title: Reported breast symptoms in the National Breast and Cervical Cancer Early Detection Program.
abstract: OBJECTIVE
  The frequency and types of breast symptoms reported by women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) have never been characterized. This study aims to establish the frequency of reported symptoms and the diagnostic outcomes associated with reported symptoms.
  
  
  METHODS
  We examined the frequency of symptoms reported prior to mammography using medical record abstraction data from women in the NBCCEDP. We also calculated adjusted odds ratios (aOR) of having an abnormal mammogram, an abnormal clinical breast examination, or a final diagnosis of breast cancer by symptoms, compared to asymptomatic women.
  
  
  RESULTS
  In our sample of women, 10.3 % reported at least one symptom. Women with symptoms were younger and more likely to be non-Hispanic white. Among those reporting symptoms, breast lump (31.7 %) and pain or tenderness (49.3 %) was most common. A relatively low proportion of women with symptoms were diagnosed with in situ (0.9 %) or invasive breast cancer (4.3 %). However, a self-reported breast lump [aOR 13.7; 95 % confidence interval (CI) 7.8-24.1], inflammation or changes to the skin/nipple (aOR 27.8; 95 % CI 8.7-88.8), and other or unspecified symptoms (aOR 3.4; 95 % CI 2.1-7.5) were associated with an increased risk of invasive breast cancer.
  
  
  CONCLUSIONS
  Although the prevalence of breast cancer among women reporting symptoms is relatively low, knowing which symptoms carry the highest breast cancer risk is important to assist in appropriate diagnostic workup.
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, F-76, Atlanta, GA, 30341, USA, ARyerson@cdc.gov.
authors.forename: A Blythe
authors.initials: AB
authors.lastname: Ryerson
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Miller
authors.forename: Christie R
authors.initials: CR
authors.lastname: Eheman
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D063189:Symptom Assessment; D055815:Young Adult