A

Clinical Problem

Cyclical Mastalgia

A1

Ref No. in MBUR4 (if any)

J10

A2

Section in MBUR4

Breast disease

B

Search strategy: databases used; period; MeSH headings; other key words.

Medline 1966-June 2001,EMBASE 1988-2001, breast disease, mammography, Cyclical mastalgia, breast pain

C

Search results: no. found;

no. used.

410 found, 2 used

D

Reference numbers of cited references in attached master list.

J10 1,2

E

Summarised results from each of the cited references

Duijm et al (J10,1) performed the only study to date examining the role of imaging in women with painful breast(s). 987 women referred with breast pain alone were compared with 987 age matched controls, asymptomatic women referred for screening mammography. Prevalence of breast cancer was the same in the two groups. 12.2% of the women with breast pain had benign or probably benign findings on imaging. These authors conclude that imaging for cyclical mastalgia alone is of value only in providing reassurance. Wilson and Blamey (J10,2) responded to this study in support of this view and in their opinion state that imaging should not be performed in women in the absence of clinical signs but that those with severe symptoms should be seen in a specialist breast clinic.

F

Statement (= the conclusion drawn from E)

Mammography should not be performed in women with breast pain in the absence of clinical signs

G

Evidence level of F classified I - IV

2

H

Investigation

Mammography

I

Recommendation *

4 Not indicated

J

Grade of Recommendation

A - C

B

K

Comment (if any) to go in booklet version of MBUR5

L

Any other comments on this problem (e.g. caveats; suggestions for research or systematic review; cost or opportunity cost; users' views.

Erika Denton