Clinical Approach to Patients with Mastalgia in Breast Disease Outpatient Clinic

Year 2016, Volume: 7 Issue: 1, 23 - 28, 01.03.2016

Sezgin Zeren , Zülfü Bayhan , Cengiz Koçak

https://doi.org/10.5799/jcei.328663

Abstract

Objective: The aim of this study was to report our approach and outcomes of patients applied to our breast disease
policlinic with mastalgia.
Methods: The records of 877 patients presented with mastalgia to breast disease policlinic between April 2014 and
January 2016 were examined retrospectively. Age, sex, body mass index (BMI), mammography breast imaging-reporting
and data system score (BIRADS), ultrasonography evaluation, biopsy status, pathology results and operation procedures
were investigated. Correlation between BIRADS score, age and BMI were analyzed.
Results: All of the patients were female and median age was 49,0 years. Ultrasound showed breast mass in 283 (32.3%)
patients and 165 (18.8%) of these underwent fine needle aspiration or true cut biopsy. Only 14 (8.5%) patients were
diagnosed as malignant. Eight of the malignant cases had breast conserving surgery. Ages of the patients showed significant
positive correlation with BIRADS classification values of the patients (r = 0.069, p = 0.04). However, BMI values
did not correlate with BIRADS classification values of the patients.
Conclusion: Mastalgia is a common symptom in women. In high risk patients for breast carcinoma, it should be investigated
seriously. Both mammography and ultrasonography can be used at the same time for diagnoses. Especially in
patients having dense breasts including young’s, mammography alone cannot be satisfying for the evaluation. J Clin
Exp Invest 2016; 7 (1): 23-28

Keywords

Mastalgia, breast policlinic, cancer, mammography

References

• 1. Eser S, Yakut C, Ozdemir R, et al. Cancer incidence rates in Turkey in 2006: A detailed registry based estimation. Asian Pac J Cancer Prev 2006;11:1731-1739.
• 2. Ozmen V. Turkiye’de meme kanseri: Klinik ve histopatolojik özellikler (13.240 olgunun analizi). J Breast Health 2014;10:98-105.
• 3. Parvani Z. Breast self-examination; Breast awareness and practices of systematic review. Professional Med J 2011;18:336-339.
• 4. Elmore JG, Armstrong K, Lehman CD, Fletcher SW. Screening for breast cancer. JAMA 2005;293:1245-1256.
• 5. Aker S, Oz H, Tuncel EK. Practice of Breast Cancer Early Diagnosis Methods among Women Living in Samsun, and Factors Associated with This Practice. J Breast Health 2015;11:115-122.
• 6. Kızılkaya MC, Erozgen F, Kocakuşak A, et al. Mastalgia in daily practice. Breast Health 2013;9:191-194.
• 7. Ölçüçüoğlu E, Yılmaz G. Mastodynia: is imaging necessary in young patients? Ulus Cerrahi Derg 2013;29:17-19.
• 8. Joyce DP, Alamiri J, Lowery AJ, et al. Breast clinic referrals: can mastalgia be managed in primary care? Ir J Med Sci. 2014;183:639-642.
• 9. Wise J. Start mammography at age 45, US guideline recommends. BMJ 2015:20;351:h5570.
• 10. Chang TH, Hsu HH, Chou YC, et al. The Values of combined and sub stratified imaging scores with ultrasonography and mammography in breast cancer subtypes. PLoS One 2015;10:e0145390.
• 11. Özan E, Köroğlu M, Parlak E, et al. Role of breast ultrasound in patients with negative mammogram presenting with breast pain without a palpable lump. J Clin Anal Med 2015;6:50-52.
• 12. Costanza ME. Has screening mammography become obsolete? Curr Oncol 2015;22:328-331.
• 13. Balçık A, Polat AV, Bayrak IK, Polat AK. Efficacy of sonoelastography in distinguishing benign from malignant breast masses. J Breast Health 2016;12:37-43.
• 14. Dinç T, Dikmen K, Coşkun F. Mastalji yakinmasi ile polikliniğe müracaat eden hastalarda meme ultrasonografi bulgulari ve risk faktörlerinin önemi. Gazi Medical Journal 2013;24:127-129.
• 15. Kataria K, Dhar A, Srivastava A, et al. A systematic review of current understanding and management of mastalgia. Indian J Surg. 2014;76:217-222.
• 16. Dinç T, Coşkun F. Comparison of fructus agni casti and flurbiprofen in the treatment of cyclic mastalgia in premenopausal women. Ulus Cerrahi Der. 2014;30:34-38.
• 17. JA. Files, VM. Miller, SS. Cha, Pruthi S. Effects of different hormone therapies on breast pain in recently postmenopausal women: findings from the Mayo Clinic KEEPS breast pain ancillary study. J Womens Health (Larchmt) 2014;23:801-805.
• 18. Abd El Moneim HM, Zaghloul NM. Expression of e-cadherin, n-cadherin and snail and their correlation with clinicopathological variants: an immunohistochemical study of132 invasive ductal breast carcinomas in Egypt. Clinics (Sao Paulo) 2011;66:1765-1771.
• 19. Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and metaanalysis of prospective observational studies. Lancet 2008;371:569-578.
• 20. JT. Schousboe, K.Kerlikowske, A.Loh, Cummings SR. Personalizing Mammography by Breast Density and Other Risk Factors for Breast Cancer: Analysis of Health Benefits and Cost-Effectiveness. Ann Intern Med 2011;155:10-20.