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Imaging in mastalgia: What, when and why?

Divij Agarwal1, Ekta Dhamija2, Devipriya S1

  • 1Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.

Current Problems in Diagnostic Radiology
|June 13, 2025
PubMed
Summary
This summary is machine-generated.

Breast pain (mastalgia) is common in women but rarely cancerous. This guide outlines an imaging strategy for diagnosing mastalgia causes, ensuring appropriate management and ruling out malignancy.

Keywords:
Breast ultrasoundCystFibrocystic changeGalactoceleGranulomatous mastitisMastalgiaMondor’s disease

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Area of Science:

  • Radiology
  • Women's Health
  • Medical Diagnostics

Background:

  • Breast pain, or mastalgia, affects over two-thirds of women.
  • While rarely indicating malignancy, mastalgia frequently leads to medical consultations.
  • Diagnostic imaging is not always required but depends on pain characteristics and patient factors.

Purpose of the Study:

  • To present an algorithmic strategy for evaluating mastalgia.
  • To guide the selection of radiological investigations based on clinical presentation.
  • To effectively identify pain causes and exclude malignancy.

Main Methods:

  • The study outlines a diagnostic algorithm for mastalgia.
  • It emphasizes tailoring imaging choices to pain type (cyclical, non-cyclical, focal), age, and clinical findings.
  • The strategy focuses on optimal utilization of imaging tools.

Main Results:

  • The proposed algorithm facilitates targeted workup of breast pain.
  • It ensures appropriate management by identifying the pain's origin.
  • The strategy aids in differentiating benign causes from potential malignancy.

Conclusions:

  • An algorithmic approach optimizes the diagnostic process for mastalgia.
  • Tailored imaging selection is crucial for accurate diagnosis and management.
  • The strategy effectively addresses patient concerns while prioritizing the exclusion of breast cancer.