Cyclical mastalgia



Introduction
Epidemiology
Clinical features
Management


Introduction

Benign cyclical mastalgia is a common cause of breast pain in younger females.

Epidemiology

  • Incidence: 1000.00 cases per 100,000 person-years
  • Peak incidence: 30-40 years
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

Clinical features
  • It varies in intensity according to the phase of the menstrual cycle
  • Cyclical mastalgia is not usually associated with point tenderness of the chest wall (more likely to be Tietze's syndrome).
  • The underlying cause is difficult to pinpoint, examination should focus on identifying focal lesions (such as cysts) that may be treated to provide symptomatic benefit.

Management

Management
  • Women should be advised to wear a supportive bra.
  • Conservative treatments include standard oral and topical analgesia
  • flaxseed oil and evening primrose oil are sometimes used but neither are recommended by NICE Clinical Knowledge Summaries
  • If the pain has not responded to conservative measures after 3 months, and is affecting the quality of life or sleep, then referral should be considered
    • Hormonal agents such as bromocriptine and danazol may be more effective. However, many women discontinue these therapies due to adverse effects.