Psychological and behavioral implications of abnormal mammograms

Caryn Lerman, Bruce Trock, Barbara K. Rimer, Alice Boyce, Chris Jepson, Paul F. Engstrom

Research output: Contribution to journalArticlepeer-review

389 Scopus citations


Objective: To evaluate women's psychological responses to abnormal mammograms and the effect on mammography adherence. To identify psychological responses and other factors that predict mammography adherence in women with normal or abnormal mammograms. Design: Survey study with prospective analysis of factors associated with mammography adherence. Setting: Health Maintenance Organization of Pennsylvania and New Jersey (HMO PA/NJ). Patients: Study patients, members of HMO PA/NJ who were 50 years of age or older, and who had had mammography done 3 months earlier, included women with normal mammograms (n = 121), women with low-suspicion mammograms (n = 119), and women with high-suspicion mammograms (n = 68), but not women with breast cancer. Measurements: Psychological responses 3 months after mammography and adherence to subsequent annual mammography were assessed. Main Results: Women with high-suspicion mammograms had substantial mammography-related anxiety (47%) and worries about breast cancer (41%). Such worries affected the moods (26%) and daily functioning (17%) of these women, despite diagnostic evaluation excluding malignancy. For each variable, a consistent trend (P > 0.05) was seen with degree of mammogram abnormality. Sixty-eight percent of women with normal results, 78% of women with low-suspicion results, and 74% of women with high-suspicion results obtained their subsequent annual mammograms (P > 0.05). The number of previous mammograms (odds ratio, 3.2; 95% CI, 1.6 to 6.2) and the effect of the previous results on concerns about breast cancer (odds ratio, 0.5; CI, 0.2 to 1.0) were independent predictors of adherence in logistic regression analyses (P < 0.05). Conclusions: A substantial proportion of women with suspicious mammograms have psychological difficulties, even after learning that they do not have cancer. Such sequelae do not appear to interfere with subsequent adherence.

Original languageEnglish (US)
Pages (from-to)657-661
Number of pages5
JournalAnnals of internal medicine
Issue number8
StatePublished - Apr 15 1991
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine


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