[Breast pain: Recommendations]

Abstract

Objectives: To evaluate the diagnostic value of clinical examination and additional tests in the exploration of breast pain, to evaluate the strategy of their care and to provide recommendations.

Methods: A literature search in English and French carried out by consulting the databases PubMed, Cochrane Library and international recommendations.

Results: Clinical examination and interrogation, with the use of visual analog scale used to differentiate non-cyclical breast pain from mastodynia (LE2). A calendar can be used to characterize the cyclical breast pain (LE3). Using a questionnaire can help to characterize the pain (LE3). In the absence of palpable abnormality, it is not recommended to modify systematic or individual screening modalities (LE2). MRI is not recommended in case of normal mammography and sonography. Explorations biopsy is guided by imaging. The therapeutic management includes reassurance after a normal clinical evaluation and/or normal radiological findings (LE2), and precise fitting of a brassière. In case of failure of this first approach, NSAIDs gel can be proposed (LE1-2).

Keywords: Cyclical mastalgia; Douleurs mammaires; Mammographie; Mammography; Mastodynia; Mastodynies; Traitement des mastodynies; Treatment of mastalgia; Ultrasonography; Échographie.