Mystalgia

Question 1

What is mystalgia?

Answer 1

Breast pain

Association with breast cancer is low

Question 2

What are three categories of the causes of breast pain?

Answer 2

Cyclical
Non-cyclical
Extra-mammary

Question 3

What is cyclical mystalgia?

Answer 3

Pain associated with menstural cycle. Typically in both breasts and due to hormonal changes in women menstruating or on HRT.

Question 4

What is non-cyclical mastalgia?

Answer 4

Unrelated to menstrual cycle. Typically caused by medication including - anti-depressants(sertraline) or anti-psychotics(haloperidol)

Question 5

What is extra-mammary pain mastalgia?

Answer 5

Caused by other things such as chest pain or shoulder pain.

Question 6

What specific things should be asked in a history of breast pain?

Answer 6

Lumps 
Skin changes 
Fevers 
Discharge 
Association with menstrual cycle 
Breast feeding or pregnancies

Question 7

What investigation should be done for isolated breast pain?

Answer 7

Pregnancy test

Imaging not indicated

Question 8

What is the management of mystalgia?

Answer 8

Treat underlying cause if identified

If idiopathic the reassurance and pain management with oral ibuprofen/paracetamol or topical NSAIDS

Cyclical breast pain - wearing soft support bra during night or better fitting