Symptomatic Breast Cancers and Why Breast Pain May Not Always Need Clinical Review

INTRODUCTION We determined whether it is safe to avoid mammograms in a group of symptomatic women with a non-suspicious history and clinical examination. PATIENTS AND METHODS Symptomatic women aged 35 years or over newly referred to a rapid-diagnosis breast clinic underwent mammography on arrival in the clinic. A breast radiologist reported on the mammograms. An experienced clinician who was unaware of the mammogram findings examined patients and decided whether a mammogram was indicated or not. If not, a management plan was formulated. Mammogram findings were then provided to the clinician and any change to the original management plan as a result of mammography was recorded. RESULTS In two-thirds (67%) of 218 patients, the clinician felt a mammogram was indicated. Half (46%) of these mammograms showed an abnormality; of these abnormal mammograms, 41% were breast cancer. Among the third (n = 71) of mammograms felt not to be indicated, 3 showed abnormalities of which 2 were breast cancer. One cancer was not suspected clinically or mammographically but was diagnosed on cyto/histopathological assessment. CONCLUSIONS A significant proportion of patients attending a symptomatic breast clinic have a non-suspicious history and normal clinical findings on examination. However, even in this group avoiding mammograms risks missing clinically occult breast cancers. It would appear sensible to offer mammograms to all symptomatic women over 35 years of age.

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Early Detection of Breast Cancer through Population-Based Mammographic Screening in Asian Women: A Comparison Study between Screen-Detected and Symptomatic Breast Cancers

The Breast Journal ◽

10.1111/j.1524-4741.2009.00687.x ◽

2009 ◽

Vol 15 (2) ◽

pp. 133-139 ◽

Cited By ~ 12

Author(s):

Esther W. L. Chuwa ◽

Allen W. Y. Yeo ◽

Heng Nung Koong ◽

Chow Yin Wong ◽

Wei Sean Yong ◽

...

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Population Based ◽

Mammographic Screening ◽

Asian Women ◽

Breast Cancers ◽

Comparison Study ◽

Symptomatic Breast

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Clinically Indeterminate Breast Lesions with Normal Imaging: A Retrospective Study in a Symptomatic Breast Care Unit

Iranian Journal of Radiology ◽

10.5812/iranjradiol.103859 ◽

2020 ◽

Vol 17 (4) ◽

Author(s):

Emre Pakdemirli ◽

Mohamed Elkorety ◽

Sherif Monib

Keyword(s):

Core Biopsy ◽

Lobular Carcinoma ◽

Needle Aspiration ◽

Breast Lesions ◽

Breast Cancers ◽

Fine Needle ◽

Triple Assessment ◽

Important Pathway ◽

Needle Aspiration Cytology ◽

Symptomatic Breast

Background: Triple assessment of breast pathologies is a very important pathway to detect breast cancers earlier. Objectives: To ascertain the necessity of clinical-guided core biopsy (CGCB) or fine-needle aspiration cytology (FNAC) for investigating clinically indeterminate breast lesions with no significant imaging findings. Patients and Methods: Retrospective analysis of 72 patients who had clinical core biopsy or fine-needle cytology was carried out to investigate clinically indeterminate breast lesions with normal imaging during the period from September 2017 to September 2019. Results: Out of 72 patients, 61 clinically indeterminate breast lesions (P3) were investigated and showed that 39 lesions (63.9%) were graded as B1, 17 lesions (27.8%) were graded as B2, two lesions (3.2%) were graded as B3 showing atypia, no lesions were graded as B4, two lesions (3.2%) were graded as B5 (one [1.6%] was found to be invasive lobular carcinoma [ILC] and the other one [1.6%] was found to be metastatic colorectal cancer to the breast), while one lesion investigated by FNAC was graded as C2 (1.6%). Conclusion: CGCB or FNAC is still necessary and vital for investigating clinically indeterminate breast lesions with normal imaging.

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The incidence of missed breast cancers in a one stop symptomatic breast clinic-our experience in Southwest Wales

European Journal of Cancer ◽

10.1016/s0959-8049(18)30682-8 ◽

2018 ◽

Vol 92 ◽

pp. S152

Author(s):

S. Khawaja ◽

M.W. Lam ◽

L. Mills ◽

A. Huws ◽

D. Thomas ◽

...

Keyword(s):

Breast Cancers ◽

Breast Clinic ◽

One Stop ◽

Symptomatic Breast

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The incidence and outcome of incidental breast lesions detected by computed tomography

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12518836439083 ◽

2010 ◽

Vol 92 (2) ◽

pp. 124-126 ◽

Cited By ~ 16

Author(s):

A Hussain ◽

A Gordon-Dixon ◽

H Almusawy ◽

P Sinha ◽

A Desai

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Breast Lesion ◽

Chest Ct ◽

Ct Scans ◽

Breast Lesions ◽

Breast Cancers ◽

The Mean ◽

The Uk ◽

Symptomatic Breast

INTRODUCTION In the UK, the majority of breast cancers are diagnosed through symptomatic breast clinics and the breast screening programmes. With increased use of computed tomography (CT) to assess various pathologies, breast lesions are picked up incidentally. The aim of this study was to investigate the incidence and outcomes of breast lesions detected incidentally on CT scans. PATIENTS AND METHODS A retrospective study was conducted to assess the incidence and outcome of incidentally found breast lesions, which were detected on chest CT scans that were conducted for other pathologies during the period from February 2007 to October 2008. RESULTS A total of 432 chest CT scans were performed over 18 months. Thirty-three (7.63%) patients were found to have an incidental breast lesion. The mean age was 73 years (range, 50–86 years). Of these, 17 (52%) were benign, eight (24%) were primary breast cancer and the remaining eight (24%) had no definite pathology. The detection rate of breast cancer was 1.85%. CONCLUSIONS CT is emerging as an important contributor to the detection of occult breast lesions. Radiological awareness of incidental breast lesions is important so that appropriate referral to a specialised breast unit is made.

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A comparison of the characteristics and prognosis of screen detected and symptomatic breast cancers

The Breast ◽

10.1016/0960-9776(93)90086-u ◽

1993 ◽

Vol 2 (3) ◽

pp. 190

Author(s):

D.M. Sibbering ◽

J.S. O'Rourke ◽

M.H. Galea ◽

A.J. Evans ◽

A.R.M. Wilson ◽

...

Keyword(s):

Breast Cancers ◽

Symptomatic Breast

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COMPARISON OF MAMMOGRAPHY AND ULTRASOUND COMBINED VERSUS ULTRASOUND ALONE IN EARLY EVALUATION OF SYMPTOMATIC BREAST CANCERS IN PAKISTAN

Journal of Cancer & Allied Specialties ◽

10.37029/jcas.v3i4.155 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Razia Bano ◽

Huma M Khan ◽

Ayesha Ehsan ◽

Awais Amjad Malik ◽

Shahper Aqeel ◽

...

Keyword(s):

Breast Cancer ◽

Diagnostic Accuracy ◽

Failure Rate ◽

Clinical Findings ◽

Initial Evaluation ◽

Breast Lesions ◽

Breast Cancers ◽

Breast Clinic ◽

Early Evaluation ◽

Symptomatic Breast

Purpose: The purpose of this study was to detect diagnostic accuracy of mammography and ultrasound combined versus ultrasound alone in early evaluation of symptomatic breast lesions.Materials and Methods: All new patients who presented to the breast clinic with symptomatic breast lesions, during the year 2012, were included in the study. A total of 695 patients were registered. Their clinical findings, mammogram, ultrasound and histopathology were reviewed.Results: Mammogram and ultrasound combined detected 693 (99.71%) lesions in total. Mammogram failed to detect lesions in 1.43% of patients, whereas the failure rate of ultrasound was 0.43%. The incidence of microcalcifications on mammogram was 19.13%.Conclusion: Ultrasound is a useful tool in the initial evaluation of symptomatic breasts. For places such as Pakistan where mammogram is not available at every centre, ultrasound can be used as an effective alternative for the assessment of symptomatic breast lesions.Key words: Breast cancer, mammography, ultrasound

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