How do women experience a false-positive test result from breast screening? A systematic review and thematic synthesis of qualitative studies

Hannah Long,Anthony Maxwell,Michelle Harvie,David P French,Joanna M Brooks

doi:10.1038/s41416-019-0524-4

Abstract

BackgroundThis is the first review to identify, appraise and synthesise women’s experiences of having a false-positive breast screening test result.MethodsWe systematically searched eight databases for qualitative research reporting women’s experiences of receiving a false-positive screening test result. Two reviewers independently screened articles. Eight papers reporting seven studies were included. Study quality was appraised. Data were thematically synthesised.ResultsWomen passively attended screening in order to prove their perceived good health. Consequently, being recalled was unexpected, shocking and disempowering: women felt without options. They endured great uncertainty and stress and sought clarity about their health (e.g. by scrutinising the wording of recall letters and conversations with healthcare professionals). Their result was accompanied by relief and welcome feelings of certainty about their health, but some received unclear explanations of their result, contributing to lasting breast cancer-related worry and an ongoing need for further reassurance.ConclusionThe organisation of breast screening programmes may constrain choice for women: they became passive recipients. The way healthcare professionals verbally communicate results to women may contribute to lasting breast cancer-related worry. Women need more reassurance, emotional support and answers to their questions before and during screening assessment, and after receiving their result.

Highlights

This is the first review to identify, appraise and synthesise women’s experiences of having a false-positive breast screening test result
One study sought to understand the views of women with false-positive screening test results with the specific purpose of developing improved breast screening services.[31]
This review found that women expressed a number of worries related to breast cancer, which were felt before their screening assessment and beyond their false-positive screening test result

Summary

Introduction

This is the first review to identify, appraise and synthesise women’s experiences of having a false-positive breast screening test result. Being recalled was unexpected, shocking and disempowering: women felt without options They endured great uncertainty and stress and sought clarity about their health (e.g. by scrutinising the wording of recall letters and conversations with healthcare professionals). Their result was accompanied by relief and welcome feelings of certainty about their health, but some received unclear explanations of their result, contributing to lasting breast cancer-related worry and an ongoing need for further reassurance. The more invasive procedures, such as needle biopsy, are associated with greater worry and less chance of re-attending the routine screening appointment.[13,17,18,19]

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Conclusion