University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Advocate Lutheran General Hospital, Park Ridge, IL, USA.
J Breast Imaging. 2024 May 27;6(3):311-326. doi: 10.1093/jbi/wbae001.
Breast pain is extremely common, occurring in 70% to 80% of women. Most cases of breast pain are from physiologic or benign causes, and patients should be reassured and offered treatment strategies to alleviate symptoms, often without diagnostic imaging. A complete clinical history and physical examination is key for distinguishing intrinsic breast pain from extramammary pain. Breast pain without other suspicious symptoms and with a negative history and physical examination result is rarely associated with malignancy, although it is a common reason for women to undergo diagnostic imaging. When breast imaging is indicated, guidelines according to the American College of Radiology Appropriateness Criteria should be followed as to whether mammography, US, or both are recommended. This review article summarizes the initial clinical evaluation of breast pain and evidence-based guidelines for imaging. Additionally, the article reviews cyclical and noncyclical breast pain and provides an image-rich discussion of the imaging presentation and management of benign and malignant breast pain etiologies.
乳房疼痛极为常见，发生于 70%至 80%的女性。大多数乳房疼痛为生理性或良性原因所致，应使患者安心并提供缓解症状的治疗策略，通常无需进行诊断性影像学检查。完整的临床病史和体格检查对于区分内在乳房疼痛与乳房外疼痛至关重要。无其他可疑症状且病史和体格检查结果阴性的乳房疼痛很少与恶性肿瘤相关，尽管它是女性进行诊断性影像学检查的常见原因。当需要进行乳房影像学检查时，应遵循美国放射学院适宜性标准指南，以确定是否推荐行乳房 X 线摄影、超声或两者联合检查。本文总结了乳房疼痛的初始临床评估和基于证据的影像学检查指南。此外，本文还回顾了周期性和非周期性乳房疼痛，并提供了有关良性和恶性乳房疼痛病因影像学表现和处理的丰富图片讨论。
