Imaging of the symptomatic breast

Abstract

Breast symptoms are of concern to women not only because of the symptom itself but the fear that it may be caused by an underlying breast cancer. Two of the most common presenting breast complaints are a breast lump and breast pain. A breast lump discovered on self-examination or during clinical examination is evaluated by a diagnostic mammogram and ultrasound. The incidence of breast cancer in a patient with a breast lump can be significant in older women and as high as 13% in women over 50 years of age. Breast pain when non-focal and in the absence of an associated physical finding or when cyclical does not require imaging. Focal breast pain, especially if associated with a breast lump, is evaluated with a diagnostic mammogram and/or an ultrasound. Other breast symptoms prompting a physician visit include an abnormal nipple discharge, abnormalities of the nipple-areolar complex, non-puerperal mastitis, and axillary abnormalities. Skin erythema and skin thickening in absence of an underlying infection should be evaluated for the rare inflammatory breast cancer. Breast implant-associated symptoms may be related to disruption of the implant and the extremely rare implant-associated lymphoma.