The following is a summary of “Mastalgia is Not An Indication for Mammogram” published in the October 2022 issue of Family Medicine by Komenaka et al.
Patients often express anxiety about mastalgia because it is a frequent breast problem. Mastalgia was investigated in this study to ascertain whether or not it is indicative of breast cancer and to assess the usefulness of a subsequent diagnostic evaluation. Analysis of prospectively gathered data on 8960 patients at a safety net hospital between June 1, 2006, and December 31, 2020. Information on mastalgia and breast cancer diagnosis from patients was compiled.
The average age of our 8,960 patients was 45 years. 70% of the population was Hispanic, and just 16% had sufficient health literacy. About 31% (2,820/8,960) of patients complained of breast soreness upon arrival. Breast cancer was diagnosed in 20(0.7%) of the 2820 patients who had complained of breast pain. Breast cancer patients typically presented at an average age of 49.6 patients had masses detected by palpation, but only 3 reported cancer-specific pain (10 bilateral, 7 contralateral). There were 1,280 individuals under the age of 40, and 88% of them had breast imaging done. At 0.9% per 1,000 exams, the cancer detection rate was low.
Breast imaging was performed on 99% of women aged 40 to 49 and 99% of women aged 50 and up. For patients aged 40–49, the CDR was 10, and for those aged 50 and more, it was 14. Breast cancer and mastalgia are rarely seen together. Therefore, patients under the age of 40 are not suggested for imaging unless additional indications exist. To determine the cause of breast pain, it does not appear necessary to perfany tests beyond standard screening mammography in individuals of the appropriate age group.