Abstract
Breast pain (mastalgia) is a common condition (usually classified as cyclical or non-cyclical) the characteristics of which have never been studied using a standardized pain instrument. We have modified the short form of the McGill Pain Questionnaire (SF-MPQ) for the measurement of mastalgia, and have administered it to 271 women with breast pain and without breast cancer. The mean pain-rating index (sum of 15 descriptors of SF-MPQ) was similar between cyclical and non-cyclical pain, and was 12.0 (of 45) for the entire group. When compared to similar studies of pain at other sites, this falls in the same range as chronic cancer pain, and just below the pain of rheumatoid arthritis. Mean %VAS (visual analog scale) was 45.12 and mean %PPI (present pain index) was 39.9. Most women described their pain as ‘heavy, aching and tender,’ and these descriptors were given significantly higher ratings by women with cyclical pain. In women with non-cyclical mastalgia, the overall pain severity was related to the size of the painful area, and the steadiness of the pain, and the affective components were more prominent than in women with cyclical mastalgia. Thus, cyclical and non-cyclical mastalgia show some differences in their characteristics with substantial overlap. The total breast pain score was most efficiently estimated by a combination of the VAS, the PPI, and the quality of life questions (R 2 = 0.96). Studies of breast pain should include both groups to better understand and characterize these differences, particularly with regard to a possible connection with breast cancer risk.
Similar content being viewed by others
References
Smallwood JA, Kye DA, Taylor I: Mastalgia; is this commonly associated with operable breast cancer? Ann R Coll Surg Engl 68: 262–263, 1986
Gateley CA, Maddox PR, Pritchard GA, Sheridan W, Harrison BJ, Pye JK, Webster DJ, Hughes LE, Mansel RE: Plasma fatty acid profiles in benign breast disorders. Br J Surg 79: 407–409, 1992
Watt-Boolsen S, Eskildsen PC, Blaehr H: Release of prolactin, thyrotropin, and growth hormone in women with cyclical mastalgia and fibrocystic disease of the breast. Cancer 56: 500–502, 1985
Rose DP, Cohen LA, Berke B, Boyar AP: Effect of a low-fat diet on hormone levels in women with cystic breast disease. II. Serum radioimmunoassayable prolactin and growth hor-mone and bioactive lactogenic hormones. J Natl Cancer Inst 78: 627–631, 1987
Rose DP, Boyar AP, Cohen C, Strong LE: Effect of a low-fat diet on hormone levels in women with cystic breast disease. I. Serum steroids and gonadotropins. J Natl Cancer Inst 78: 623–626, 1987
Boyd NF, McGuire V, Shannon P, Cousins M, Kriukov V, Mahoney L, Fish E, Lickley L, Lockwood G, Tritchler D: Effect of a low-fat high-carbohydrate diet on symptoms of cyclical mastopathy. Lancet 2: 128–132, 1988
Griffith CD, Dowle CS, Hinton CP, Blamey RW: The breast pain clinic: a rational approach to classification and treatment of breast pain. Postgrad Med J 63: 547–549, 1987
Fentiman IS, Caleffi M, Brame K, Chaudary MA, Hayward JL: Double-blind controlled trial of tamoxifen therapy for mastalgia. Lancet 1: 287–288, 1986
Maddox PR, Harrison BJ, Horobin JM, Walker K, Mansel RE, Preece PE, Nicholson RI: A randomised controlled trial of medroxyprogesterone acetate in mastalgia [see comments]. Ann R Coll Surg Engl 72: 71–76, 1990
Nappi C, Affinito P, Di Carlo C, Esposito G, Montemagno U: Double-blind controlled trial of progesterone vaginal cream treatment for cyclical mastodynia in women with benign breast disease. J Endocrinol Invest 15: 801–806, 1992
Plu-Bureau G, Thalabard JC, Sitruk-Ware R, Asselain B, Mauvais-Jarvis P: Cyclical mastalgia as a marker of breast cancer susceptibility: results of a case-control study among French women. Br J Cancer 65: 945–949, 1992
Goodwin PJ, DeBoer G, Clark RM, Catton P, Redwood S, Hood N, and Boyd NF: Cyclical mastopathy and premen-opausal breast cancer risk. Results of a case-control study. Breast Cancer Res Treat 33: 63–73, 1995
Deschamps M, Band PR, Coldman AJ, Hislop TG, Longley DJ: Clinical determinants of mammographic dysplasia pat-terns. Cancer Detect Prev 20: 610–619, 1996
Leinster SJ, Walsh PV, Whitehouse GH, Sumidaie AM: Factors associated with mammographic parenchymal patterns. Clin Radiol 39: 252–256, 1988
Tavaf-Motamen H, Ader DN, Browne MW, Shriver CD: Clinical evaluation of mastalgia. Arch Surg 133: 211–213, 1998
Bishop HM, Blamey RW: A suggested classification of breast pain. Postgrad Med J 55 (suppl 5): 59–60, 1979
Melzack R: The McGill pain questionnaire: major properities and scoring methods. Pain 1: 277–299, 1979
Williams AC: Measures of function and psychology. In: Wall, PD, and Melzack R (eds) Textbook of Pain, Churchill Living-stone, New York, pp 427–446, 1999
Wisbey JR, Mansel RE, Pye JK, Kumar S, Peece PE, Hughes LE: Natural history of breast pain. Lancet 672–674, 1983
Melzack R: The short-form McGill Pain Questionnaire. Pain 30: 191–197, 1987
Katz J, Melzack R: Measurement of pain. Surg Clin North Am 79: 231–252, 1999.
Ader DN, Shriver CD, Browne MW: Cyclical mastalgia: pre-menstrual syndrome or recurrent pain disorder? J Psychosom Obstet Gynaecol 20: 198–202, 1999
Sitruk-ware LR, Sterkers N, Mowszowicz I, Mauvais-Jarvis P: Inadequate corpus luteal function in women with benign breast diseases. J Clin Endocrinol Metab 44: 771–774, 1977
Kumar S, Mansel RE, Scanlon MF, Hughes LE, Edwards CA, Woodhead JS, Newcombe RG: Altered responses of prolactin, luteinizing hormone and follicle stimulating hormone secre-tion to thyrotrophin releasing hormone/gonadotrophin releasing hormone stimulation in cyclical mastalgia. Br J Surg 71: 870–873, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Khan, S.A., Apkarian, A.V. The Characteristics of Cyclical and Non-Cyclical Mastalgia: A Prospective Study using a Modified McGill Pain Questionnaire. Breast Cancer Res Treat 75, 147–157 (2002). https://doi.org/10.1023/A:1019685829799
Issue Date:
DOI: https://doi.org/10.1023/A:1019685829799