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Mastalgia - Coggle Diagram
Mastalgia
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Non-cyclical
Medication
e.g. hormonal contraceptives (e.g. OCP), antidepressants (sertraline and other SSRI's), antipsychotics (haloperidol)
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Often unilateral, sharp/ burning
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Clinical features
Associated features
Nipple discharge
Pathologic: bloody, associated with a mass, spontaneous
Intraductal papilloma, duct ectasia
Physiologic: only with compression, frequently bilateral
Lump
Benign
Solid
Fibroadenoma
Mobile, rubbery "breast mouse"
Cystic
Generally fluctuate with cycle, common during periods of hormonal irregularity
Well demarcated, firm and mobile
Malignant
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Invasive
Ductal carcinoma, lobular carcinoma, tubular carcinoma, medullary carcinoma, papillary carcinoma, mucinous carcinoma
Gynecomastia
Physiologic
Newborn, adolescence, aging
Pathologic
Drugs, decreased testosterone, increased oestrogen, idiopathic
Skin changes e.g. ulceration, dimpling (peau d'orange), inflammation may be caused by cancer
Hx: family history, hormonal status, menstrual history, pregnancies, breastfeeding
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Cyclical
Most common, typically a heavy, poorly-localised pain affecting both breasts during and just before the menstrual cycle
Often associated with tenderness, swelling and lumpiness
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