Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 5, September-October, p. 895–900

doi: 10.17219/acem/28820

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Mastalgia Due to Degenerative Changes of the Spine

Okay Pirti1,A,B, Aziz M. Barlas1,A, Serdar Kuru1,C, Selim Temel1,A, Mustafa K. Urhan1,B, Kemal Kismet1,D, Adnan Hasanoglu1,E, Osman Guler1,F

1 Department of General Surgery, Ankara Education and Research Hospital, Ankara, Turkey


Background. Mastalgia is a common and enigmatic condition; the cause and optimal treatment are still inadequately defined. Cervical radiculopathy, which is the result of cervical nerve root pathology often caused by spaceoccupying lesions such as cervical disc herniation, spondylosis, or osteophytosis, is frequently encountered in physical therapy.
Objectives. The aim of the study was to evaluate the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain.
Material and Methods. One hundred patients were included in the study, all with breast pain continuing throughout the day and lasting at least three months. Breast and axillary physical examinations, mammographic and/or ultrasonographic evaluations were normal in all the patients. The patients’ pain levels were scored using a visual analog scale (VAS). Cervical and thoracic spine magnetic resonance imaging (MRI) was performed on all the participants.
Results. Among 96 patients that had pathological findings on magnetic resonance imaging (96%), 49 women had diffuse annular bulging of the cervical spine, and 47 had cervical disc protrusion. Additionally, 12 patients had thoracic disc protrusion. At the end of the three-month period, the patients who were given only conservative treatment returned for follow-up evaluations. According to the VAS scores, five patients had mild to moderate improvement, 55 showed significant improvement, and 29 achieved complete remission.
Conclusion. The authors concluded that if none of the known causes of breast pain are found in a patient, the patient should be evaluated for vertebral pathologies.

Key words

breast, mastalgia, vertebral pathology

References (18)

  1. Smith RL, Pruthi S, Fitzpatrick LA: Evaluation and management of breast pain. Mayo Clin Proc 2004, 79, 353–372.
  2. Cairncross L: Mastalgia. Cont Med Educ 2010, 28, 504–506.
  3. Boyles R, Toy P, Mellon J Jr: Effectiveness of manual physical therapy in the treatment of cervical radiculopathy: A systematic review. J Man Manip Ther 2011, 19, 135–142.
  4. Gould D, Kelly D, Goldstone L, Gammon J: Examining the validity of pressure ulcer risk assessment scales: Developing and using illustrated patient simulations to collect the data. J Clin Nurs 2001, 10, 697–706.
  5. Rosolowich V, Saettler E, Szuck B: Mastalgia. Obstet Gynaecol Can 2006, 28, 49–71.
  6. Iglehart JD, Kaelin CM: Diseases of the breast. [In:] Sabiston Textbook of Surgery, Eds: Beauchamp RD, Evers BM, Mattox KL. Elsevier Inc. 2004, USA, 867–944.
  7. Duijm LE, Guit GL, Hendriks JH, Zaat JO, Mali WP: Value of breast imaging in women with painful breasts: Observational follow up study. BMJ 1998, 317, 1492–1495.
  8. Carette S, Fehlings MG: Clinical practice. Cervical radiculopathy. N Engl J Med 2005, 353, 392–399.
  9. Rodine RJ, Vernon H: Cervical radiculopathy: A systematic review on treatment by spinal manipulation and measurement with the neck disability index. J Can Chiropr Assoc 2012, 56, 18–28.
  10. Arce CA, Dohrmann GJ: Herniated thoracic disks. Neurol Clin 1985, 3, 383–392.
  11. Papadakos N, Georges H, Sibtain N, Tolias CM: Thoracic disc prolapse presenting with abdominal pain: Case report and review of the literature. Ann R Coll Surg Engl 2009, 91, 4–6. DOI: 10.1308/147870.809X401038.
  12. Sebastian D: T2 radiculopathy: A differential screen for upper extremity radicular pain. Physiother Theory Pract 2013, 29, 75–85.
  13. Xiong Y, Lachmann E, Marini S, Nagler W: Thoracic disk herniation presenting as abdominal and pelvic pain: A case report. Arch Phys Med Rehabil 2001, 82, 1142–1144.
  14. Eleraky MA, Apostolides PJ, Dickman CA, Sonntag VK: Herniated thoracic discs mimic cardiac disease: Three case reports. Acta Neurochir (Wien) 1998, 140, 643–646.
  15. Georges C, Toledano C, Zagdanski AM: Thoracic disk herniation mimicking renal crisis. Eur J Intern Med 2004, 15, 59–61.
  16. Gore DR, Sepic SB, Gardner GM: Roentgenographic findings of the cervical spine in asymptomatic people. Spine 1986, 11, 521–524.
  17. Olawaiye A, Withiam-Leitch M, Danakas G, Kahn K: Mastalgia: A review of management. J Reprod Med 2005, 50, 933–939.
  18. Davies EL, Gateley CA, Miers M, Mansel RE: The long-term course of mastalgia. J R Soc Med 1998, 91, 462–464.