Long-term clinical outcomes in women with breast pain in the absence of additional clinical findings: mammography remains indicated
| Autor: | Mark A. Helvie, Lauren F. Stein, Mitra Noroozian, Kara Gaetke-Udager |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Breast imaging Biopsy Breast pain Breast Neoplasms Sensitivity and Specificity Young Adult Breast cancer Internal medicine medicine Mammography Humans Breast Young adult skin and connective tissue diseases Aged Neoplasm Staging Retrospective Studies Gynecology Aged 80 and over medicine.diagnostic_test business.industry Cancer Reproducibility of Results Retrospective cohort study Middle Aged medicine.disease Tumor Burden Patient Outcome Assessment Oncology Female medicine.symptom Neoplasm Grading Diagnostic Mammography business Mastodynia |
| Zdroj: | Breast cancer research and treatment. 149(2) |
| ISSN: | 1573-7217 |
| Popis: | The purpose of the study was to determine the long-term clinical outcomes of women with breast pain in the absence of additional symptoms or signs (isolated breast pain), and the utility of mammography in their work-up. IRB approved, HIPAA compliant study retrospectively reviewed 1,386 patients referred for breast imaging with ICD-9 code for breast pain between 1/1/2006 and 12/31/2007. Of these, 617 consecutive women (mean age, 49 years) with isolated breast pain, mammogram, and follow-up (mean, 51 months) constituted the study group. Clinical data, mammographic and sonographic BI-RADS assessments, and geographic relationship between the site of cancer and pain were evaluated. The frequency of malignancies and of specific benign outcomes, both at and subsequent to the time of presentation, was determined. Breast cancer and specific benign outcomes were diagnosed in the painful breast of 11/617 (1.8 %) and 63/617 (10.2 %) women, respectively. Majority of the cancers (9/11, 81.8 %) were diagnosed subsequent (5–52 months) to initial imaging evaluation, whereas the majority of benign outcomes (52/63, 82.5 %) were diagnosed at initial presentation. Diagnostic mammography at initial presentation had a negative predictive value of 99.8 % (95 % CI 99.1 %, 100 %), specificity of 98.5 % (95 % CI 97.2 %, 99.3 %), and sensitivity of 66.7 % (95 % CI 11.6 %, 94.5 %). Three cancers were subsequently diagnosed in the contralateral (non-painful) breast. Eleven of 14 (78.6 %) cancers were in the symptomatic breast, of which 9 (81.8 %) geographically corresponded to the same area of focal pain. Thus, infrequently, breast cancer may clinically present as or be preceded by isolated breast pain and diagnostic mammography is useful for assessment. |
| Databáze: | OpenAIRE |
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