Breast pain (mastalgia) is the most common complaint associated with disorders of the breast, being present in 45–85% of women who present for evaluation of breast symptoms. It is important to note that the presence of breast pain does not exclude cancer, as some studies show that up to 5% of patients with breast cancer present with pain. The most common type is a cyclical pattern related to the hormonal changes of menses. These patients invariably have nodularity in the breast and pain that lasts for the week preceding menstruation. The pain is usually relieved by the onset of bleeding. The second most common pattern is noncyclical, which accounts for more than a fourth of women with breast pain. These patients describe a burning discomfort that is not relieved by menses. The amount of nodularity is much less prominent and there may be no palpable abnormality. Breast nodularity is probably a reflection of the complicated hormonal milieu, namely, ovarian estrogen production, diminished progesterone secretion, and hyperprolactinemia.
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