Gynaecology/ Breast Pain

Question 1

What percentage of women with breast cancer present with breast pain?

Answer 1

1.2%-6.7%

Question 2

What are the features of cyclical breast pain?

Answer 2

• Pain is worse during the week prior to the onset of menses
• pain resolves with the onset of menses
• bilateral pain
• pain is worse in the upper outer quadrant

Question 3

What hormones have been associated with cyclical breast pain?

Answer 3

• Estrogen and prolactin (which stimulate ductal elements)
• Progesterone(which stilmulates breast stroma)

Question 4

Cyclical breast pain is comprised of which conditions?

Answer 4

• Cyclical mastalgia
• nodular sensitive breasts (formerly fibrocystic breast disease)

Question 5

What are features of noncyclical breast pain?

Answer 5

• Unilateral
• variable location of pain
• not associated with menstrual cycles

Question 6

What are causes of noncyclical breast pain?

Answer 6

• Ductal ectasia
• mastitis (most common in lactating women during the first month postpartum)
• inflammatory breast cancer
• hidradenitis suppurativa
• pregnancy
• thrombophlebitis
• prior breast surgery
• medications (eg, hormone replacement therapy)
• trauma

Question 7

What imaging modalities can assist with determining the cause of breast pain?

Answer 7

• Ultrasound
• mammogram

Question 8

What are supportive treatments for breast pain?

Answer 8

• Well-fitting bra
• warm compresses
• low fat/high complex carbohydrate diet
• oral and topical NSAIDs
• danazol
• tamoxifen
• Caffeine avoidance
• evening primrose oil
• vitamin supplementation