False-Positive Mammograms Cost U.S. $4 Billion Annually, Study Says

False-positive mammogram results are costing the U.S. healthcare system more than $4 billion annually, a recent study revealed. The figures are larger than what was previously documented and support the notion that mammography as a standard screening process to detect breast cancer may not be cost-effective.

The study, conducted by researchers at Boston Children’s Hospital and Harvard Medical School, looked at insurance data from the years 2011 to 2013 for 702,154 women aged 40 to 59 who had received false-positive mammograms and misdiagnoses of breast cancer.

“The average expenditures for each false-positive mammogram, invasive breast cancer, and ductal carcinoma in situ in the twelve months following diagnosis were $852, $51,837 and $12,369, respectively. This translates to a national cost of $4 billion each year,” the authors wrote in the study published recently in the journal Health Affairs.

Among those surveyed, 11% received a false-positive mammogram result. That translates to about 3.2 million women in the United States with a false-positive result, which costs $2.8 billion, according to a CNBC article about the study. An additional $1.2 billion is being spent on overdiagnosis of invasive breast cancers and a type of noninvasive cancer known as ductal carcinoma in situ.

The figures were much higher than previously documented, and the authors stated in the study that the findings “may tilt the balance to the point where screening appears relatively cost-ineffective,” according to CNBC.

“Ultimately, the decision to undergo breast cancer screening must be based on careful consideration of the trade-offs between the benefits and the harms of screening,” the study’s authors wrote. “We need a balanced message that continues to encourage women to seek medical care when they detect a breast lump, but we should also caution them about the negative consequences of overdetection from mammography.”

The American Cancer Society recommends that women age 40 and older should have a mammogram every year, and should be continued regardless of a woman’s age, barring any major contraindication or disease. The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women 50 to 74 years. The USPSTF says that the decision to start this screening “should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms.”

Mammography remains a standard diagnostic procedure in breast cancer screening. However, widespread use has resulted in false-positives, misdiagnoses, and overtreatment among women. There is growing debate on whether or not the benefits of encouraging women to undergo routine mammograms to detect early cancer starting at a certain age outweigh the disadvantages.

Newer diagnostic technologies have the potential to enhance or even replace mammography. For instance, detection rates can be improved through the use of a mammography supplemental technique called molecular breast imaging (MBI). False-positives can be reduced through the use of sodium MRI devices. Newer compression devices can make mammograms less painful. Researchers are also working on a simple blood test to detect cancer years before a mammogram can make it apparent.