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Characterizing breast symptoms in family practice
Margaret M Eberl1, Robert L Phillips, Henk Lamberts
1Department of Family Medicine, University at Buffalo, New York, USA. Margaret.Eberl@lifetimehealth.org
Annals of Family Medicine
|November 13, 2008
Summary
Breast symptoms are common in primary care, with breast mass being a key indicator for potential breast cancer. This study analyzed over 300,000 encounters to understand symptom prevalence and outcomes.
Area of Science:
- Primary Care Medicine
- Epidemiology
- Oncology
Background:
- Breast symptoms are frequent reasons for primary care visits, yet their characterization and outcomes remain understudied.
- Understanding the epidemiology of breast symptoms in primary care is crucial for informing clinical practice and patient management.
Purpose of the Study:
- To determine the frequency and outcomes of breast symptoms presenting in primary care settings.
- To analyze the proportion of visits and resultant diagnoses for breast symptoms by patient age.
- To establish the diagnostic value of specific breast symptoms for identifying breast cancer.
Main Methods:
- Utilized a prospective longitudinal sample of patients from Dutch family physician offices (1985-2003).
- Included data from 84,285 active female patients and 367,834 total encounters.
- Coded all visits using the International Classification of Primary Care (ICPC) for breast-related reasons for encounter.
Main Results:
- Breast symptoms accounted for approximately 3% of all visits by female patients (29.7 per 1,000 patient-years).
- Breast pain and breast mass were the most prevalent complaints, particularly in women aged 25-44 and 65+.
- Breast cancer was diagnosed in 3.2% of women with breast symptoms; a breast mass significantly increased the likelihood of breast cancer (LR=15.04).
Conclusions:
- A small proportion of breast symptom presentations lead to a breast cancer diagnosis, highlighting the need for careful evaluation.
- The presence of a breast mass is a significant predictor of breast cancer in primary care settings.
- Systematic data collection and classification in primary care provide valuable insights into disease symptoms and diagnostic patterns.
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