Breast pain, or mastalgia, is a common problem. Many women suffer breast pain so severe that it affects their lifestyles, marriages and sexual relationships, and even prevents some from hugging their children.
If no obvious physical cause is found, the problem is all too often dismissed, without appropriate empathy and reassurance, as a normal physiological effect. A careful, sympathetic clinical approach, however, followed by reassurance after examination, will be sufficient treatment for most.
Symptoms of Mastalgia usually presents as a heaviness or discomfort in the breast or as a pricking or stabbing sensation. The pain may radiate down the inner arm when the patient is carrying heavy objects or when the arm is in constant use, as in scrubbing floors.
Key facts and checkpoints
The typical age span for mastalgia is 30-50 years.
The peak incidence is 35-45 years.
There are four common clinical presentations:
1. diffuse, bilateral cyclical mastalgia
2. diffuse, bilateral non-cyclical mastalgia
3. unilateral diffuse non-cyclical mastalgia
4. localised breast pain
The specific type of mastalgia should be identified.
The commonest type is cyclical mastalgia.
Premenstrual mastalgia (part of type 1) is common.
An underlying malignancy should always be excluded.
Less than 10% of breast cancers present with localised pain.
Only about 1 in 200 women with mastalgia are found to have breast cancer.
The problems, especially types 2 and 3, are difficult to alleviate.
2011 John Murtagh's Fifth edition published