Utility of targeted sonography in the evaluation of focal breast pain

Objective. To determine the utility of targeted sonography in the evaluation of patients with focal breast pain. Methods. From January 1995 through December 1999, 110 targeted sonographic examinations were performed in 99 patients for evaluation of focal breast pain in the absence of an associated palpable mass. The sonographic, mammographic, and clinical findings were reviewed. The hospital pathology database was searched to identify any interval cancers and false-negative interpretations. Results. No cancer was identified in any of the 110 examinations. Eighty-five (77.3%) of the examinations had negative findings. Cysts were identified in 15 cases (13.6%), and 3 solid masses (2.7%) were identified. Two of these 3 solid masses had biopsies and were shown to be benign, whereas the third mass was followed for 29 months without change. Most patients were premenopausal, had no family or personal history of breast cancer, and were not taking exogenous hormones. Eighty-five patients (77%) were referred by primary care physicians. Conclusions. In patients with focal breast pain without an associated palpable mass, sonography may be more useful for patient reassurance than for cancer detection.