• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

Is Breast Pain an Indicator of Breast Cancer?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Breast pain may be a symptom of breast cancer
  • However, radiographic studies have indicated only a 0-1.2% incidence of breast cancer in association with breast pain
  • US Data regarding the cancer incidence of patients entering a breast imaging center for evaluation of breast pain is not available
  • Kushwaha et al. (American Journal of Roentgenology, 2018) analyzed the incidence of breast pain, and the incidence of breast cancer in women with breast pain, and compared these data who women who present as part of the general screening population
    • The authors also performed a cost-benefit analysis

METHODS:

  • Three different community breast imaging centers were included in the study
  • Participants
    • All female patients presenting with breast pain (2014)
  • Demographic characteristics and imaging findings were recorded
  • Digital mammography was used on all women
    • Digital tomosynthesis was done at the request of the physician or patient
    • MRI performed by order of the physician as necessary
    • Ultrasound, when performed, was whole-breast of the breast and axilla

RESULTS:

  • 799 patients were included
  • Total 85,841 imaging exams were performed
    • 1.4% (1,196 studies) were done for breast pain
  • Pain was
    • Diffuse in 30% | Focal in 30% | Localized in 40%
  • A benign sonographic correlate was detected in the pain area in 5% of patients (39/799)
  • No cancers were found in the symptomatic breast
    • One patient had a single cancer detected in the contralateral asymptomatic breast
  • When compared to concurrent cancer detection rate in the screening population (5.5 cases/1000 examinations)
    • Breast pain was not associated with breast cancer (p = 0.027)
  • Cost analysis
    • Patients <40 years (316/799)
      • 454 workup studies for breast pain
      • 1 biopsy
      • All findings were benign
      • Cost of these studies was $87,322
    • Patients ≥40 years or older (483/799)
      • 745 workup studies for breast pain
      • 6 biopsies
      • Cost of $152,732

CONCLUSION:

  • Breast pain was not helpful as a screening symptom/indication for breast cancer and consequent breast cancer screening cost significant money for imaging centers
  • The authors recommend the following work-up for breast pain alone (no mass) “should include an annual screening mammogram for women 40 years or older and reassurance for female patients younger than 40 years.”

Learn More – Primary Sources:

Overutilization of Health Care Resources for Breast Pain

image_pdfFavoriteLoadingFavorite

< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

Mammography Guidelines for Average-Risk Women
BI-RADS: Standardizing Breast Imaging and Reporting 
Breast Cancer Screening using MRI vs Mammography – How Do They Compare?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Log In to ObG First

Please log in to access OBGFirst and the 2T Ultrasound Atlas

Password Trouble?

Sign Up for ObGFirst

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!

ObG First Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site