Mastalgia: A narrative literature review of current understanding and management

Abstract

Mastalgia, or breast pain, is one of the most common breast symptoms experienced by women of reproductive age. The cyclical variant of mastalgia is predominant, and patients need proper assessment and management to allay their 2 chief concerns: (1) the severity of pain negatively impacting daily life and (2) the fear of harbouring malignancy. This article presents a brief review of various modalities of management for cyclical mastalgia and emphasizes data collected from peer-reviewed literature published in the last decade.

Response to different medical treatment options for mastalgia in fibrocystic breast disease

“…3 Mastalgia caused by fibrocystic breast disease is treated by breast specialists as well as by those not specialized in breast diseases. 4 Unfortunately, these patients are treated inappropriately for prolonged duration with nonpharmacological management by Evening Primrose Oil 2,5 in a fear of more side effects of pharmacological managements by certain drugs. 6 Inappropriate selection of non-pharmacological treatment as a first line management option, sometimes creates financial burden and unchanged or recurrence of clinical symptoms.…”

“…8,9 Non pharmacological options of medical managements includes some life style modifications (LSM) like-an appropriately fitting and supportive bra, avoidance of caffeine drinks, reduction of dietary fat, increase fiber rich diet, physical exercise to reduce weight and relaxation training are said to be helpful for the treatment of mastalgia 10 and some nutritional supplementations like oil of evening primrose (EPO) will help more than half of these women 5,10,11 . For those with intractable symptoms, Pharmacological options of medical management like-an anti-gonadotropin, (Danazol 6) , or a prolactin inhibitor (Bromocriptine 5) , may be tried. Very rarely, it is necessary to prescribe an anti-estrogen, for example tamoxifen 12,13 , or a luteinizing hormonereleasing hormone (LHRH) agonist to deprive the breast epithelium of estrogenic drive.…”

Nuclear medicine hybrid imaging (SPECT/CT) in distinguishing the presence of a hepatic hemangioma: Single center study

“…Correspondingly, most of the 99mTc-RBC scan positive cases, require only follow up without further treatment, whereas negative cases require further evaluation for definite diagnosis and clinical management. The scintigraphic method gives characteristic pattern for diagnosing HH, with initial hypoperfusion followed by a gradual accumulation of activity, giving the so-called "perfusion-blood pool mismatch" pattern (18). In spite of the guidelines for hemangioma that recommend including initial flow images, it is not routinely performed at our department, as the delayed phase combined with SPECT/CT is the most accurate one (19).…”

The effect of sex counseling based on (permission, limited information, specific suggestions, intensive therapy) model on sexual satisfaction in women with cyclic mastalgia: A randomized controlled clinical trial

“…In many cases, the probable cause of breast pain is the changes in hormone levels or psychological stress (due to anxiety or fear of cancer). [ 6 7 ] Other causes include imbalance between hormones of estrogen, progesterone, elevation prolactin level, fat metabolism disorder, stress, anxiety, depression, breast size, weight gain, nutrition, lack of vitamins, and caffeine consumption. [ 8 ] Mastalgia could be severe enough to alter one's lifestyle.…”