Focal breast pain: imaging evaluation and outcomes

Owen, Wendi A.; Brazeal, Hilary; Shaw, Hillary L.; Lee, Michelle V.; Appleton, Catherine M.; Holley, Susan

doi:10.1016/j.clinimag.2019.02.008

Cited by 11 publications

(5 citation statements)

References 12 publications

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“…Some suggest that symptoms of non-cyclical focal breast pain may be associated with higher incidence of breast malignancy 25 than other presentations of breast pain. However, this is inconsistent and not been noted by others [36][37][38][39] .…”

Section: Comparison With Existing Literaturementioning

confidence: 64%

No association between breast pain and breast cancer: a prospective cohort study of 10 830 symptomatic women presenting to a breast cancer diagnostic clinic

et al. 2021

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Background Women with breast pain constitute upto 20% of breast clinic attendees. Aim: To investigate breast cancer incidence in women presenting with breast pain and establish health economics of referring women with breast pain to secondary care. Design & Setting: Prospective cohort study of all consecutive women referred to a breast diagnostic clinic over 12 months. Methods: Women were categorised by presentation into 4 distinct clinical groups and cancer incidence investigated. Results: Of 10 830 women, 1972 (18%) were referred with breast pain, 6708 (62%) with lumps, 480 (4%) with nipple symptoms,1670 (15%) with ‘other’ symptoms. Mammography, performed in 1112 women with breast pain, identified cancer in 8 (0.7%). In 1972 women with breast pain, breast cancer incidence was 0.4% compared with ~5% in each of the three other clinical groups. Using ‘breast lump’ as reference, odds ratio (OR) of women referred with breast pain having breast cancer was 0.05 (95% confidence interval 0.02–0.09; P<0.001). Compared to reassurance in primary-care, referral was more costly (net cost £262) without additional health benefits (net Quality Adjusted Life Year (QALY) loss -0.012) Greatest impact on the incremental cost effectiveness ratio (ICER) was when QALY loss due to referral associated anxiety was excluded. Primary-care reassurance no longer dominated, but the ICER remained greater (£45,528/QALY) than typical UK National Health Service cost-effectiveness thresholds. Conclusions: This study shows that referring women with breast pain to a breast diagnostic clinic is an inefficient use of limited resources. Alternative management pathways could improve capacity and reduce financial burden.

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Section: Comparison With Existing Literaturementioning

confidence: 64%

No association between breast pain and breast cancer: a prospective cohort study of 10 830 symptomatic women presenting to a breast cancer diagnostic clinic

et al. 2021

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“…Lobular tumours can also manifest merely as an area of posterior acoustic shadowing without an associated visibly distinct mass [12]. Finally, as in mammography, ILC can escape detection on sonographic investigation and remain invisible [13], as it is demonstrated in the case presentation as well.…”

Section: Discussionmentioning

confidence: 86%

Whole Breast Invasive Lobular Carcinoma Not Detected Radiographically

Vlastarakos

Marinopoulos

Dimopoulou

et al. 2020

Cureus

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Breast cancer is the most commonly occurring cancer in women, with invasive lobular carcinoma being the second most common histologic form. A 78-year-old female patient presented complaining of an enlarged palpable lymph node in the left axilla. Breast ultrasound, digital mammography, and contrast-enhanced spectral mammography (CESM) revealed no abnormal findings. Core needle biopsy of the lymph node revealed infiltrative, diffuse neoplastic growth suggestive of adenocarcinoma, indicating that the primary site should be sought in the breast. The patient underwent mastectomy and the histopathology was suggestive of invasive lobular carcinoma throughout the whole extent of the breast parenchyma. Breast cancer should be definitely included in the differential diagnosis of enlarged axillary lymph nodes, even if there is no other clinical or radiographic presentation of breast disease.

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“…False aneurysms present in the setting of trauma, coagulopathies, vascular invasion by breast malignancy, or uncontrolled hypertension. 3 Enlarged veins may be due to axillary or subclavian vein blockage, or superior vena cava blockage. CT scan will show dilated, tortuous, superficial collateral veins.…”

Section: A Novel Treatment For Microthrombosis Of the Breastmentioning

confidence: 99%

“…Zaheer Faizi, MD MS 1 , Daniel W. Kim, MD 1 , Joseph Morales, MD 1 , Abuoma Okorie, BS 2 , Marissa Matto, BS 3 , Kainat Faizi, BS 4 , Jandie Schwartz, DO 1 , and Chantal Reyna, MD 1 A 41-year-old female presented to the ED with new onset left breast pain, bruising and swelling starting 5 days prior to presentation. Symptoms originated at the medial inferior quadrant of the left breast and progressively worsened to involve the lateral inferior quadrant.…”

Section: A Novel Treatment For Microthrombosis Of the Breastmentioning

confidence: 99%