Non-cyclical mastalgia

This term describes pain felt in the breasts, which is not cyclical or linked to the menstrual cycle.

Occasionally pain may be continuous but it more commonly occurs with a random time pattern. This may be demonstrated by asking the patient to keep a breast pain chart for at least two months.

Notes:

• breast pain is a common symptom experienced by up to two thirds of all women. It is most commonly minor or moderate and is accepted as part of the normal changes of the menstrual cycle. A small proportion of women however have more significant symptoms. Studies have shown that those presenting with mastalgia are psychologically no different from women attending outpatients for other conditions.

• two thirds of women with mastalgia have cyclical pain and the remaining third have pain which is non-cyclical.

• a study in Ireland showed (3):
  • 3,331 reported mastalgia as the only symptom
  • incidence of breast cancer in patients presenting with mastalgia alone was 1.2 %
  • all patients diagnosed with breast cancer in this cohort were over 35 years of age.

Reference:

• Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005 Jul 21;353(3):275-85

• Mansel RE. Breast Pain BMJ 1994;309:866-868.

• Joyce DP et al. Breast clinic referrals: can mastalgia be managed in primary care? Ir J Med Sci. 2014 Dec;183(4):639-42

• Goyal A. Breast Pain. BMJ Clin Evid. 2011; 2011: 0812