Sonographic Ultrasound Evaluation of Mastalgia and to Determine the Relationship between Breast Duct Diameter and Severity of Mastalgia

Authors

  • Sundus Aziz
  • Amjad Sattar
  • Ayesha Walid
  • Anila Rahim
  • Nasreen Naz
  • Husson Ara

Abstract

OBJECTIVE: To determine the breast ultrasound findings in patients with Mastalgia and the relationship between breast duct diameter and severity of Mastalgia.

METHODOLOGY: A prospective cross-sectional study carried out at Dow Institute of Radiology, Dow University of Health Sciences from June-December 2021. Female patients, irrespective of age, presenting with Mastalgia without any prominent finding on clinical examination were included. A fellowship-trained radiologist performed an ultrasound. Data analysis was performed on SPSS 22.0

RESULTS: Total 380 patients were included. The mean age of the patients was 36.3±11.5 years, and the mean VAS score was 3.2±1.2. A total of 234(61.6%) had mild pain, 139(36.6%) had moderate pain and 7(1.8%) had severe pain. The mean duct diameter in patients with Mastalgia was 2.9±3.7 mm, with 220(57.9%) patients having a diameter <2.0 mm and 160(42.1%) having a diameter >2.0 mm. Duct ectasia was found in 161(42.4%). Mastalgia was significantly higher in patients with duct ectasia (p-value <0.001) and in patients with fibrocystic change (p-value <0.001).

CONCLUSION: Duct ectasia, fibrocystic changes, infective/inflammatory changes, and axillary lymphadenopathy were sonographic features of Mastalgia. Mastalgia was significantly higher in patients with duct ectasia, duct diameter >2.0 mm and in patients with fibrocystic changes.

Keywords: Mastalgia, Duct ectasia, fibrocystic changes, breast pain.

References

Mohammed AA. Evaluation of Mastalgia in patients presented to the breast clinic in Duhok city, Iraq: Cross-sectional study. Ann Med Surg (Lond). 2020; 52: 31-35. doi: 10.1016/j.amsu. 2020.02.012.

Olawaiye A, Withiam-Leitch M, Danakas G, Kahn K. Mastalgia: A review of management. J Reprod Med. 2005; 50(12): 933-9.

Dzoic-Dominkovic M, Ivanac G, Bojanic K, Kralik K, Smolic M, Divjak E et al. Exploring Association of Breast Pain, Pregnancy, and Body Mass Index with Breast Tissue Elasticity in Healthy Women: Glandular and Fat Differences. Diagnostics (Basel). Diagnosis (Basel). 2020; 10(6): 393.

doi: 10.3390/diagnostics10060393.

Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clin Proc. 2004; 79(3): 353-72. doi: 10.4065/79.3.353.

Scurr J, Hedger W, Morris P, Brown N. The prevalence, severity, and impact of breast pain in the general population. Breast J. 2014; 20(5): 508-13. doi: 10.1111/tbj.12305. Epub 2014 Jul 7.

Ader DN, South-Paul J, Adera T, Deuster PA. Cyclical Mastalgia: prevalence and associated health and behavioral factors. J Psychosom Obstet Gynaecol. 2001; 22(2): 71-6. doi: 10.3109/ 01674820109049956.

Expert Panel on Breast Imaging, Jokich PM, Bailey L, D'Orsi C, Green ED, Holbrook AI et al. ACR Appropriateness Criteria® Breast Pain. J Am Coll Radiol. 2017; 14(5S): S25-S33. doi: 10.1016/j. jacr.2017.01.028.

Arslan M, Küçükerdem HS, Can H, Tarcan E. Retrospective Analysis of Women with Only Mastalgia. J Breast Health. 2016; 12(4): 151-154. doi: 10.5152/tjbh.2016.2944.

Naz N, Sohail S, Memon MA. Utility of breast imaging in Mastalgia. J Liaquat Uni Med Health Sci. 2010; 9(1): 12-15.

Taydas O, Koc U. Evaluation of the Relationship between Breast Duct Diameter Measured by Ultrasonography and Mastalgia in Postmenopausal Patients. EJMI 2020; 4(2): 195-198. doi: 10.14744/emji.2020.56981.

McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med. 1988; 18(4): 1007-19. doi: 10.1017/s0033291700009934.

Ferris-James DM, Iuanow E, Mehta TS, Shaheen RM, Slanetz PJ. Imaging approaches to diagnosis and management of common ductal abnormalities. Radiographics. 2012; 32(4): 1009–1030.

doi: 10.1148/rg.324115150.

Tiu CM, Chiou SY, Chou YH, Lai CH, Chiou HJ, Chiang HR et al. Clinical significance of ductal dilatation on breast ultrasonogram. J Med Ultrasound. 2005; 13(3): 127-134.

Holbrook AI. Breast Pain, A Common Grievance: Guidance to Radiologists. AJR Am J Roentgenol. 2020; 214(2): 259-264. doi: 10.2214/AJR.19. 21923. Epub 2019 Dec 4.

Shobeiri F, Oshvandi K, Nazari M. Cyclical mastalgia: Prevalence and associated determinants in Hamadan City, Iran. Asian Pacific J Trop Biomed. 2016; 6(3): 275-8. doi: 10.1016/j. apjtb.2015.12.008.

Makumbi T, Galukande M, Gakwaya A. Mastalgia: prevalence at a sub-Saharan African tertiary hospital. Pain Res Treat. 2014; 2014: 972726. doi: 10.1155/2014/972726.

Alt?ntas Y, Bayrak M. Evaluation of 1294 Female Patients with Breast Pain: A Retrospective Study. Adv Ther. 2018; 35(9): 1411-9. doi: 10.1007/s 12325-018-0769-y. Epub 2018 Aug 9.

Ramalingam K, Srivastava A, Vuthaluru S, Dhar A, Chaudhry R. Duct Ectasia and Periductal Mastitis in Indian Women. Indian J Surg. 2015; 77(Suppl 3): 957-62. doi: 10.1007/s12262-014-1079-5. Epub 2014 May 8.

Mohammed AA. Mammary duct ectasia in adult females; risk factors for the disease, a case-control study. Ann Med Surg (Lond). 2021; 62: 140-144. doi: 10.1016/j.amsu.2021.01.023.

Nirhale DS, Dhende M, Shingade P, Chavan S, Sonawane T, Kulkarni G. A study on clinical profile and management of Mastalgia. Int Surg J. 2018; 5(5): 1889-93. doi: 10.18203/2349-2902.isj2018 1604.

Clegg-Lamptey JN, Aduful HK, Yarney J, Adu-Aryee NA, Vanderpuye V, Kyereh M et al. Profile of breast diseases at a self-referral clinic in Ghana. West Afr J Med. 2009; 28(2): 114-7.

Shaukat N, Jaleel F. Ultrasound findings in patients with Mastalgia. J Surg Pak Int. 2016; 21(4): 130-3. doi: 10.21699/jsp.21.4.4.

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Published

2023-06-21

How to Cite

1.
Aziz S, Sattar A, Walid A, Rahim A, Naz N, Ara H. Sonographic Ultrasound Evaluation of Mastalgia and to Determine the Relationship between Breast Duct Diameter and Severity of Mastalgia. J Liaq Uni Med Health Sci [Internet]. 2023 Jun. 21 [cited 2024 May 14];22(02):110-4. Available from: http://ojs.lumhs.edu.pk/index.php/jlumhs/article/view/1033