Frequency of mastalgia among women veterans. Association with psychiatric conditions and unexplained pain syndromes.
OBJECTIVE
To determine the prevalence and frequency of mastalgia and its association with psychiatric conditions and unexplained pain syndromes.


METHODS
Cross-sectional mailed survey completed by 1,219 female veterans enrolled at the VA Puget Sound Health Care System in 1998.


METHODS
Breast pain in the past year, unrelated to pregnancy, was categorized as infrequent (< or =monthly) or frequent (> or =weekly) mastalgia. Surveys assessed posttraumatic stress disorder (PTSD), depression, panic disorder, and alcohol misuse with validated screening tests, as well as self-reported past-year chronic pelvic pain, fibromyalgia, and irritable bowel syndrome.


RESULTS
The response rate was 63%. Fifty-five percent of the respondents reported past-year mastalgia. Of these, 15% reported frequent mastalgia. Compared to women without mastalgia, women reporting frequent mastalgia were more likely to screen positive for PTSD (odds ratio [OR] 5.2, 95% confidence interval [CI] 3.2 to 8.4), major depression (OR 4.2, 2.6 to 6.9), panic disorder (OR 7.1, 3.9 to 12.8), eating disorder (OR 2.6, 1.5 to 4.7), alcohol misuse (OR 1.8, 1.1 to 2.8), or domestic violence (OR 3.1, 1.9 to 5.0), and to report fibromyalgia (OR 3.9, 2.1 to 7.4), chronic pelvic pain (OR 5.4, 2.7 to 10.5), or irritable bowel syndrome (OR 2.8, 1.6 to 4.8). Women with infrequent mastalgia were also more likely than women without mastalgia to screen positive for PTSD, depression, or panic disorder, or report pelvic pain or irritable bowel syndrome, although associations were weaker than with frequent mastalgia.


CONCLUSIONS
Like other unexplained pain syndromes, frequent mastalgia is strongly associated with PTSD and other psychiatric conditions. Clinicians seeing patients with frequent mastalgia should inquire about anxiety, depression, alcohol misuse, and trauma history.
Johnson
Kay M
KM
Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA. Kay.Johnson2@med.va.gov
Bradley
Katharine A
KA
Bush
Kristen
K
Gardella
Carolyn
C
Dobie
Dorcas J
DJ
Laya
Mary B
MB
D000328:Adult; D001941:Breast Diseases / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000523:psychology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000523:psychology; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology; D044469:Racial Groups; D013577:Syndrome; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D014930:Women