Women presenting with breast pain are often sent by their clinicians for different types of breast cancer testing — typically undergoing mammography, an ultrasound, and a physical exam — despite there being a lack of association between the pain and cancer.
Researchers from Arizona and California decided to examine the benefit of this testing and if the workup is cost effective.
They reviewed medical records of 7202 consecutive patients, who were seen at least 1 time, at the Breast Clinic at Maricopa Medical Center in Phoenix from June 1, 2006 to February 28, 2017.
About 15% of patients (1017 of 7202) presented with a complaint of breast pain, according to the study
that was presented at the 2017 San Antonio Breast Cancer Symposium. Some patients (702) were referred to the breast clinic for a breast “mass,” but were found to have only breast pain. Of the 1719 patients with breast pain, 15 (<1%) were found to have breast cancer. None of the patients found to have cancer were at increased risk per Gail Model risk estimates.
Most patients underwent evaluation of their breast pain: 85% breast imaging (mammogram, ultrasound, MRI, or CT scans), 32% biopsy, and 68% blood tests.
Although breast pain is a common complaint, workup beyond physical examination does not appear to be cost effective for patients under age 40 for whom it is not recommended to undergo screening, concluded the researchers. In patients age 40 and older, mammography should be performed if the patient has not been participating in routine screening. Diagnostic imaging in the absence of findings on screening and laboratory tests do not appear beneficial in patients with breast pain.