Psychological Assessment and Treatment Effectiveness in Mastalgia: Developing a Treatment Algorithm

Area of Science:

• Medical Research
• Clinical Therapeutics
• Women's Health

Background:

• Mastalgia significantly impacts women's physical, social, and sexual well-being.
• Existing treatments for mastalgia lack global or local guidelines.
• The psychoneurotic association with mastalgia is a long-standing claim in medical literature.

Purpose of the Study:

• To evaluate the psychological status of women with mastalgia.
• To assess the effectiveness of various treatment options for mastalgia.
• To establish evidence-based first-line treatment recommendations for mastalgia.

Main Methods:

• The study included 106 women with breast and/or chest wall pain, excluding pregnant patients or those with drug allergies.
• Psychological status was assessed using the Depression Anxiety and Stress Scale (DASS-42).
• Pain severity was measured using the Visual Analog Scale (VAS); patients were categorized, and severe pain cases were randomized to topical NSAIDs or evening primrose oil + vitamin E.

Main Results:

• Mean DASS-42 scores for depression, anxiety, and stress were 7.31, 7.08, and 11.15, respectively, with no significant correlation to pain scores or duration.
• Topical NSAIDs showed a 67.44% response rate as a first-line treatment.
• Evening primrose oil + vitamin E demonstrated a high response rate (90.63%) when used as a first-line treatment.

Conclusions:

• Topical NSAIDs and evening primrose oil + vitamin E are effective first-line treatments for mastalgia.
• These options should be considered before escalating to systemic medications like tamoxifen or danazol.
• Pain severity and duration in mastalgia patients are not significantly correlated with their psychological state.