Imaging in mastalgia: What, when and why?

Breast pain, or mastalgia, is an extremely common symptom among women, affecting over two-thirds of women during their lifetime. Although rarely linked to malignancy, breast pain often prompts women to seek medical consultation. While imaging is not always necessary, the selection of the radiological investigations should be guided by the type and characteristics of breast pain (cyclical, non-cyclical or focal pain), patient age, and associated clinical findings. The primary aim is to identify and appropriately manage the cause of pain, while excluding any underlying malignancy. The aim of this article is to delineate an effective algorithmic strategy for the workup of mastalgia, which is tailored to identify the cause for pain, while optimally utilizing the imaging tools.