Assess the patient fully to exclude any non-breast pathology. Exclude clinically the presence of any mass lesion and reassure the patient that there is no sinister cause for her pain.
The effect of the pain on the patient's life should then be assessed as it may interfere with work, exercise and relationships with partners or children.
It is also helpful when considering treatment to ask the patient to complete a pain chart for at least two menstrual cycles as this would allow the pattern and duration of the pain to be quantified.
Treatment should be considered when there is a history of pain for at least six months and pain charts show that pain is present for more than seven days per cycle
Reference:
Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005 Jul 21;353(3):275-85
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