Rate of breast cancer diagnoses among postmenopausal women with self-reported breast symptoms.
BACKGROUND
Breast cancer rates in women with multiple breast symptoms have not been well described.


METHODS
We examined the association between self-reported symptoms (lump, nipple discharge, pain, other) and breast cancer risk for screening and diagnostic mammograms in 57,681 women. Subanalyses evaluated risk among women with no prior mammograms, new symptoms, and repeated symptoms. One thousand, three hundred and eighty-nine women were diagnosed with cancer within 12 months of their mammograms. We calculated the breast cancer rate for each symptom and odds ratios (OR) with 95% confidence intervals (CI) for breast cancer among symptomatic women compared with asymptomatic women.


RESULTS
Women reporting a lump had an increased odds of breast cancer compared with asymptomatic women (OR for diagnostic examination = 2.8, 95% CI = 2.3 to 3.4; OR for screening examination = 3.6, 95% CI = 2.6 to 5.0). No other symptoms were associated with breast cancer after controlling for a reported lump. A new lump at a diagnostic examination was significantly predictive of cancer among women with no prior mammograms (OR = 12.2, 95% CI = 2.8 to 53.5); reporting symptoms at 2 successive exams had little effect on breast cancer risk (OR for lump = 1.2, 95% CI = 0.6 to 2.5).


CONCLUSIONS
Having a lump is the most predictive symptom of breast cancer whether it is reported at a screening or diagnostic examination or in conjunction with other symptoms.
Aiello
Erin J
EJ
Group Health Cooperative, Center for Health Studies, Seattle, WA 98101, USA. aiello.e@ghc.org
Buist
Diana S M
DS
White
Emily
E
Seger
Deborah
D
Taplin
Stephen H
SH
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012650:Self Disclosure