Gynecology Book

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Mastalgia

Aka: Mastalgia, Breast Pain, Mastodynia
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  1. Differential Diagnosis
    1. Pain related to Menses
    2. Costochondritis
    3. Chest Trauma
    4. Sclerosing adenosis
    5. Breast Cancer (represents under 5% of Breast Pain)
  2. History
    1. Location
      1. Focal Breast Pain more concerning than diffuse pain
    2. Duration of Breast Pain
    3. Unilateral or Bilateral
    4. Changes with Menstrual Cycle
    5. Relationship to hormonal replacement therapy
    6. Rank Breast Pain on a 10 point scale
    7. Altered life style
    8. Excessive Worry or emotional stress
  3. Pathophysiology
    1. Breast Pain thought to be related to Estrogen excess
  4. Algorithm
    1. Breast Mass present
      1. Evaluate as Breast Mass
    2. No Breast Mass present
      1. Younger than age 35
        1. Repeat Breast Exam in 1-2 months
      2. Older than age 35 years
        1. Breast Imaging
          1. Mammogram
          2. BreastUltrasound
        2. Suspicious lesion
          1. Breast Biopsy
        3. Non-suspicious lesion
          1. Follow-up Exam
          2. Breast imaging
        4. Negative Imaging
          1. Follow-up Breast Exam in 1-2 months
  5. Associated Conditions
    1. Premenstrual Dysphoric Disorder (PMDD or PMS)
  6. Management
    1. Wear supportive Brassiere or Sports Bra
    2. Eliminate Caffeine
    3. Vitamin E Supplementation up to 800 IU qd
    4. Herbal therapies with variable efficacy
      1. Evening Primrose Oil 1500-3000 mg PO qd
      2. Chaste Tree Berry 30 to 40 mg qd (PMS)
      3. References
        1. Hardy (2000) J Am Pharm Assoc 40:234-42
    5. Medroxyprogesterone
      1. Dose: 150 mg IM q3 months
      2. Very effective in pre-menopausal women
        1. Marked reduction in Mastalgia
      3. Reference
        1. Euhus (1997) J Am Coll Surg 184:596-604
  7. References
    1. Belieu (1994) Obstet Gynecol Clin North Am 21:461-77
    2. Conry (1994) Am Fam Physician 49(2): 445-50

Mastodynia (C0024902)

Definition (NCI) Painful sensation in the breast region.
Definition (NCI) A disorder characterized by marked discomfort sensation in the breast region.
Definition (MSH) Pain in the breast generally classified as cyclical (associated with menstrual periods), or noncyclical, i.e. originating from the breast or nearby muscles or joints, ranging from minor discomfort to severely incapacitating.
Concepts Sign or Symptom (T184)
MSH D059373
ICD9 611.71
ICD10 N64.4
SnomedCT 53430007, 237452006, 198117005, 155959001, 266645003
English Mastodynia, BREAST PAIN, MASTALGIA, MASTODYNIA, breast pain, mastodynia, breast pain (symptom), mastodynia (diagnosis), Mastalgia (finding), Pain of breast (disorder), Ache breast, Pain breast, Sore breasts, Soreness breast, breasts soreness, breasts sores, sore breasts, ache breast, breast soreness, breasts sore, breast ache, breast painful, breast pains, acheing breasts, breasts pain, soreness breast, breast sores, breasts pains, pain breast, sore breast, pain in the breast, breast sore, painful breasts, of breast pain, pain in breast, painful breast, Mastodynias, Mastalgias, Mammalgia, Breast Pain, Mastalgia, Breast Pains, Pain, Breast, Mammalgias, Pains, Breast, Painful breasts, Breast pain, Pain in the breast, Pain of breast, Breast painful, Pain of breast (finding), breast; pain, mastalgia, pain; breast, Mastodynia - painful breast, Pain in breast
Italian Dolore mammario, Dolore alla mammella, Mastodinia, Mammelle doloranti, Dolore alle mammelle, Irritazione della mammella
Dutch pijn borst, mastalgie, pijnlijke borsten, pijnlijkheid borst, mastodynie, mamma; pijn, pijn; mamma, Mastodynie, borstpijn
French Mastodynie, Douleur au sein, Mastalgie, Endolorissement mammaire, Seins endoloris, Seins douloureux, DOULEUR MAMMAIRE, MASTALGIE, Douleur mammaire
German Schmerz Brust, schmerzhafte Brueste, Empfindlichkeit der Brueste, Schmerz in der Brust, Mastalgie, Mastodynie, empfindliche Brueste, MASTALGIE, Brustschmerz
Portuguese Mastodinia, Moinha mamária, Úlcera da mama, Mamas dolorosas, Mastalgia, Mama dorida, DOR MAMARIA, MASTALGIA, Dor mamária
Spanish Dolor en las mamas, Mastodinia, Mamas adoloridas, Mamas dolorosas, Pain of breast, Pain in breast, Mastodynia - painful breast, Mastalgia, Pain in the breast, MASTALGIA, dolor de mamas, mamas dolorosas, mastalgia, mastodinia (hallazgo), mastodinia, Dolor de mama
Japanese 乳房痛, ﾆｭｳﾎﾞｳﾂｳ
Czech Bolavé prsy, Bolest prsu, Mastalgie, Pobolívání prsu, Bolestivé prsy, Bolestivost prsu, Mastodynie
Korean 유방통
Hungarian emlőfájdalom, Emlőfájdalom, Emlő fájdalom, Emlőérzékenység, Fájó emlők, Fájdalmas emlők, Mastalgia, Mastodynia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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