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Mastalgia

Manju Mahajan, MD, FAAFP Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Painful breast tissue, often bilateral, which can be cyclic and noncyclic. It also may be focal or diffuse

    • 2/3 of breast pain is cyclic and usually associated with hormonal changes re...

DIAGNOSIS

HISTORY

  • Location, duration, frequency, severity, associated symptoms, related activities (e.g., trauma), and aggravating and ameliorating factors

  • Complete medical history with focus on gynecol...

TREATMENT

GENERAL MEASURES

  • Stop or modify the current hormonal therapy.

  • A repeat examination may help to establish any cyclic nodularity pattern.

  • Wear a properly fitted support bra (maybe fitted by a pro...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

As needed 

Patient Monitoring

  • As needed for patients not receiving pharmacotherapy

  • Time of follow-up will vary by type of pharmacotherapy and patient’s particular pr...

REFERENCES

1
Cornel LF, Sandhu NP, Pruthi S, et al. Current management and treatment options for breast pain. Mayo Clin Proc. 2020;95(3):574-580.
2
Scurr  J, Hedger  W, Morris  P, ...

ADDITIONAL READING

  • Groen JW, Grosfeld S, Bramer WM, et al. Cyclic and non-cyclic breast-pain: a systematic review on pain reduction, side effects, and quality of life for various treatments...

SEE ALSO

  • Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

  • Algorithms: Breast Discharge; Breast Pain

CODES

ICD10

N64.4 Mastodynia 

SNOMED

  • 53430007 Pain of breast (finding)

  • 237453001 Cyclical mastalgia

  • 237454007 Non-cyclical mastalgia

  • 315250005 Persistent mastalgia (finding)

  • 135876005 Mastalgia of puberty (f...

CLINICAL PEARLS

  • When evaluating a patient with focal non-cyclical breast pain, imaging may be beneficial to identify anatomical causes.

  • In the adolescent population, do not biopsy; instead, refer to a ...

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