title: Evaluation and outcomes of women with a breast lump and a normal mammogram result.
abstract: BACKGROUND
  Many women experience a breast lump. Clinical guidelines suggest that a normal mammogram result alone is not adequate to exclude a diagnosis of cancer.
  
  
  OBJECTIVE
  To examine the characteristics of women with a breast lump and a normal mammogram that were associated with receiving further evaluation, and to examine cancer outcomes.
  
  
  METHODS
  Observational cohort.
  
  
  METHODS
  Women aged 35 to 70 years who participated in a population-based mammography registry and who did not have a history of breast cancer noted at the time of their mammogram that they had a breast lump, and had a "normal" (Breast Imaging Reporting and Data System 1 or 2) mammogram result (n=771).
  
  
  METHODS
  Telephone survey performed 6 months after the mammogram to ascertain information about evaluation. Cancer outcomes within 12 months of the index mammogram were confirmed through linkage with a cancer registry.
  
  
  RESULTS
  Only 56.9% of women reported receiving an adequate evaluation for their breast lump, including a subsequent clinical breast exam, a visit to a breast specialist, an ultrasound, a biopsy, or aspiration. Latinas were less likely than white women to have received adequate evaluation, as were obese women compared with normal-weight women, and uninsured women compared with women with insurance. Among women with at least 12 months of follow-up, 1.4% were diagnosed with cancer.
  
  
  CONCLUSIONS
  Many women do not receive adequate evaluation for a recent breast lump. Interventions should be designed to improve the follow-up of women with this common clinical problem.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02120-1613, USA. jhaas@partners.org
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Haas
authors.forename: Celia P
authors.initials: CP
authors.lastname: Kaplan
authors.forename: Phyllis
authors.initials: P
authors.lastname: Brawarsky
authors.forename: Karla
authors.initials: K
authors.lastname: Kerlikowske
mesh_terms: D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000175:diagnosis*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005348:Fibrocystic Breast Disease / Q000175:diagnosis; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016896:Treatment Outcome