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Published on: July 21, 2011
Clinical evaluation of mastalgia
H Tavaf-Motamen1, D N Ader, M W Browne
1Department of Surgery, Walter Reed Army Medical Center, Washington, DC, USA. tavafh@aol.com
Archives of Surgery (Chicago, Ill. : 1960)
|March 4, 1998
Summary
Quantifying breast pain (mastalgia) requires daily diaries, not retrospective questionnaires. A visual analog scale in daily diaries offers reproducible results for accurate assessment of cyclical mastalgia.
Area of Science:
- Medical research
- Clinical assessment
- Pain management
Background:
- Mastalgia is a common gynecological complaint.
- Accurate quantification of subjective breast pain is challenging.
- Retrospective questionnaires may be limited by recall bias.
Purpose of the Study:
- To develop and validate a reproducible method for quantifying subjective breast pain (mastalgia).
- To compare retrospective screening questionnaire data with prospective daily diary entries.
- To assess the accuracy of identifying cyclical mastalgia.
Main Methods:
- Prospective diary study involving 30 female military healthcare beneficiaries.
- Daily recording of mastalgia using a visual analog scale (VAS).
- Correlation of daily diary data with a pre-study screening questionnaire.
Main Results:
- Daily diaries revealed significantly higher peak perimenstrual mastalgia in patients identified with cyclical mastalgia by screening (5.3 vs 3.5, P<.001).
- Seventeen out of 30 patients met diagnostic criteria for cyclical mastalgia based on diary data.
- The screening questionnaire had a 73% positive and 60% negative predictive value for cyclical mastalgia.
Conclusions:
- Accurate assessment of mastalgia necessitates prospective diary evaluation due to symptom variability and recall bias.
- A daily visual analog scale is a reproducible and patient-friendly tool for mastalgia assessment.
- Retrospective questionnaires are insufficient for accurate mastalgia quantification.
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