Impact of Breast Pain on Health Care Utilisation in a Clinic Based Sample and its Associated Life Style Factors

Objectives: Mastalgia is a common presentation in breast new patient clinic in the UK and poses significant pressure on the utilisation of breast services. A prospective descriptive study was carried out to evaluate the prevalence of breast pain, aetiology and associated pattern of health care utilisation. Method: We assessed the aetiology of breast pain in a clinic based sample using a questionnaire distributed to patients presenting with breast pain over a 3month period and recorded their investigations and outcomes. Results: Over the 3months period, 526 patients attended breast clinic, of those 115 presented with breast pain (22%). 32(28%) of these patient were under age 35. Imaging studies was performed in 96% of patients and they were found to be normal or benign in 99% of cases. All patients under age of 35 had normal scans. Lifestyle questionnaire reviewed a weak association with lifestyle factors such as smoking (20%), moderate to high caffeine intake (15%), alcohol (5%). 45% patients suffers from other pain issues. Conclusions: Breast pain is a common condition, which poses a significant pressure on utilisation of breast services, accounting for 22% of referrals in our current study. It is associated with high use of mammography in young women. Aetiology of breast pain remains unclear. Should we continue to perform investigations in patients with breast pain alone and normal clinical examination or should we tailor to age/risk? Further studies needed to understand the pathology and associated factors.