Inefficient imaging: Providers overutilize resources when treating women with breast pain

Breast pain impacts more than half of all women and affects the quality of life of 41 percent of women. Healthcare resources are overutilized to treat these patients, according to a new study published in the American Journal of Roentgenology, suggesting imaging providers should pay closer attention to recommended protocols and referring physicians may need additional education.

The authors studied data from more than 700 patients who presented with breast pain in 2014 at three community breast imaging centers. Pain was on the left side in 43 percent of patients, on the right side in 28 percent and bilateral in 26 percent. Pain was described as “intermittent” in 25 percent of patients, “constant” in 7 percent and unspecified in all other patients.  

Overall, 99 percent of patients presented for diagnostic evaluation and 95 percent of those patients had negative findings. A cancer was detected in one patient. Comparing the presence of cancer in the study group with the concurrent cancer detection rate in the screening population, breast pain was determined to not be a sign of breast cancer.

“Breast pain that occurs in the absence of other symptoms represents an area of over-utilization of health care resources,” wrote Anne C. Kushwaha, MD, of the department of diagnostic radiology at the University of Texas MD Anderson Cancer Center in Houston, Texas, and colleagues. “Dollars spent for this care contribute toward an ineffective use of imaging services.” 

In addition, 316 patients under the age of 40 underwent 454 workup studies for their breast pain for a total cost of more than $87,000. All findings were benign.

“Breast imaging centers should consider altering their imaging protocols and educating their referring physicians regarding the workup of breast pain,” the authors wrote. “Our recommendations for value-based health care for women presenting solely with breast pain should include an annual screening mammogram for women 40 years or older and reassurance for female patients younger than 40 years.”