Time to revisit the enigma of mastalgia management
DOI:
https://doi.org/10.18203/2349-2902.isj20242782Keywords:
Mastalgia, Mastodynia, Breast pain, Management of mastalgiaAbstract
Mastalgia (breast pain) also known as mastodynia, is one of the most common causes of breast issues for which a female visits a medical practitioner. It is divided into cyclical mastalgia, which is associated with menstruation, or can be noncyclical mastalgia which can present premenopausal or postmenopausal. The incidence of breast cancer associated with mastalgia is extremely low and reassurance plays a major role in the treatment of patients. Hormonal changes have been associated with the pathogenesis of cyclical mastalgia. Outdated treatment modalities are still being followed even though newer and more effective treatment options have been established. Objective assessment of breast pain should be done with the visual analog scale. Non-pharmacological therapy should be encouraged in every patient of mastalgia such as counseling and reassurance, sports bra, yoga, and relaxation therapy. Tamoxifen and ormeloxifene are now the drug of choice in severe mastalgia and care should be taken to counsel the patients about use and common and detrimental side effects. The available treatment modalities and their directions to use are discussed in this review.
Metrics
References
Mohammed AA. Evaluation of mastalgia in patients presented to the breast clinic in Duhok city, Iraq: Cross-sectional study. Ann Med Surg (Lond). 2020;52:31-5.
RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clin Proc. 2004;79(3):353-72.
Jokich PM, Bailey L. Expert panel on breast imaging. ACR appropriateness criteria® breast pain. J Am Coll Radiol. 2017;14(5):25-33.
Sen M, Kilic MO, Cemeroglu O, Icen D. Can mastalgia be another somatic symptom in fibromyalgia syndrome? Clinics (Sao Paulo). 2015;70(11):733-7.
Mansel RE, Dogliotti L. European multicentre trial of bromocriptine in cyclical mastalgia. Lancet. 1990;335:190-3.
SEER training modules, module name. U. S. National Institutes of Health, National Cancer Institute. 2023. Available at: https://training.seer. cancer.gov. Accessed on 3 June 2024.
Love SM, Gelman RS, Silen W. Sounding board. Fibrocystic "disease" of the breast-a nondisease? N Engl J Med. 1982;307(16):1010-4.
Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med. 1985;312(3):146-51.
Malherbe K, Khan M, Fatima S. Fibrocystic breast disease. 2023. Available at: https://www.ncbi. nlm.nih. Accessed on 3 June 2024.
Malarkey WB, Schroeder LL, Stevens VC, James AG, Lanese RR. Twenty-four-hour preoperative endocrine profiles in women with benign and malignant breast disease. Cancer Res. 1977;37(12):4655-9.
Wisbey JR, Kumar S, Mansel RE, Peece PE, Pye JK, Hughes LE. Natural history of breast pain. Lancet. 1983;2(8351):672-4.
Parlati E, Travaglini A, Liberale I, Menini E, Dell'Acqua S. Hormonal profile in benign breast disease. Endocrine status of cyclical mastalgia patients. J Endocrinol Invest. 1988;11(9):679-83.
Ramakrishnan R, Werbeck J, Khurana KK, Khan SA. Expression of interleukin-6 and tumor necrosis factor alpha and histopathologic findings in painful and nonpainful breast tissue. Breast J. 2003;9(2):91-7
Arslan M, Küçükerdem HS, Can H, Tarcan E. Retrospective analysis of women with only mastalgia. J Breast Health. 2016;12(4):151-4.
Joyce DP, Alamiri J, Lowery AJ. Breast clinic referrals: can mastalgia be managed in primary care? Ir J Med Sci. 2014;183(4):639-42.
Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227-36.
Gautam S, Srivastava A, Kataria K, Dhar A, Ranjan P, Kumar J. New Breast Pain Chart for Objective Record of Mastalgia. Indian J Surg. 2016;78(3):245-8.
Yılmaz EM, Çelik S, Arslan H, Değer D. Relation between Mastalgia and Anxiety in a Region with High Frequency of Posttraumatic Stress Disorder. J Breast Health. 2015;11(2):72-5.
Hadi MS. Sports Brassiere: Is It a Solution for Mastalgia? Breast J. 2000;6(6):407-9.
Tejwani PL, Srivastava A, Nerkar H, et al. Centchroman regresses mastalgia: a randomized comparison with danazol. Indian J Surg. 2011;73(3):199-205.
Fox H, Walker LG, Heys SD, Ah-See AK, Eremin O. Are patients with mastalgia anxious, and does relaxation therapy help? Breast. 1997;6:138-42
Jaiswal G, Thakur GS. An alternative yogic approach for cyclical mastalgia-A narrative review. J Family Med Prim Care. 2021;10(2):601-8.
Colak T, Ipek T, Kanik A, Ogetman Z, Aydin S. Efficacy of topical nonsteroidal antiinflammatory drugs in mastalgia treatment. J Am Coll Surg. 2003;196(4):525-30.
Uzan S, Denis C, Pomi V, Varin C. Double-blind trial of promegestone (R 5020) and lynestrenol in the treatment of benign breast disease. Eur J Obstet Gynecol Reprod Biol. 1992;43(3):219-27.
Fentiman IS, Caleffi M, Brame K. Double-blind controlled trial of tamoxifen therapy for mastalgia. Lancet. 1986;8376:287-8.
Maddox PR, Harrison BJ, Mansel RE. Low-dose danazol for mastalgia. Br J Clin Pract Suppl. 1989;68:43-53.
Kumar S, Mansel RE, Scanlon MF. Altered responses of prolactin, luteinizing hormone and follicle stimulating hormone secretion to thyrotrophin releasing hormone/gonadotrophin releasing hormone stimulation in cyclical mastalgia. Br J Surg. 1984;71(11):870-3.
Dhar A, Srivastava A. Role of centchroman in regression of mastalgia and fibroadenoma. World J Surg. 2007;31(6):1178-84.
L Elizabeth, N Rizkalla, Simerjit R, Vishwanath L. Vitamin D supplementation in the treatment of non-cyclical breast pain. J Pain Relief. 2018;7(5):330.
Pye JK, Mansel RE, Hughes LE. Clinical experience of drug treatments for mastalgia. Lancet. 1985;2(8451):373-7.
Ahmad Adni LL, Norhayati MN, Mohd Rosli RR, Muhammad J. A systematic review and meta-analysis of the efficacy of evening primrose oil for mastalgia treatment. Int J Environ Res Public Health. 2021;18(12):6295.
Downloads
Published
How to Cite
Issue
Section
