Breast pain - common symptom for women during their reproductive years

Aetiology

• Mastalgia is rarely associated with malignancy unless there is a palpable breast mass

Pathophysiology

• Usually cyclic but can be noncyclic
• Most women presenting with cyclic mastalgia have an intense variant of physiologic breast changes that occur during the menstrual cycle
  • The cyclic variant is usually diffuse and most intense during the immediate premenstrual phase of the cycle
  • Cyclic mastalgia is usually bilateral but can be unilateral
• Noncyclic mastalgia is usually localized, often persistent, and less responsive to treatment than cyclic mastalgia

Management

• After complete evaluation and examination including a mammogram for a woman aged 35 or older, the patient can be reassured that there is no evidence of cancer and that her symptoms are physiologic
• Therapies (if required) include evening primrose oil and tamoxifen