Scapulothoracic bursitis as a significant cause of breast and chest wall pain

Underrecognized and undertreated

Cristiano Boneti, Candy Arentz, Vicki Klimberg

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: Pain is one of the most commonly reported breast complaints. Referred pain from inflammation of the shoulder bursa is often overlooked as a cause of breast pain. The objective of this study is to evaluate the role of shoulder bursitis as a cause of breast/chest pain. Method: An IRB-approved retrospective review from July 2005 to September 2009 identified 461 patients presenting with breast/chest pain. Cases identified with a trigger point in the medial aspect of the ipsilateral scapula were treated with a bursitis injection at the point of maximum tenderness. The bursitis injection contains a mixture of local anesthetic and corticosteroid. Presenting complaint, clinical response and associated factors were recorded and treated with descriptive statistics. Results: Average age of the study group was 53.4 ± 12.7 years, and average BMI was 30.4 ± 7.4. One hundred and three patients were diagnosed with shoulder bursitis as the cause of breast pain and received the bursitis injection. Most cases (81/103 or 78.6%) presented with the breast/chest as the site of most significant discomfort, where 8.7% (9/103) had the most severe pain at the shoulder, 3.9% (4/103) at the axilla and 3.9% (4/103) at the medial scapular border. Of the treated patients, 83.5% (86/103) had complete relief of the pain, 12.6% (13/103) had improvement of symptoms with some degree of residual pain, and only 3.9%(4/103) did not respond at all to the treatment. The most commonly associated factor to the diagnosis of bursitis was the history of a previous mastectomy, present in 27.2% (28/103) of the cases. Conclusions: Shoulder bursitis represents a significant cause of breast/chest pain (22.3% or 103/461) and can be successfully treated with a local injection at site of maximum tenderness in the medial scapular border.

Original languageEnglish (US)
JournalAnnals of Surgical Oncology
Volume17
Issue numberSUPPL. 3
DOIs
StatePublished - Oct 2010
Externally publishedYes

Fingerprint

Bursitis
Thoracic Wall
Mastodynia
Chest Pain
Breast
Injections
Pain
Referred Pain
Trigger Points
Scapula
Shoulder Pain
Axilla
Research Ethics Committees
Mastectomy
Local Anesthetics
Adrenal Cortex Hormones
Thorax
Age Groups
History
Inflammation

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Scapulothoracic bursitis as a significant cause of breast and chest wall pain : Underrecognized and undertreated. / Boneti, Cristiano; Arentz, Candy; Klimberg, Vicki.

In: Annals of Surgical Oncology, Vol. 17, No. SUPPL. 3, 10.2010.

Research output: Contribution to journalArticle

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title = "Scapulothoracic bursitis as a significant cause of breast and chest wall pain: Underrecognized and undertreated",
abstract = "Objectives: Pain is one of the most commonly reported breast complaints. Referred pain from inflammation of the shoulder bursa is often overlooked as a cause of breast pain. The objective of this study is to evaluate the role of shoulder bursitis as a cause of breast/chest pain. Method: An IRB-approved retrospective review from July 2005 to September 2009 identified 461 patients presenting with breast/chest pain. Cases identified with a trigger point in the medial aspect of the ipsilateral scapula were treated with a bursitis injection at the point of maximum tenderness. The bursitis injection contains a mixture of local anesthetic and corticosteroid. Presenting complaint, clinical response and associated factors were recorded and treated with descriptive statistics. Results: Average age of the study group was 53.4 ± 12.7 years, and average BMI was 30.4 ± 7.4. One hundred and three patients were diagnosed with shoulder bursitis as the cause of breast pain and received the bursitis injection. Most cases (81/103 or 78.6{\%}) presented with the breast/chest as the site of most significant discomfort, where 8.7{\%} (9/103) had the most severe pain at the shoulder, 3.9{\%} (4/103) at the axilla and 3.9{\%} (4/103) at the medial scapular border. Of the treated patients, 83.5{\%} (86/103) had complete relief of the pain, 12.6{\%} (13/103) had improvement of symptoms with some degree of residual pain, and only 3.9{\%}(4/103) did not respond at all to the treatment. The most commonly associated factor to the diagnosis of bursitis was the history of a previous mastectomy, present in 27.2{\%} (28/103) of the cases. Conclusions: Shoulder bursitis represents a significant cause of breast/chest pain (22.3{\%} or 103/461) and can be successfully treated with a local injection at site of maximum tenderness in the medial scapular border.",
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