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      Breast Pain: Clinical Pattern and Aetiology in a Breast Clinic in Eastern Nigeria

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          Abstract

          Background:

          Patients with breast pain are likely to be very worried because some consider pain in the breast as an indication of malignancy.

          Objective:

          To highlight the causes of pain in the patients are presenting to our breast clinic.

          Materials and Methods:

          A prospective study of all consenting patients with breast disease presenting to the breast clinic was conducted from January 2004 to December 2008.

          Results:

          A total of 664 patients presented to the breast clinic during the study period. Of this number, 127 presented with breast pain either as the sole symptom or in association with other symptoms. The presenting complaints were a pain, pain with lump, and pain with nipple discharge in 63 (49.6%), 59 (46.4%), and 5 (4.0%) patients, respectively. The pain was noncyclical in 96 (75.6%) patients. The site of the pain was whole breast in 87 (68.5%) patients and a lump in 40 (31.5%). The clinical diagnosis in 31 (24.4%) cases was fibrocystic disease, 28 (22.0%) cancer, 23 (18.1%) unknown, 10 (7.9%) fibroadenoma, 8 (6.3%) duct ectasia, 6 (4.7%) normal breast, and others 21 (16.5%) cases benign diseases were diagnosed. The histological diagnosis was fibrocystic changes, carcinoma, and fibroadenoma in 15 (42.9%), 10 (28.6%), and 5 (14.3%) patients, respectively. Others were benign phyllodes, abscess, duct ectasia, chronic mastitis, and lipoma, each constituting 1 (2.9%) case.

          Conclusion:

          Breast pain constitutes a small proportion of complaints to our breast clinic. Fibrocystic changes were the most common cause of breast pain both clinically and histologically.

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          Most cited references14

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          Pattern and correlates of premenstrual symptomatology amongst Nigerian University students.

          This study aimed to evaluate the pattern and correlates of premenstrual symptomatology amongst Nigerian female undergraduates. Female University students (n = 409) completed questionnaires detailing sociodemographic, menstruation/gynecological history and personality traits. They were then rated with a checklist for premenstrual symptoms. The most frequent premenstrual symptoms were 'breast tenderness' (35.5%), 'sleeplessness' (15.6%), 'decreased interest in usual activities' (15.4%), 'lethargy/easy fatigability/lack of energy' (13.2%) and 'change in appetite' (13.2%). The prevalence of premenstrual symptomatology was 50.1% and the correlates of increasing premenstrual symptomatology included increasing age, increasing severity of menstrual pain, personality traits of neuroticism and agreeableness and increasing body mass index. Although the rate of premenstrual symptomatology in sub-Saharan African women was comparable with that in the western cultures, there may be cross-cultural differences in the pattern of presentation. Dysmenorrhoea and personality traits should be taken into consideration when planning and implementing effective strategy to manage perimenstrual problems in this region.
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            Mastalgia: a review of management.

            Mastalgia affects up to two-thirds of women at some time during their reproductive lives. It is usually benign, but thefear of underlying breast cancer is why many women present for evaluation. Mastalgia can be associated with premenstrual syndrome, fibrocystic breast disease, psychologic disturbance and, rarely, breast cancer. Occasionally, extramammary conditions, like Tietzie syndrome, present as mastalgia. A thorough clinical evaluation is required to assess the cause. The majority of women can be reassured after a clinical evaluation. Approximately 15% require pain-relieving therapy. Mechanical breast support; a low-fat, high-carbohydrate diet; and topical nonsteroidal antiinflammatory agents are reasonable first-line treatments. Hormonal agents, such as bromocriptine, tamoxifen and danazol, have all demonstrated efficacy in the treatment of mastalgia. Side effects, however, limit their extensive use. Danazol is the only FDA-approved hormonal treatment and is best used in cyclic form to limit the adverse effects. Lisuride maleate is a new agent recently studied for the treatment of mastalgia. Initial data on this medication are encouraging. Sixty percent of cyclic mastalgia recurs after treatment. Noncyclic mastalgia responds poorly to treatment but resolves spontaneously in up to 50% of cases.
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              • Article: not found

              Value of breast imaging in women with painful breasts: observational follow up study.

              To determine the value of breast imaging in patients with localised or diffuse pain in the breast in whom physical examination shows no abnormalities.
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                Author and article information

                Journal
                Niger J Surg
                Niger J Surg
                NJS
                Nigerian Journal of Surgery : Official Publication of the Nigerian Surgical Research Society
                Medknow Publications & Media Pvt Ltd (India )
                1117-6806
                2278-7100
                Jan-Jun 2016
                : 22
                : 1
                : 9-11
                Affiliations
                [1] Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
                Author notes
                Address for correspondence: Dr. Ochonma A Egwuonwu, Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. E-mail: egwuobi@ 123456yahoo.com
                Article
                NJS-22-9
                10.4103/1117-6806.169822
                4785698
                27013851
                394e1ee4-7590-4da5-bbc1-ec81bc73481c
                Copyright: © Nigerian Journal of Surgery

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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                Original Article

                aetiology,breast,pain
                aetiology, breast, pain

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