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Beyond Mastalgia Subtype: Sensory Pain Burden, Attitudes, and Complementary Medicine Utilization in Women with
Perya Abbasoglu1, Alp Russell Abbasoglu2, Aysu Aliyeva2
1Department of General Surgery, Istanbul Medipol University, İstanbul, Turkey.
Background:
Women with mastalgia may use herbal preparations, dietary products and supplements, physical self-care approaches, or traditional procedures. We examined whether use of these specific practices and attitudes toward complementary medicine were associated with mastalgia subtype or multidimensional pain burden.
Methods:
This cross-sectional study included 105 women with mastalgia (53 cyclic and 52 non-cyclic) without clinically relevant breast pathology. Pain intensity, Short-Form McGill Pain Questionnaire sensory and affective scores, and exploratory interference items were assessed. A 23-item inventory recorded intentional use of herbal, dietary, physical, and traditional practices for breast pain without a fixed recall window. Practice breadth was the number of listed practices used. General attitudes toward complementary medicine were measured with the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ). Menopause-adjusted linear models evaluated HCAMQ scores, and negative binomial models evaluated practice breadth.
Results:
The most frequently reported modalities were topical Hypericum perforatum oil and massage (69.5% each), soy (68.6%), and flaxseed (65.7%). No modality-specific difference between mastalgia subtypes remained significant after false-discovery-rate correction. In alternative menopause-adjusted HCAMQ models, sensory (B=-0.266; 95% CI, -0.491 to -0.041; p=0.020) and affective pain (B=-0.459; 95% CI, -0.846 to -0.072; p=0.020) were associated with more favorable attitudes. In the sensory practice-breadth model, older age (IRR=1.019 per year; 95% CI, 1.004 to 1.033; p=0.011) and sensory pain (IRR=1.023 per point; 95% CI, 1.003 to 1.043; p=0.022) were associated with broader use. Affective pain, education, and mastalgia subtype were not associated with practice breadth after adjustment.
Conclusions:
Higher sensory pain scores were associated with broader use of the listed practices, while sensory and affective pain scores were associated with attitudes in separate alternative models. Mastalgia subtype was not associated with either outcome after adjustment. These exploratory cross-sectional findings do not establish causation and support routinely asking women with mastalgia about complementary treatment use.
