Incidental breast cancers identified in the one-stop symptomatic breast clinic

Abstract

Purpose: Breast cancers can be asymptomatic at an early stage and hence screening programmes play an important role in detecting breast cancers early. Even in those patients who present with breast symptoms, breast cancers may be present at a site remote to the site of symptoms. In this study, we aimed to assess the frequency, site and imaging modality used to identify these incidental cancers in the symptomatic one-stop breast clinic.

Methods: All patients who were seen in our breast clinic with breast symptoms over a two-year period were included in the study. We correlated the presenting symptoms of patients diagnosed with breast cancer with imaging (mammogram and ultrasound) findings. Incidental cancers were defined as "histologically confirmed breast cancers which were impalpable, remote to the site of symptoms and only identified on imaging."

Results: In the study period, 281 women were diagnosed with breast cancer out of 4,400 patients seen at the one-stop breast clinic. Thirty six patients (12.8%) diagnosed with breast cancer had an incidental cancer which was only identified by imaging. The majority of contralateral, incidental cancers were identified by both mammography and ultrasound (US) and patients were all above 35 years.

Conclusion: We suggest mammography of both breasts and US of the symptomatic breast in order to identify incidental cancers.

Keywords: Breast; Mammography; Ultrasonography.

Figure 1

Diagrammatic representation of breast cancers diagnosed in the one-stop clinic.