Clinical value of mammography for symptomatic women 35 years of age and younger.

OBJECTIVE This retrospective observational study was designed to answer the following question: Is mammography clinically effective in the evaluation of women </=35 years old with breast symptoms or findings. STUDY DESIGN A retrospective review was undertaken of 1908 consecutive initial mammogram reports of symptomatic women </=35 years old who came to a referral breast clinic. The clinic records were analyzed for the working diagnoses and management plans before and after the input of the initial mammogram reports. RESULTS Of the 4160 initial mammograms of women who came (1992-1995) to the Breast Diagnostic Center at Women's and Children Hospital, Los Angeles, Calif, 1908 were of women </=35 years old. The mammogram reports were reviewed and tabulated by age group for mammography recommendations. The working diagnoses and management plans in the center's charts were retrospectively evaluated before and after the mammogram reports to ascertain whether the mammogram reports altered clinical management in this patient population and age group. No clinically unsuspected cancers were perceived by mammography performed at the center in women </=35 years old. (All of the 23 invasive cancers were palpable and had prior diagnoses after fine-needle aspiration biopsy.) The initial mammogram reports did not change the working diagnosis or clinical management of these cases in this patient population and clinic setting. Ultrasonography was recommended by the radiologists in 37% of the study cases. CONCLUSIONS Routine initial mammography was not cost-effective or clinically beneficial in the evaluation of breast symptoms or findings and management of the cases of women </=35 years old who came to our center.