Women with Breast Pain Not Likely to Benefit from Breast Imaging

Researchers have found that women with breast pain who receive imaging (mammograms, magnetic resonance imaging [MRI] scans, or ultrasound exams) as part of breast pain evaluation, undergo follow-up diagnostic testing, but do not gain a benefit from these further imaging modalities.

The investigators, from Boston University School of Medicine (BUSM; MA, USA) and Boston Medical Center (BMC; MA, USA), published their findings January 31, 2012, on-line in Journal of General Internal Medicine.

Breast pain is a common breast health problem, but very few women with breast pain alone have an underlying breast cancer. The guidelines for management of women with breast pain are not precise, although past studies have suggested that other imaging modalities beyond the routine screening mammogram can provide reassurance for women with breast pain.

The researchers studied a group of 916 women who were referred from 2006-2009 for breast pain at Boston Medical Center. They compared the clinical management of women who received imaging to assess breast pain to women who did not. Six tumors were detected: all these women either had a lump on exam, or had a routine screening mammogram find a cancer in the other breast. For women who had a completely normal breast examination, the addition of an ultrasound, mammogram, or MRI scan did not help the patient or the physician in their decisions. The additional ultrasounds and other studies beyond the regular screening mammogram did have a potential negative side, including additional physician visits, more mammograms and other tests as well as more biopsies.

“While some have suggested that doing further testing in women with breast pain will help to reassure the patient, we did not find this to be the case,” explained lead author Mary Beth Howard, MS, an MD candidate, BUSM class of 2015. “More tests are not always a good thing. They can lead to still further tests or even biopsies which themselves have some risk. They can sometimes increase anxiety without providing any benefit to the patient.”

According to the researchers, if the goal is to improve the quality of healthcare, it is important to determine if imaging in women with breast pain is a beneficial diagnostic tool. “We hope this study is a first step in providing better direction for managing women with breast pain, and hopefully emphasizing that additional imaging studies are not indicated in women unless there is a focal breast complaint, such as a mass or lump,” concluded Ms. Howard.

Related Links:
Boston University School of Medicine
Boston Medical Center