The prevalence and clinical pattern of mastalgia in women attending Mulago breast clinic.

Abstract

Background/Introduction Mastalgia is a common breast condition in women referred to breast clinics worldwide. The prevalence is known in the Western world and Asia. The level of the disease is yet to be documented from any African setting especially Uganda and Mulago breast clinic in particular. Objective The aim of the study was to determine the prevalence and describe the clinical pattern with factors associated with mastalgia in women attending Mulago breast clinic. Methods This was a cross-sectional study done at the Mulago breast clinic, Kampala Uganda. A total number of 1048 women were seen of whom, 168 who had a diagnosis of mastalgia were studied using a questionnaire and their results subjected to statistical analysis, using SPSS version 10; in a period of 5 months running between November 2004 and May 2005. Results The overall prevalence of mastalgia was found to be 16.03%. Two categories of the condition were identified: - non-cyclical and cyclical types of pain. These constituted the pattern of mastalgia in women attending Mulago Breast Clinic. The specific prevalence of non-cyclical and cyclical mastalgia is 13.17% and 2.86% respectively. The clinical presentation and description of mastalgia and consequences were similar to those observed in Western and Oriental women populations. However, there was an earlier onset of noncyclical as compared to cyclical mastalgia, which was observed to manifest beyond 24 years of age with a significant p – value of 0.006. Though not statistically significant, both extremes of breast size together with the existence of pain, along breast walls more notably the lateral wall, and radiating to the arms was observed to be noncyclical in nature. In addition, cyclical mastalgia was associated with irregular menstrual cycles together with breast pain mainly radiating to the axilla, and more responsive to empirical analgesics. However, there was lack of significant association between proposed aetiological factors (smoking, coffee drinking, obesity and alcohol intake) and mastalgia at Mulago compared to the Western population. Conclusions and Recommendations Mastalgia is a common condition in our population; therefore the description of our local disease pattern will help in improvement of its treatment and enable randomized clinical trials on mastalgia. A daily breast pain chart should be adopted for mastalgia management at Mulago Hospital. Studies on risk factors should be carried out on a bigger population in a prospective study after adoption of the daily breast pain chart.