Breast complaints and age as indicators of breast diseases

Breast complaints seem to be related to the age of the patients, than to their pathology and in women over 55 years breast cancer is more frequent. We have looked for a definite correlation between patients’ sign and symptoms, age and risk of benign or malignant breast diseases. From 1983 to 1994 we observed 2356 consecutive patients with breast disease who were asked to complete a questionnaire before clinical examination. Only 242 (10.3%) patients had already a mammography or breast ultrasonography. Patients were assigned by age to three groups: group A (40 years old or younger) = 47.3%, group B (41-55 years) = 26.9%, group C (over 55 years) = 23.8%. Pain was the most frequent complaint (58.8%) in group A whereas a breast lump was most commonly found in groups B and C. In only 49.5% of the patients a breast mass was really detected at clinical examination. Breast cancer was found in 240 (10.2%) patients (group A = 0.8%, group B = 12.8%, group C = 25.8%). The predominant finding in all groups was fibrocystic breast disease (FBD). A statistically significant correlation between malignancy and breast lump was evident only in groups B and C (P < 0.05) but no correlation between malignancy and pain was found in any group (P = NS). The occurrence of cancer in 541 patients with FNAB-confirmed FBD over a median follow-up of 56 months (range 12-140 months) was similar to that reported for the general population. Many patients with breast complaints do not have any breast disease and more than 90% of the examined patients do not have cancer. In women 40 years of age and under with no history of malignancy the cancer rate is very low (< 1%) and a significant correlation between breast complaints and risk of cancer does not seem to exist. There is a need for a better information as to the significance of breast complaints.