The specificity of US was 95% for nondense breasts and 87% for dense breasts [9]. Some authors suggest that, despite the low incidence of malignancy, US may be useful in that it could potentially find treatable causes of breast pain, such as cysts [9]. On the other hand, a prospective, observational follow-up study of 987 patients with breast pain alone found benign findings in 8.6% of cases, which consisted mostly of small cysts [14]. The authors argued that in the absence of a palpable abnormality, any cyst that may be found by US would be unlikely to be large enough to cause pain or benefit from aspiration. MRI Breast MRI Breast There is no relevant literature regarding the use of MRI in the evaluation of focal and noncyclical breast pain. Sestamibi MBI Sestamibi MBI There is no relevant literature regarding the use of MBI in the evaluation of focal and noncyclical breast pain. Variant 4: Female with clinically significant breast pain (focal and noncyclical). Age greater than or equal to 40. Initial imaging. Mammography Though the incidence is low, mammography may be used to exclude malignancy in cases of focal and noncyclical breast pain. Mammography was found to have a high sensitivity (100%) and NPV (100%) in a retrospective review of 206 patients with focal breast pain [11]. While this study found specificity to be slightly lower at Breast Pain 87.6%, another retrospective study of focal, noncyclical pain calculated a specificity of mammography of 97% for nondense breasts and 96% for dense breasts [9]. Additionally, Tumyan et al [38] in a retrospective study of mammography in combination with US found a NPV of 100%, though the study was limited by a significant number of patients being lost to follow-up. A mammogram should be obtained if the patient has not undergone mammography within the last 3 to 6 months.
Breast Pain. The specificity of US was 95% for nondense breasts and 87% for dense breasts [9]. Some authors suggest that, despite the low incidence of malignancy, US may be useful in that it could potentially find treatable causes of breast pain, such as cysts [9]. On the other hand, a prospective, observational follow-up study of 987 patients with breast pain alone found benign findings in 8.6% of cases, which consisted mostly of small cysts [14]. The authors argued that in the absence of a palpable abnormality, any cyst that may be found by US would be unlikely to be large enough to cause pain or benefit from aspiration. MRI Breast MRI Breast There is no relevant literature regarding the use of MRI in the evaluation of focal and noncyclical breast pain. Sestamibi MBI Sestamibi MBI There is no relevant literature regarding the use of MBI in the evaluation of focal and noncyclical breast pain. Variant 4: Female with clinically significant breast pain (focal and noncyclical). Age greater than or equal to 40. Initial imaging. Mammography Though the incidence is low, mammography may be used to exclude malignancy in cases of focal and noncyclical breast pain. Mammography was found to have a high sensitivity (100%) and NPV (100%) in a retrospective review of 206 patients with focal breast pain [11]. While this study found specificity to be slightly lower at Breast Pain 87.6%, another retrospective study of focal, noncyclical pain calculated a specificity of mammography of 97% for nondense breasts and 96% for dense breasts [9]. Additionally, Tumyan et al [38] in a retrospective study of mammography in combination with US found a NPV of 100%, though the study was limited by a significant number of patients being lost to follow-up. A mammogram should be obtained if the patient has not undergone mammography within the last 3 to 6 months.