A RETROSPECTIVE ANALYSIS OF WOMEN WITH ONLY MASTALGIA

Abstract

OBJECTIVE: To determine if mastalgia is a sign of breast cancer and to evaluate the benefit of diagnostic workup, particularly mammography in its work up.

MATERIAL AND METHOD: This was a descriptive cross-sectional study based on data retrieved from the hospital information management system conducted at the Radiology Department of Northwest General Hospital and Research Centre Peshawar for two years from 2022 to 2023. 127 female patients complaining of focal or diffuse breast pain were referred for mammography.

RESULTS: 11.8% of the cases had cyclical while 88.2% had acyclic mastalgia. 28.3% of the patients were below 40 years, and 71.7% were above 40 years, with the mean age being 46 years. 11% of patients had a higher BIRADS (4 or 5) on mammogram. These 14 patients were referred for histopathology, out of which 11 patients had histopathology performed. 3.9% had breast cancer, and 4.7 % had benign findings on histopathology. Complementary ultrasound was normal in 29.1% patients, 18.9% had dilated ducts, 6.3% had benign-looking enlarged axillary nodes, 5.5% had fibroadenoma, 5.5% had multiple small simple cysts, 2.4% had small hypoechoic lesion, 0.8 % had lipoma, and 18.9% of patients did not undergo ultrasound examination.

CONCLUSION: Studies assessing the outcomes of diagnostic workup in patients with mastalgia report that the cancer rate in these women is comparable to the general population. The clinician should thus reassure and counsel the patient regarding pain management. If imaging is performed, the American College of Radiology Appropriateness Criteria should be followed.