A new radiological approach to cyclic mastalgia: venous doppler ultrasound

Retrospective Analysis of Women with Only Mastalgia

OBJECTIVE

Mastalgia is the most common symptom in women, who has gone under breast imaging. 70% of women face with mastalgia at least once in their lifetime. In our study, we aimed to investigate the examinations and the results of the females referred to our outpatient clinics with mastalgia and to determine the frequency of malignancy.

MATERIALS AND METHODS

Files of all women patients referred to General Surgery Outpatient Clinics between 01.06.2014-31.05.2015 has been investigated retrospectively. Cases only with breast pain complaint (n=789) out of 2798 women has been included in the study. Women with lump in breast, nipple discharge, redness, breast retraction and pregnant and lactating women were excluded. Breast examination findings, ultrasonography (USG), mammography results, whether biopsies are done or not and diagnoses have been investigated retrospectively.

RESULTS

Mean age was 42.97±12.36 (16-74) years. 59.7% (n=471) of the women had bilateral mastalgia and 91.1% (n=719) of the breast examinations were found to be normal. USG was required from 664 (84.2%) women and mammography was required from 448 (56.8%) women. Considering diagnoses; fibrocystic changes in 32.3% (n=201), ductal ectasia in 8.8% (n=55), fibroadenomas in 6.1% (n=38), reactive lymphoid hyperplasia in 1.1% (n=7) was observed. Only 1 (0.2%) woman was diagnosed with invasive ductal carcinoma.

CONCLUSION

According to researches, 0.5% of the women with mastalgia were diagnosed with breast cancer. In our study this rate was found as 0.2%. Women with only mastalgia without any abnormality in physical examination should be informed about dealing with pain.

Comparison of fructus agni casti and flurbiprofen in the treatment of cyclic mastalgia in premenopausal women

OBJECTIVE

Cyclic mastalgia is described as a diffuse, periodic and bilateral breast pain that can not be localized. Although there are several methods of treatment, the most efficient treatment method is still controversial. The aim of this study is to determine, compare and discuss the results of the patients under 40 years old age with a complaint of cyclic mastalgia and without any clinical signs, family history and ultrasonography finding, treated with fructus agni casti extract or flurbiprofen.

MATERIAL AND METHODS

One hundred and fourteen premenapousal patients younger than 40 years old with a complaint of cyclic mastalgia and without any clinical, family or ultrasonography findings were analyzed prospectively. Fructus agni casti extract (Group 1) or flurbiprofen (Group 2) were administered to the patients. VAS scores were accepted as full recovery whit a score of zero, as significant healing when the score improved more than 50%, as mild-moderate healing when the improvement was less than 50% and as no healing in case of no improvement.

RESULTS

The mean age in group 1 was 28.29±5.81, and in group 2 was 29.09±4.49. The mean number of days with pain was 6.0±1.70 days in group 1, and was 6.3±1.63 in group 2. There was no significant difference in VAS scores between the two groups after treatment.

CONCLUSION

Fructus agni casti extract and flurbiprofen are commonly used medications in the treatment of cyclic mastalgia. Both of these medications significantly reduce the complaints and have acceptable side-effects. There is no proven superiority over each other. Further clinical and laboratory studies are necessary to determine the ideal medication fort he treatment of cyclic mastalgia.

Influence of sex hormones in women on breast elasticity measured by shear wave sonoelastography--a cross-sectional study

The physiology of breast depends on age, hormonal status, menstrual cycle, lactation, and others. The aim of our study was to evaluate correlations between hormonal status and breast glandular and fat tissue elasticity in healthy women. We examined 77 women aged 20-55 with shear wave sonoelastography and estimated their hormonal levels. There were no important correlations between breast elasticity, follicle-stimulating hormone (FSH), estrogen, prolactine, and thyroid hormones (p > 0.05). Androgens negatively influenced glandular to fat elasticity ratio (Rs = -0.25, p < 0.005). Luteinizing hormone to FSH ratio correlated positively with glandular and fat elasticity, especially in outer-upper quadrant (Rs = 0.24, p = 0.003).

Factors influencing breast elasticity measured by the ultrasound Shear Wave elastography - preliminary results

INTRODUCTION

Many physiological changes of breast elasticity depend on the age, hormonal status, menstrual cycle and many others. The aim of this study was to evaluate viscoelastic properties of normal breast tissues in a large group of women and to search for factors which play a role in its mechanical properties.

MATERIAL AND METHODS

101 women aged 18-74 years who underwent B-mode sonography and additionally sonoelastography. We measured viscoelasticity in 8 quadrants by a share wave ultrasonic device estimating Young modules in regions of interest.

RESULTS

Mean elasticity measured in all 8 scans in glandular and fatty tissue were 11.28 ±5.79 kPa (0.1-46.26 kPa) and 9.24 ±4.48 kPa (0.1-29.78 kPa), respectively. The correlation between age and mean elasticity of glandular tissue was Rs = 0.27 (p = 0.007). The correlation between glandular tissue elasticity heterogeneity and breast mastalgia measured by VAS was Rs = -0.23 (p = 0.241). Fat tissue elasticity correlated with duration of lactation was Rs = 0.21 (p = 0.01).

CONCLUSIONS

There are several parameters influencing breast viscoelasticity measured by share wave sonoelastography. Glandular tissue elasticity correlates positively with age, fatty tissue elasticity correlates positively with duration of lactation and heterogeneity of the elasticity map of glandular tissue correlates with breast pain and fat tissue with BMI.