Factors Associated With False-Positive Recalls in Mammography Screening
Background: We aimed to identify factors associated with false-positive recalls in mammography screening compared with women who were not recalled and those who received true-positive recalls. Methods: We included 29,129 women, aged 40 to 74 years, who participated in the Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA) between 2011 and 2013 with follow-up until the end of 2017. Nonmammographic factors were collected from questionnaires, mammographic factors were generated from mammograms, and genotypes were determined using the OncoArray or an Illumina custom array. By the use of conditional and regular logistic regression models, we investigated the association between breast cancer risk factors and risk models and false-positive recalls. Results: Women with a history of benign breast disease, high breast density, masses, microcalcifications, high Tyrer-Cuzick 10-year risk scores, KARMA 2-year risk scores, and polygenic risk scores were more likely to have mammography recalls, including both false-positive and true-positive recalls. Further analyses restricted to women who were recalled found that women with a history of benign breast disease and dense breasts had a similar risk of having false-positive and true-positive recalls, whereas women with masses, microcalcifications, high Tyrer-Cuzick 10-year risk scores, KARMA 2-year risk scores, and polygenic risk scores were more likely to have true-positive recalls than false-positive recalls. Conclusions: We found that risk factors associated with false-positive recalls were also likely, or even more likely, to be associated with true-positive recalls in mammography screening.
Submitted May 28, 2022; final revision received September 18, 2022; accepted for publication September 27, 2022.
Author contributions: Conceptualization: Mao, He, Czene. Data curation: Mao. Formal analysis: Mao, He. Funding acquisition: Mao, He, Humphreys, Czene. Investigation: All authors. Methodology: Mao, He, Humphreys, Czene. Project administration: He, Eriksson. Resources: Hall, Czene. Software: Mao, He, Humphreys, Eriksson. Supervision: He, Czene. Validation: Mao. Visualization: Mao. Writing—original draft: Mao, He, Czene. Writing—review & editing: All authors.
Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding: Research reported in this publication was supported by Vetenskapsrådet under award numbers 2018-02547 (K. Czene) and 2020-01302 (K. Humphreys); Cancerfonden under award numbers 19 0266 (K. Czene) and 2020-0714 (K. Humphreys); FORTE under award number 2018-00877 (W. He); Stockholm County Council under award number 20200102 (K. Czene); China Scholarship Council under award number 20180621002 (X. Mao); and the Hundred Talents Program at Zhejiang University (W. He).
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