Clinical Presentation and Management of Mastalgia: A Cohort Study

Introduction: Recurring mastalgia, non-cyclical mastalgia and non-specific extra-mammary pain are usually categorised as breast pain. Aim: To determine the most usual aetiology of mastalgia and its response to management modalities like topical Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), bromocriptine and danazol. Materials and Methods: This cohort study was conducted amongst 130 reproductive women within 21 years to 50 years of age group, with breast pain as a chief complaint, in the General Surgery Department from June 2004 to December 2005. General and local clinical assessment was performed as per the proforma. Patients’ past records associated with breast pain were noted in the Out Patient Department (OPD). Patients underwent a comprehensive quantifiable assessment. Patients with flagrant lumps in the breast and lumps discovered with ultrasound or mammography, underwent Fine Needle Aspiration Cytology (FNAC). Results: Amongst the total 130 patients, 41 (31.54%) were in age group of 21-30 years, 72 (55.38%) were in 31-40 years of age group and 17 (13.08%) were in 41-50 years of age group. The most frequent complaint was pain in the breast region which was seen in 92 patients comprising 70.77%, followed by pain with lump in 29 cases comprising 22.31 percent and pain with discharge in 9 patients comprising approximately 6.92%. Cyclic mastalgia was recorded in 22, 44 and 1 patients, non-cyclical mastalgia in 19, 27 and 6 patients and non-specific extra mammary pain in 0, 1 and 10 patients; in the age group of 21-30, 31-40 and 41-50 years respectively. Conclusion: From the present study it is concluded that danazol, followed by bromocriptine and topical NSAIDs were effective in management of mastalgia. Their advantages in relieving symptoms must be balanced against their potential for unfavourable consequences.