Estimated breast cancer risk and screening outcomes among premenopausal women with non-cyclic mastalgia.

OBJECTIVES Breast pain is a common but worrisome symptom, which can cause a significant psychological burden of cancer stress. It is not known whether breast cancer risk estimation models can be used as an adjunct to the clinical and radiological assessment in counseling women with mastalgia. The aim of our study was to compare the estimated breast cancer risk and screening outcomes between patients with mastalgia and women requesting prophylactic examinations. MATERIAL AND METHODS 112 premenopausal women with non-cyclic breast pain and 182 control women who presented for prophylactic examination were screened with mammography and ultrasound. Breast cancer risk estimated with the Gail and Tyrer-Cuzick models along with screening outcomes were compared between the groups. RESULTS Premenopausal patients with mastalgia had lower estimated breast cancer risk than controls. The difference was observed with both the Gail and Tyrer-Cuzick models (Gail 5-year risk: 0.66 +/- 0.4% vs. 0.77 +/- 0.4%, p=0.0002; Tyrer-Cuzick 5-year risk: 0.85 +/- 0.4% vs. 0.95 +/- 0.3%, p=0.002; Gail lifetime risk: 8.98 +/- 3.6% vs. 9.6 +/- 3.9%, p=0.015; Tyrer-Cuzick lifetime risk: 8.3 +/- 3.1 % vs. 8.9 +/- 2.7 %, p=0.045). Radiological and clinical outcomes were comparable between the groups. CONCLUSIONS Breast pain was associated with lower estimated breast cancer risk but had no effect on screening outcomes in the study population.