Role of Breast Ultrasound in Patients with Negative Mammogram Presenting with Breast Pain Without a Palpable Lump

Aim: To determine if addition of an ultrasound examination to mammography has an impact on detecting breast cancer in the patients who present with breast pain without a palpable lump. Material and Method: The mammography data from January 2008 to April 2011 was retrospectively reviewed for patients who presented with focal breast pain without a palpable lump. A total of 135 patients in which an ultrasound examination was performed in addition to mammography were retrospectively analyzed for their imaging findings and eventual outcome based on biopsy results, imaging follow-up, or clinical follow-up. For the purpose of test analysis, categories 1-3 were considered negative on mammography and ultrasound and categories 0, 4, and 5 were considered positive on mammography while categories 4 and 5 were considered positive on ultrasound. Results: The addition of an ultrasound examination in the presence of a normal or benign mammogram in the whole group upgraded the examination category in 14 (%10.3) of 135 cases without increasing the sensitivity for detection of breast cancer. In patients presenting with breast pain without a palpable lump, addition of an ultrasound examination to a negative or benign mammogram does not increase the sensitivity for detecting breast cancer. Discussion: Breast pain also known as mastalgia or mastodinia, is a common symptom affecting up to 70% of women at some time or the other in their lives. There is limited data about the value of ultrasound in addition to mammography, for detection of breast cancer in patients presenting with breast pain without a palpable lump. To the best of our knowledge, our study is one of first studies revealing this issue in the literature. Further studies including more participants of patients with mastalgia, will provide additional data