Intended for healthcare professionals


Women's attitudes to false positive mammography results

BMJ 2000; 321 doi: (Published 02 December 2000) Cite this as: BMJ 2000;321:1409

A formerly clueless patient responds

  1. Carol Jean Godby (, senior research scientist
  1. OCLC-Online Computer Library Center, Columbus, OH 43201,USA
  2. Austin Automation Center (311), Department of Veterans' Affairs, Austin, TX 78772, USA
  3. Liverpool Health Authority, Liverpool L3 6AL
  4. Veterans Administration Outcomes Group, Veterans Administration Medical Center, White River Junction, VT 05009, USA
  5. Dartmouth Medical School, Lebanon, NH 03756, USA

    EDITOR—I am a patient who received a diagnosis of low grade ductal carcinoma in situ in 1997, on my 43rd birthday, after obtaining a routine screening mammogram showing a cluster of indeterminate microcalcifications. Although I consider myself informed about women's health, I was ambushed by this news. Like the patients in the study by Schwartz et al,1 I had never heard of ductal carcinoma in situ until it became a terrifying issue that put my life on hold.

    Surveying the literature written for patients makes it easy to understand why someone like me could have missed this. I ransacked it, starting with the copy of Our Bodies, Our Selves2 that I grabbed from my bookshelf on the day I came home to an ominous message on my answering machine from the radiology clinic. In the 30 pages about breast cancer, the only comment about suspicious mammograms was buried in a sidebar that had apparently been added in a recent revision and had no referring text. I learnt that most books and pamphlets written for patients assume that a woman's entry into the breast cancer culture starts with the discovery of a lump.

    Many have long revision histories that predate the widespread use of mammography. Discussions of screen-detected disease are often meagre and carelessly patched in. On the day I received my diagnosis my surgeon dutifully educated me with a pamphlet entitled Breast Lumps.3 It covered the normal breast, benign and malignant lumps, the simple procedure of self examination of breasts, and what happens after the discovery of a lump. Of course, little of this applied to me. I had what was finally described in a small inset on page 11 as an area of abnormality on a mammogram. The rest of the pamphlet contained a list of …

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