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A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
Published on: January 18, 2018
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ACR Appropriateness Criteria® Breast Pain.
, Peter M Jokich1, Lisa Bailey2
1Principal Author, Rush Breast Imaging Center, Chicago, Illinois.
Summary
Breast pain is common but rarely indicates cancer. Imaging is often unnecessary unless pain is focal and noncyclic, with specific guidelines for different age groups.
Area of Science:
- Radiology
- Oncology
- Women's Health
Background:
- Breast pain affects up to 80% of women.
- It is rarely a symptom of breast cancer.
- It frequently leads to diagnostic imaging referrals.
Purpose of the Study:
- To outline appropriate diagnostic imaging workup for breast pain.
- To provide evidence-based guidelines for breast pain evaluation.
- To clarify when imaging is indicated versus when it is not.
Main Methods:
- Review of the American College of Radiology Appropriateness Criteria.
- Analysis of current medical literature from peer-reviewed journals.
- Application of RAND/UCLA Appropriateness Method and GRADE methodology.
Main Results:
- Imaging is typically not indicated for cyclic or nonfocal breast pain.
- For focal, noncyclic pain, imaging may be used for reassurance or to identify treatable causes.
- Initial imaging choices for focal, noncyclic pain vary by age: ultrasound for <30, mammography/tomosynthesis/ultrasound for ≥30.
Conclusions:
- Breast pain evaluation requires consideration of pain characteristics and patient age.
- Cancer is a rare cause of focal, noncyclic breast pain.
- Guidelines aid in appropriate and timely diagnostic imaging for breast pain.
Keywords:
AUCAppropriate Use CriteriaAppropriateness Criteriabreast painbreast tendernesscyclic breast paindiffuse breast painfocal breast painmastalgiamastodynianoncyclic breast painnonfocal breast painMore Related Videos
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