Mastalgia is one of the most common reasons to apply to breast disease polyclinics. It is defined as a painful and/or tension sensation originating in the breast and areola. According to Klimberg 66% of women have mastalgia and 21% of them are severe. Mastalgia affects the patients’ quality of life negatively. Even though etiology points to caffeine consumption, smoking, increased plasma fat acid levels, changes in hormone levels and prolactin levels as causes of mastalgia, it is a known fact that treatment of mastalgia is a dilemma for breast specialists. Despite too many clinical studies are investigated different drugs, there is no consensus on the treatment. For the pain syndromes, which no organic reason can be found, it is propounded that-especially in women - pain is psychogenic.
Exclusion of cancer diagnosis is the most important process in the management of patients who apply to breast clinics for mastalgia. Even though it increases the workload of polyclinics, mastalgia is often a benign pathology and the ratio of breast cancers among women suffering from mastalgia is 0.4%. After the exclusion of malignity, infections and organic etiologies, the treatment is determined according to the duration and frequency of pain. Although reduced caffeine intake, non-steroid anti-inflammatory agents, vitamin E and gamma linoleic acid are used for treatment of benign mastalgia, in placebo-controlled studies, the efficacy of these treatments was unproven.
breast pain without organic etiology is related to personality traits and may result with anxiety and depression. Therefore, psychiatric consultation/liaison is important in the treatment of mastalgia patients.