The effect of imaging on the clinical management of breast pain.

Journal of General Internal Medicine
Mary Beth HowardKaren Freund

Abstract

Breast pain is a common complaint to primary care and breast specialists. Literature recommends imaging to provide reassurance of benign etiology. The effect of imaging on reassurance and subsequent healthcare utilization has not been described. To determine if initial imaging for breast pain reduces subsequent utilization. Retrospective cohort study at a hospital-based breast health practice. Women referred for breast pain from 2006-2009. Imaging ordered at initial provider visit; clinical utilization, defined as the number of follow-up visits, diagnostic imaging studies, and biopsies completed within 12 months following initial visit. Sixty-percent of women were age 40 or younger, 87% were from racial/ethnic minority groups. Twenty-five percent had imaging ordered at initial visit. Of those who received initial imaging, 75% had normal radiographic findings, yet 98% returned for additional evaluation. In adjusted analyses, women with initial imaging had increased clinical services utilization (OR 25.4, 95% CI: 16.7, 38.6). Women with normal clinical breast exams who received initial imaging exhibited increased odds for subsequent clinical services utilization (OR 23.8, 95% CI: 12.9, 44.0). Six cancers were diagnosed; imaging i...Continue Reading

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Citations

Apr 29, 2016·The Breast Journal·Kim ClarkinWilliam Halperin
May 25, 2018·AJR. American Journal of Roentgenology·Anne C KushwahaWei T Yang
Dec 5, 2019·AJR. American Journal of Roentgenology·Anna I Holbrook
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Sep 30, 2017·Current Opinion in Obstetrics & Gynecology·Manuel Martín-DíazAurora Bueno-Cavanillas

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