Abstract
Purpose
The frequency and types of breast symptoms reported by women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) have never been characterized. This study aims to establish the frequency of reported symptoms and the diagnostic outcomes associated with reported symptoms.
Methods
We examined the frequency of symptoms reported prior to mammography using medical record abstraction data from women in the NBCCEDP. We also calculated adjusted odds ratios (aOR) of having an abnormal mammogram, an abnormal clinical breast examination, or a final diagnosis of breast cancer by symptoms, compared to asymptomatic women.
Results
In our sample of women, 10.3 % reported at least one symptom. Women with symptoms were younger and more likely to be non-Hispanic white. Among those reporting symptoms, breast lump (31.7 %) and pain or tenderness (49.3 %) was most common. A relatively low proportion of women with symptoms were diagnosed with in situ (0.9 %) or invasive breast cancer (4.3 %). However, a self-reported breast lump [aOR 13.7; 95 % confidence interval (CI) 7.8–24.1], inflammation or changes to the skin/nipple (aOR 27.8; 95 % CI 8.7–88.8), and other or unspecified symptoms (aOR 3.4; 95 % CI 2.1–7.5) were associated with an increased risk of invasive breast cancer.
Conclusions
Although the prevalence of breast cancer among women reporting symptoms is relatively low, knowing which symptoms carry the highest breast cancer risk is important to assist in appropriate diagnostic workup.

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The authors declare that they have no conflict of interest.
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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
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Ryerson, A.B., Miller, J. & Eheman, C.R. Reported breast symptoms in the National Breast and Cervical Cancer Early Detection Program. Cancer Causes Control 26, 733–740 (2015). https://doi.org/10.1007/s10552-015-0544-1
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DOI: https://doi.org/10.1007/s10552-015-0544-1