Diagnostic and therapeutic approach to mastalgia. A daily challenge in the gynecological visit.

Abstract

Mastalgia is one of the main reasons for daily consultation with the gynecologist. It is estimated that approximately 70% of women will experience mastalgia at some point in their lives, and it is also a symptom that can occur recurrently. It is a condition that usually represents great distress in the patient given the possible association with some malignant process, which has been shown to only occur in up to 3% of cases, so she should be reassured during the first contact consultation. It is a symptom with multiple etiologies, which in most cases are due to benign pathologies of the mammary gland. Evaluation by imaging studies should adhere to the recommendations issued by the different international guidelines and not request unnecessary studies that lead to overdiagnosis and overtreatment. The treatment approach can represent a great challenge for the gynecologist, since there are various options that range from non-pharmacological therapies, such as lifestyle modifications and multiple pharmacological therapies, however, there are few randomized clinical trials that allow demonstrating one's superiority. The objective of the present is to review the various recommendations in the diagnostic approach and treatment that support the clinical management of mastalgia.