Title: Updated Study of the Aetiopathogenesis and Clinical Management of Mastalgia

Author: Dr Mohammad Eqbal Ahmad

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.99

Abstract

Introduction: Breast pain or Mastalgia is a common and disturbing clinical disorder in females. Due to the complex and multiple aetiological factors, and different modalities of treatment, it poses a challenging problem to the surgeons.

Methods: Study of the aetiologies associated and treatment modality effective in treatment of 450 female patients of Breast pain, attending surgical O.P.D. of Nalanda Medical College, Patna, in the period July 14 – May 17, was done.

Results: 450 patients with a median age of 35 (range 19-51 years) were observed. The aetiologies associated, investigations and satisfactory treatment modalities were studied. The incidence of patients needing hormone replacement therapy with Danazol, was noted.

Conclusion: 140 patients (31.1%) had a direct relation with menstrual cycle. They got relief in pregnancy and after menopause (Cyclical Mastalgia). Reassurance with periodic breast support and NSAIDS (topical / oral) got them relief. 91 patients (20.2%) having fibroadenoma(s) benefitted by surgical removal, histology exam of the nodule(s), followed by reassurance and Analgesics. 290 patients (64.4%) needed hormone replacement therapy with Danazol, for a period of 4-6 months. They included some patients of cyclical mastalgia as well as those having nodules.

Keywords: Mastalgia, F.N.A.C., Birads score, Ultrasonomammography, Danazol.

References

1.      Smith R L, Pruthi S, Fitzpatrick LA (2004) – Evaluation and Management of Breast Pain Mayo clinic Proc. 79(3) 353-372.

2.      Mansel R E, Webster DJT, Sweetland HM (2009) – Brest Pain and nodularity, Benign disorders and diseases of the breast 3rd edn., Saunders Elsevier, Philadelphia, pp 107-138

3.      Shukla H S, Kumar S (1989) – Part II Benign Breast disorders in India, World J Sury 13(6) 746-749.

4.      Gateley CA, Mansel RE – Management of painful and nodular breast Br. Med. Bull. 47(2) 284-294.

5.      Wisbey JR, Kumar S, Mansel RE, Preece PE, Pye JK, Hughes LE (1985) Natural History of Breast Pain Lancet, 672-274.

6.      Asch RH, Greenblatt RB (1971) – The use of Danazol in management of Benigen Breast disorder Am.J.Obst. Gyne 127 pp.130-134.

7.      Srivastava A, Dhar A (2007) – Role of Centchroman in regression of Mastalgia and fibroadenoma, World J. Surg. 31 pp.1178-1184.

8.      Kataria K, Dhar A et al : Review of the current understanding and management of Mastalgia: Ind J Sug Vol 73(3)  pp 217-222.

Corresponding Author

Dr Mohammad Eqbal Ahmad

MBBS, MS (Surj.) FAIS, D.A.

Associate Professor Dept. of Surgery, Nalanda Medical College, Patna