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. 2008 Nov-Dec;6(6):528-33.
doi: 10.1370/afm.905.

Characterizing breast symptoms in family practice

Margaret M Eberl  1 , Robert L Phillips Jr, Henk Lamberts, Inge Okkes, Martin C Mahoney
Affiliations

Characterizing breast symptoms in family practice

Margaret M Eberl et al. Ann Fam Med. 2008 Nov-Dec.

Abstract

Purpose: The frequency and outcome of breast symptoms have not been well characterized in primary care settings. To enhance and inform physician practice, this study aims to establish the proportion of visits and resultant diagnoses by age by examining longitudinal data on breast-related reasons for encounter.

Methods: We used data from a prospective longitudinal sample of patients seeking care in Dutch family physician offices between 1985 and 2003 to provide routine family practice data on breast symptoms as the reason for encounter; all visits were coded using the International Classification of Primary Care. Data on breast symptom prevalence are based upon 84,285 active female patients and 367,834 total encounters.

Results: Overall breast symptoms were reported in about 3% of all visits by female patients (29.7 per 1,000 active female patients per year); breast pain and breast mass were the most common breast-related complaints. Breast symptom complaints were highest among women aged 25 to 44 years (48 of 1,000) and among women aged 65 years and older (33 per 1,000). Of the women complaining of breast symptoms, 81 (3.2%) had breast cancer diagnosed. Breast mass had a markedly elevated positive likelihood ratio for breast cancer (15.04; 95% confidence interval, 11.74-19.28).

Conclusions: As expected, of patients with breast symptoms only a small subset was subsequently given a diagnosis of breast cancer (3.2%); however, the presence of a breast mass was associated with an elevated likelihood of breast cancer. These data illustrate the use of systematic data collection and classification from primary care offices to extract information regarding disease symptoms and diagnoses.

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Figures

Figure 1.
Figure 1.
Age distribution for episodes of care based on active female patients (N = 84,285), Dutch Transition Project, 1985–2003.
Figure 2.
Figure 2.
Proportion of final diagnosis of breast cancer per 100 breast-related reasons for encounter, Dutch Transition Project, 1985–2003, by symptom/complaint. Other=other breast symptom; RFE=reason for encounter.
See this image and copyright information in PMC

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