Objective: In the medical encyclopedia ;Mastodynia, mastalgia or mammalgia are names for a medical symptom that means -pain in the breast .This common problem seen in the west, finds little mention in our country and our literature. The purpose of this study is to report the pattern of various breast diseases amongst women presenting with mastalgia (breast pain) in Mosul breast clinic emphasizing their assessment and hoping to initiate further studies on their natural profile. Patients and methods:A retrospective study of 682 female patients with mastalgia. From the Breast Clinic in Al Jamhoory Teaching Hospital in Mosul between Aug 2002 -March 2004. Records of six hundred eighty two patients with breast pain with or without lumpiness utilizing Cardiff daily breast pain chart filled by the patients were reviewed. Their mean age was about 38 years. All patients were examined clinically and by ultrasound (probe7.5MHz). Mammography and histopathological examination were done to those with equivocal and suspicious clinical and ultrasonographic results. Results: Cyclical breast pain was reported in 422 patients (62%), normal breast nodularity in 154 (22%), inflammatory lesions in 40 (6%), benign breast pathology in 56 (8%), benign tumours in 6(less than 1%) and malignant tumours in 4 (less than 1%). Conclusions: Breast pain is a common problem in the breast clinic. This study showed that cyclical breast pain and nodularity represent the commonest conditions followed by benign and inflammatory lesions. Breast pain needs to be evaluated as with many other medical problems, by good history (including breast pain chart) and examination. This to be followed by imaging (as the age implies) and histopathological assessments. Surgeons evaluating breast pain should have more rational criteria in using further sophisticated, expensive and invasive tests.

Background:The objective structured clinical examination is gaining popularity in most medical schools for its validity, reliability, and objectivity. It requires a lot of physical and financial resources and commitment. Objective: To outline steps important to be considered when conducting objective structured clinical examination as an assessment skill for final undergraduate candidates in surgery with emphasis on the student's perception, satisfaction and acceptability. Design: A purposive sample of 151 of 6 th year undergraduate medical students attempted final objective structured clinical examination in Surgery. Setting: Department of Surgery, College of Medicine, University of Mosul during the academic year 2011-2012. Method: Purposive sample including 151 participants, who attempted objective structured clinical final examination in surgery for graduation. There were 65 males & 86 females. The examination was performed over 8 days. A well-organized ten objective structured clinical examination stations were chosen for assessment. The time allowed for each station was 6 minutes. An objective structured clinical examination organizing committee was established. The subjects for objective structured clinical examination stations were determined, a detailed plan of the students grouping and movement was established, and a notice for all students about objective structured clinical examination details was given. At completion of examination, students were given self-administered questionnaire and feedback to test their perception and satisfaction about the examination. Results: Data of completed self-administered questionnaire were analyzed. Regarding station information, 78.8 % of students reported that the task questions in the stations are appropriate to the length of station, 82.7% replied that the stations are practical and 72.1% answered that the information in stations are clear. Reply from 86.7% was that the task was clearly stated, 82.1% responded that patient`s complaint in the clinical stations is brief and given in basic language, while 74.1% replied that findings are "well understood" and clearly described. Analyzing the stations structure, 80.7% of students stated that the number of the stations was enough and 84.7% agreed that the location of stations was good. Conclusion: Objective structured clinical examination for undergraduates' surgical finals is a practical assessment tool even if large numbers of students are involved. Data of this study showed that overall student's perception, satisfaction and acceptability of objective structured clinical examination were encouraging.

Objective: To assess the feasibility and effectiveness of percutaneous needle aspiration under local anesthesia for the treatment of acute breast abscesses in the outpatient breast clinic. Design: A retrospective study of forty three female patients with acute breast abscesses. Setting: Breast clinic in Al Jamhoory teaching hospital in Mosul between February 2004 to February 2007. Methods: Forty three patients with acute breast abscesses were studied. Special enquiries were made regarding lactation, symptomatology and sites of abscesses. All patients had preliminary breast ultrasound (U/S) examination. In the breast clinic, percutaneous needle aspiration of pus under local anesthesia was done followed by systemic antibiotic therapy. Repeated aspiration was carried out later when deemed necessary and follow up by (U/S) was conducted. Results: Forty three patients aged between 16-75 years (mean 37 years) having a provisional diagnosis of acute breast abscesses. All patients presented with a palpable tender mass, of which 4 patients had retroareolar abscesses. All patients had (U/S) of breast. Five patients were found on breast U/S to have inflammation without evidence of focal pus and they only required antibiotics. Four patients refused aspiration and underwent primary incision and drainage under general anesthesia (GA), while in two patients the abscesses were pointing and opened spontaneously before intervention, and they settled with wound toilet and antibiotics alone. The remaining thirty two patients had their abscesses aspirated, and the treatment was successful in twenty nine patients (91%) with no complications or recurrence. The treatment failed in three patients who required subsequent incision and drainage. Conclusions: Percutaneous needle aspiration of acute small unilocular breast abscesses after prior breast (U/S) followed by systemic broad spectrum antibiotics is successful, when the abscesses are completely drained. The use of this modality of the treatment has still not found wide application in our locality. This study is an attempt to recommend its use wherever facilities exist for its feasibility, low cost, no interruption with lactation and better cosmesis, though incision and drainage still may be necessary for definitive treatment for large or multilocular abscesses.