Ont Health Technol Assess Ser. 2016 Jul 1;16(16):1-22. eCollection 2016.
Adjunct screening with ultrasound has the potential to detect breast cancers that may not be visible on screening mammography. The use of adjunct ultrasonography is thought to be a safe and inexpensive approach to improving the sensitivity of screening with mammography alone, but potentially at the expense of increasing the rate of false-positive findings. The objective of this review was to examine women's experiences of inaccurate breast cancer screening results and how they affect perceptions of breast cancer screening technologies.
This report synthesizes 16 primary qualitative studies, which together involved 690 participating women, to examine women's experiences of inaccurate breast cancer screening results. Qualitative meta-synthesis was used to integrate findings across primary research studies.
The experience of a false-positive result caused short-term anxiety until the negative result was confirmed. It also led to reoccurring anxiety during future screening. The anxiety experienced in the face of a false-positive result was magnified in high-risk women, who often reflected on the previous breast cancer experiences of family members while awaiting further results. Despite this increased anxiety, women who had experienced a false-positive result were generally not deterred from future screening. Rather, the experiences heightened their awareness of breast cancer and led to a desire for more examinations and more technologies. Women who had experienced false-negative results struggled to restore trust in screening but recognized that some breast cancers were identified through mammography. They were willing to see themselves as exceptions to an otherwise beneficial service.
Qualitative studies provide some insight into how breast cancer screening inaccuracy affects women, including their faith in the screening technology. Although women suffered marked anxiety from experiencing false-positive mammography tests and loss of confidence from false-negative results, these feelings generally did not diminish women's belief in the value of mammography screening. In many cases, the experiences reinforced the importance of risk reduction as well as screening.
超声辅助筛查有可能检测出在乳腺钼靶筛查中不可见的乳腺癌。辅助超声检查被认为是一种安全且廉价的方法，可提高单纯乳腺钼靶筛查的敏感性，但可能会增加假阳性结果的发生率。本综述的目的是研究女性对不准确的乳腺癌筛查结果的体验，以及这些结果如何影响她们对乳腺癌筛查技术的看法。
本报告综合了16项主要的定性研究，这些研究共涉及690名参与的女性，以研究女性对不准确的乳腺癌筛查结果的体验。采用定性元分析来整合各主要研究的结果。
假阳性结果的经历会导致短期焦虑，直到阴性结果得到确认。这也会导致在未来筛查期间反复出现焦虑。面对假阳性结果时所经历的焦虑在高危女性中更为严重，她们在等待进一步结果时常常会回想家庭成员之前的乳腺癌经历。尽管焦虑增加，但经历过假阳性结果的女性通常不会因此而放弃未来的筛查。相反，这些经历提高了她们对乳腺癌的认识，并导致她们渴望进行更多检查和采用更多技术。经历过假阴性结果的女性努力恢复对筛查的信任，但也认识到一些乳腺癌是通过乳腺钼靶检查发现的。她们愿意将自己视为这项原本有益的服务的例外情况。
定性研究为乳腺癌筛查不准确如何影响女性提供了一些见解，包括她们对筛查技术的信心。尽管女性因乳腺钼靶检查出现假阳性结果而遭受明显焦虑，因假阴性结果而失去信心，但这些感受通常并未削弱女性对乳腺钼靶筛查价值的信念。在许多情况下，这些经历强化了降低风险以及筛查的重要性。
