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Diagnostic Imaging for Breast PainA Teachable Moment

Educational Objective:
To describe when diagnostic imaging is unnecessary in patients with breast pain.
1 Credit CME

A 36-year old-woman with no personal or family history of cancer presented to her primary care physician’s office with 3 months of intermittent breast pain. She experienced diffuse right breast pain that was not associated with menses. She had regular menses and denied fevers, trauma, discharge, skin changes, or other risk factors for breast cancer. Breasts were unremarkable on examination apart from diffuse, mild tenderness to palpation of the right breast. There were no focal masses or axillary lymphadenopathy.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding author: Colin Bergstrom, MD, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8852 (cbergstr1288@gmail.com).

Published Online: August 17, 2020. doi:10.1001/jamainternmed.2020.2432

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

Additional Information: Dr Bergstrom was an internal medicine resident at the time of preparation and submission of manuscript for this article. Dr Keshvani was an internal medicine resident and JAMA Internal Medicine Teachable Moment Editorial Fellow.

References
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Kushwaha  AC , Shin  K , Kalambo  M ,  et al.  Overutilization of health care resources for breast pain.   AJR Am J Roentgenol. 2018;211(1):217-223. doi:10.2214/AJR.17.18879PubMedGoogle ScholarCrossref
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Holbrook  AI , Moy  L , Akin  EA ,  et al; Expert Panel on Breast Imaging.  ACR appropriateness criteria® breast pain.   J Am Coll Radiol. 2018;15(11S):S276-S282. doi:10.1016/j.jacr.2018.09.014PubMedGoogle ScholarCrossref
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Mohallem Fonseca  M , Lamb  LR , Verma  R , Ogunkinle  O , Seely  JM .  Breast pain and cancer: should we continue to work-up isolated breast pain?   Breast Cancer Res Treat. 2019;177(3):619-627. doi:10.1007/s10549-019-05354-1PubMedGoogle ScholarCrossref
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