Ultrasound Analysis of Patients with Mastalgia with and without Palpable Mass

Abstract

OBJECTIVES To assess the clinical significance of mastalgia by investigating its association with breast lumps and the utility of diagnostic workup in cases where a palpable abnormality does not accompany mastalgia. METHODOLOGY This prospective cross-sectional study was conducted from May to July 2023 at the Radiology Department, Khyber Teaching Hospital, Peshawar. The sample size was 246, taking 80% prevalence of mastalgia, 5% margin of error and 95% confidence level. All females referred, after physical examination, to ultrasound breast with complaints of mastalgia were included in this study. RESULTSAmong 246 women with a mean age of 30.9 years presented with mastalgia, 17.5% (43) had breast lump. 69.2% (170) women had BIRADS 1, while 31% (76) had BIRADS 2. None had BIRADS 3,4 or 5. 37 (15.1%) had cyclic, while 209 (85%) presented with non-cyclic mastalgia. Pathologies detected in women with lumps were abscess in 15 (34.8%), fibroadenoma in 14 (32.5%), mammary duct ectasia in 9 (20.9%), fibrocystic change in 4 (9.3%) and hematoma in 1 (2.3%) patient. Among 203 patients without palpable lump, 33 (16.3%) had positive sonographic findings, with mammary duct ectasia in 30 (91%), intramammary lymph nodes in 2 (6.1%) and fibroadenoma in 1 (3%) patient. CONCLUSION Sonographic findings of females with mastalgia were either normal or suggestive of benign lesions; hence, excessive use of ultrasound examinations may not be needed due to the fear of breast cancer.