group than in the noninvasive group (first period 12 parts per thousand vs 1.9 parts per thousand, p < 0.001; second period 4.4 parts per thousand vs 3.1 parts per thousand, p < 0.001). During the first period, the invasive assessment group showed diverse breast cancer rates for each type of mammographic feature, with a higher rate for asymmetric density (31.9 parts per thousand). When the second period was compared with the first, the breast cancer rate decreased in the invasive assessment group (from 12 parts per thousand to 4.4 parts per thousand, p < 0.001) and increased in the noninvasive assessment group (from 1.9 parts per thousand to 3.1 parts per thousand, p < 0.001). Conclusion: In the context of mammography screening, the risk of breast cancer diagnosis during the first two years after FPR was particularly high for women undergoing invasive assessment; importantly, the risk was modified by type of mammographic feature prompting the recall. This information could help to individualize follow-up after exclusion of malignancy.