Mastalgia

Breast pain - common symptom for women during their reproductive years

Aetiology

  • Mastalgia is rarely associated with malignancy unless there is a palpable breast mass

Pathophysiology

  • Usually cyclic but can be noncyclic
  • Most women presenting with cyclic mastalgia have an intense variant of physiologic breast changes that occur during the menstrual cycle
    • The cyclic variant is usually diffuse and most intense during the immediate premenstrual phase of the cycle
    • Cyclic mastalgia is usually bilateral but can be unilateral
  • Noncyclic mastalgia is usually localized, often persistent, and less responsive to treatment than cyclic mastalgia

Management

  • After complete evaluation and examination including a mammogram for a woman aged 35 or older, the patient can be reassured that there is no evidence of cancer and that her symptoms are physiologic
  • Therapies (if required) include evening primrose oil and tamoxifen