ABSTRACT
Cyclic mastalgia is defined as a breast pain that has a relationship to the menstrual cycle. As far as research studies are concerned the main etiological factors for cyclical mastalgia include dietary factors and hormonal imbalance. In this study, the clinicopathological aspect of cyclical mastalgia is studied with special reference to serum oestrogen and breast volume. This study provides valuable data on cyclical mastalgia with special reference to serum oestrogen level and breast volume.METHODSA total of 101 patients meeting inclusion criteria were selected for this prospective comparative observational study. Sample was selected from OPD patients from Surgery Department, Medical College Kolkata. A detailed history of the patients who was taken with special reference to the dietary habits and lifestyle. A thorough physical examination including breast size and volume were taken (by visual assessment method, size of the undergarments the patient wear and then breast circumference measurement) and the findings were noted. Patients underwent Tru-Cut biopsy for histopathological study and Oestrogen Receptor Status. All data was captured in a predesigned Case Data Sheet and analysis of all the data was done from the CDS using master chart or grand chart.RESULTS58.3% patients with cyclical mastalgia have h/o fatty diet. Patients with increased breast volumes had increased levels of serum oestradiol which signifies that mastalgia with medium and large size breast would respond to antioestrogens better than those patients with small sized breast volume. Majority of the patients with cyclical mastalgia in our study had medium breast volumes as per Bra-size, where the range of 32-36 has the highest frequency (42.8%). The mean measurement of bra size is 33.7 and the standard deviation is 3.737. In our study, we find positive correlation with breast volume and serum oestrogen level (Pearson correlation of breast volume as 1 and serum oestrogen level as 0.381 respectively) and negative correlation with breast volume and serum progesterone level (Pearson correlation of breast volume as 1 and serum progesterone level as -0.134 respectively).CONCLUSIONSThis study shows a significant positive correlation between breast volume, fatty diet and oestrogen level with cyclical mastalgia.
ABSTRACT
Objective: To assess prevalence of cyclical mastalgia and its main determinants in women who attended in health centers of Hamadan City, Iran. Methods: This case-control study was conducted on 400 women (case: cyclical mastalgia, n = 240; control: without cyclical mastalgia, n = 160) who attended family planning clinic for routine follow-up in health centers. The cluster sampling was used. Information was collected by interviewing and using a standardized validated questionnaire. Severity of mastalgia was assessed through using visual analog scaling. Data processing and statistical analysis were performed by using SPSS 19.0. Results: The results revealed that majority of women (60.0%) experienced cyclical mastalgia. Out of these, 22.5% and 37.5% were mild and moderate-to-severe mastalgia, respectively. No association was revealed in experience of depression and anxiety in mastalgia group. In a multivariable logistic regression model, the increasing age, age of marriage, history of abortion and history of premenstrual syndrome were main determinants of mastalgia, while use of oral contraceptive and regular exercise was associated with lower incidence of mastalgia. Conclusions: Most of women with breast discomfort suffered cyclical mastalgia which severity can be determined by advanced age, age of marriage, history of abortion and history of premenstrual syndrome, but inversely by oral contraceptive use and exercise activity.