ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2014
Risk of breast cancer in symptomatic women in primary care: a case-control study using electronic records.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is real world evidence influencing practice? A systematic review of CPRD research in NICE guidances.BMC health services research · 2016Pooled it
- Likelihood of breast cancer among women presenting with breast-related symptoms in primary care, with a focus on isolated mastalgia: a retrospective cohort study.BMC primary care · 2026Article
- Clinical features, diagnosis, and referral of women with breast abnormalities in primary health care settings in rural Ethiopia: a retrospective record analysis.BMC primary care · 2026Article
- Recent strategies in diagnosis, screening, prevention, and treatment of breast cancer in young women.Discover oncology · 2025Review
- General practitioners' clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries.Scandinavian journal of primary health care · 2025Article
- Variations in Depression and Anxiety among Jordanian Women Undergoing Mastectomy and Reconstruction Surgery: Impact of Familial Support.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Synthesis, andCurrent computer-aided drug design · 2024Article
- Use of artificial intelligence to identify patients to be assessed in a breast clinic on 2-week wait: a retrospective cohort study.Annals of medicine and surgery (2012) · 2023Article
- Awareness of symptoms, anticipated barriers and delays to help-seeking among women at higher risk of breast cancer: A UK multicentre study.Preventive medicine reports · 2023Article
- Pre-Referral Primary Care Blood Tests and Symptom Presentation before Cancer Diagnosis: National Cancer Diagnosis Audit Data.Cancers · 2023Article
- Article
- Identification, characterization, and prognosis investigation of pivotal genes shared in different stages of breast cancer.Scientific reports · 2023Article
- Age and sex can predict cancer risk in people referred with breast symptoms.BMJ (Clinical research ed.) · 2023Article
- A Clinical Prediction Model for Breast Cancer in Women Having Their First Mammogram.Healthcare (Basel, Switzerland) · 2023Article
- Presence of Breast Cancer Information Recorded in United Kingdom Primary Care Databases: Comparison of CPRD Aurum and CPRD GOLD (Companion Paper 1).Clinical epidemiology · 2023Article
- Concordance with urgent referral guidelines in patients presenting with any of six 'alarm' features of possible cancer: a retrospective cohort study using linked primary care records.BMJ quality & safety · 2022Article
- No association between breast pain and breast cancer: a prospective cohort study of 10 830 symptomatic women presenting to a breast cancer diagnostic clinic.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Guideline interval: A new time interval in the diagnostic pathway for symptomatic cancer.Cancer epidemiology · 2021Article
- Metastatic Breast Cancer Masked as Constipation.Cureus · 2021Article
- Comparison of the urgent referral for suspected breast cancer process with patient age and a predictive multivariable model.BJS open · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundBreast cancer is the most common cancer in the UK. GPs are encouraged to refer all women whose symptoms may represent cancer, rather than selecting those at highest risk.
aimTo identify and quantify features of breast cancer in primary care. DESIGN AND
settingA UK case-control study using the Clinical Practice Research Database (CPRD).
methodPossible features of breast cancer were identified in the year before diagnosis, and odds ratios calculated using conditional logistic regression. Positive predictive values (PPVs) were estimated for consulting women.
resultsA total of 3994 women aged ≥40 years with breast cancer between 2000 and 2009, and 16 873 age-, sex-, and practice-matched controls were studied. Median age at diagnosis was 63 years (interquartile range 55-74 years). Four features were significantly associated with breast cancer: breast lump (odds ratio [OR] 110; 95% confidence interval [CI] = I88 to 150), breast pain (OR = 4.2; 95% CI = 3.0 to 6.0), nipple retraction (OR = 26; 95% CI = 10 to 64), nipple discharge (OR = 19; 95% CI = 8.6 to 41): all P-values <0.01. In the year before diagnosis, 1762 (44%) of cases had a breast lump compared with 132 (0.8%) controls. The PPV of breast cancer with a breast lump was 4.8% in women aged 40-49 years, rising to 48% in women aged >70 years. PPVs were lower in women who also reported breast pain.
conclusionGenerally, the figures support current referral practice. However, the low likelihood of cancer for all the non-lump symptoms means that the current guidance recommends investigation for possible cancer at a more liberal risk threshold than for other cancers. Although supported by patients, this may not meet current NHS criteria for cost-benefit.
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