Increased patient concern after false-positive mammograms - Clinician documentation and subsequent ambulatory visits

OBJECTIVE: To measure how often a breast-related concern was documented in medical records after screening mammography according to the mammogram resu lt (normal, or true-negative vs false-positive) and to measure changes in h ealth care utilization in the year after the mammogram. DESIGN:Cohort study. SETTING: Large health maintenance organization in New England. PATIENTS: Group of 496 women with false-positive screening mammograms and a comparison group of 496 women with normal screening mammograms, matched fo r location and year of mammogram. MEASUREMENTS AND MAIN RESULTS: 1) Documentation in clinicians' notes of pat ient concern about the breast and 2) ambulatory health care utilization, bo th breast-related and non-breast-related, in the year after the mammogram. Fifty (10%) of 496 women with false-positive mammograms had documentation o f breast-related concern during the 12 months after the mammogram, compared to 1 (0.2%) woman with a normal mammogram (P =.001). Documented concern in creased with the intensity of recommended followup (P =.009). Subsequent am bulatory visits, not related to the screening mammogram, increased in the y ear after the mammogram among women with false-positive mammograms, both in terms of breast-related visits (incidence ratio, 3.07; 95% confidence inte rval [CI], 1.69 to 5.93) and non-breast-related visits (incidence ratio, 1. 14; 95% CI, 1.03 to 1.25). CONCLUSIONS: Clinicians document concern about breast cancer in 10% of wome n who have false-positive mammograms. and subsequent use of health care ser vices are increased among women with false-positive mammogram results.