Focal noncyclical breast pain is rarely a sign of cancer, however, ultrasound may be an appropriate imaging modality for initial examination, according to an article published in the Journal of the American College of Radiology.
A multidisciplinary expert panel annually reviews the American College of Radiology Appropriateness Criteria, evidence-based guidelines for specific clinical conditions, including imaging guidelines for breast cancer screening and diagnosis. The panel reviewed the use of imaging for patients who present with breast pain which, although common, is rarely associated with breast cancer.
According to the panel, appropriate workup depends on the nature and focality of the pain, as well as the age of the patient. Imaging evaluation is usually not indicated if the pain is cyclic or nonfocal, while imaging may be appropriate for complaints of focal, noncyclic pain, mainly for reassurance and to identify treatable causes. Ultrasound can be the initial examination used to evaluate women under age 30 with focal, noncyclic breast pain; for women 30 and older, diagnostic mammography, digital breast tomosynthesis, and ultrasound may all serve as appropriate initial examinations.
In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.