Mastalgia: Risk Factors and Treatment Strategies Used at Two Breast Clinics in Pakistan
Background: Mastalgia is one of the commonest symptoms of breast disorder and a major cause of anxiety amongst women. The aim of this study was to determine the risk factors associated with the onset and severity of mastalgia, their association with various breast disorders, and response to strategies used for its treatment.
Material and Methods: This prospective descriptive study was carried out at Combined Military Hospitals (CMH) of Rawalpindi and Thall over a period of six months from January to July 2017. Women presenting to breast surgery clinic with complaints of breast pain, heaviness, and tenderness were included in the study. Patients were initially evaluated at the time of presentation, treatment was initiated, followed by re-evaluation after six months. A multiple logistic regression model was used to determine association of mastalgia with various conditions and their effect on severity of mastalgia.
Results: A total of 93 women presented to the breast clinics during this period. Cyclical mastalgia was noted in 39.8% women while 60.2% had non-cyclical mastalgia. In 41.9% patients no underlying pathology was noted, 49.5% patients had benign disorders while 8.6% had malignancy. Increased BMI (P = .002) and lack of exercise (P = .01) were associated with onset of mastalgia while use of oral contraceptive pills (P < .001) was associated with low risk of mastalgia. Of all the patients, 45.1% responded to measures like reassurance, dietary and lifestyle modifications while 54.9% were treated with pharmacological therapy. Those diagnosed having underlying malignant disorder were treated according to the type and stage of malignancy.
Conclusions: Various factors affect the onset and severity of mastalgia and different treatment strategies can be used to alleviate the symptoms. Hence, complete and thorough evaluation of the patients presenting with mastalgia should be carried out to rule out any underlying pathology.
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