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A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
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Focal breast pain: imaging evaluation and outcomes
Wendi A Owen1, Hilary A Brazeal1, Hillary L Shaw1
1Breast Imaging Division, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110, USA.
Clinical Imaging
|March 3, 2019
Summary
Focal breast pain (FBP) is rarely linked to cancer. For women 40+, a negative mammogram may allow deferring targeted ultrasound, simplifying breast cancer screening.
Area of Science:
- Radiology
- Oncology
- Breast Imaging
Background:
- Focal breast pain (FBP) is a common reason for breast imaging.
- Determining the diagnostic yield and optimal imaging strategy for FBP is crucial.
Purpose of the Study:
- To assess cancer detection rates and characteristics in women with FBP.
- To identify the most effective imaging evaluation for FBP.
Main Methods:
- Retrospective review of 944 women aged 18+ with FBP and no other symptoms.
- Analysis of imaging work-up (mammogram, ultrasound), findings, BI-RADS® assessment, and pathology.
- Tracking of subsequent imaging and clinical follow-up.
Main Results:
- Malignancy was rarely detected at the site of FBP (3 cancers found among 12 biopsies).
- Mammography detected all cancers at the pain site; ultrasound provided correlates for 2.
- Incidental cancers were diagnosed both initially (4) and on follow-up (13).
Conclusions:
- Focal breast pain is infrequently associated with breast cancer.
- For women aged 40 and older with FBP, no other clinical findings, and a negative mammogram, targeted ultrasound may be deferred.
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