What is the psychological impact of mammographic screening on younger women with a family history of breast cancer? Findings from a prospective cohort study (PIMMS)

It is not yet known whether the benefits of regular screening for women with a family history of breast cancer (FHBC) outweigh the harms. One of the harms associated with having a mammogram is recall for further tests such as additional imaging and biopsies [1]. This has been shown to cause significant anxiety in the short term, and possibly the long term, in women in routine screening [2]. Given the greater cancer worry in women with a FHBC [3], it is possible they may be particularly adversely affected by a recall. This multicentre, prospective study investigated both the positive and negative psychological effects of regular mammographic screening in women <50 years with a family history of breast cancer [4].

Women who received an immediate all-clear result after mammography (n = 1,174) and women who were recalled for further tests prior to receiving an all-clear result (false positive) (n = 112) completed questionnaires: 1 month before mammography, and 1 month and 6 months after receiving final results. The questionnaires included measures of cancer worry, psychological consequences and perceived benefits of breast screening.

For women receiving an immediate all-clear result, participating in annual mammographic screening is psychologically beneficial. Furthermore, women who are recalled for further tests do not appear to be psychologically harmed by screening. Women's positive views about mammography suggest that they view any distress caused by recall as an acceptable part of screening.