Is there an association between mastalgia and fibromyalgia? Comparing prevalence and symptom severity

Genç, Volkan; Genç, Aysun; Üstüner, Evren; Düşünceli, Ebru; Öztuna, Derya; Bayar, Sancar; Kurtaiş, Yeşim

doi:10.1016/j.breast.2011.01.016

Cited by 17 publications

(22 citation statements)

References 23 publications

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“…However, even though many women with Dercum’s disease have painful lipomas in the breast, both idiopathic mastalgia and lipomas are common in the breast and it is undecided if a single painful lipoma of the breast should render the diagnosis Dercum’s disease. On the other hand, it has been discussed if chronic pain syndromes, such as fibromyalgia, might be associated with mastalgia [35]. …”

Section: Definition and Clinical Descriptionmentioning

confidence: 99%

Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

Hansson

Svensson

Brorson

2012

Orphanet J Rare Dis

105

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Definition and clinical picture: We propose the minimal definition of Dercum's disease to be generalised overweight or obesity in combination with painful adipose tissue. The associated symptoms in Dercum's disease include fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint aches. Classification:We suggest that Dercum's disease is classified into: I. Generalised diffuse form A form with diffusely widespread painful adipose tissue without clear lipomas, II. Generalised nodular form -a form with general pain in adipose tissue and intense pain in and around multiple lipomas, and III. Localised nodular form -a form with pain in and around multiple lipomas IV. Juxtaarticular form -a form with solitary deposits of excess fat for example at the medial aspect of the knee.Epidemiology: Dercum's disease most commonly appears between the ages of 35 and 50 years and is five to thirty times more common in women than in men. The prevalence of Dercum's disease has not yet been exactly established.Aetiology: Proposed, but unconfirmed aetiologies include: nervous system dysfunction, mechanical pressure on nerves, adipose tissue dysfunction and trauma. Diagnosis and diagnostic methods: Diagnosis is based on clinical criteria and should be made by systematic physical examination and thorough exclusion of differential diagnoses. Advisably, the diagnosis should be made by a physician with a broad experience of patients with painful conditions and knowledge of family medicine, internal medicine or pain management. The diagnosis should only be made when the differential diagnoses have been excluded. Differential diagnosis: Differential diagnoses include: fibromyalgia, lipoedema, panniculitis, endocrine disorders, primary psychiatric disorders, multiple symmetric lipomatosis, familial multiple lipomatosis, and adipose tissue tumours. Genetic counselling: The majority of the cases of Dercum's disease occur sporadically. A to G mutation at position A8344 of mitochondrial DNA cannot be detected in patients with Dercum's disease. HLA (human leukocyte antigen) typing has not revealed any correlation between typical antigens and the presence of the condition. Management and treatment: The following treatments have lead to some pain reduction in patients with Dercum's disease: Liposuction, analgesics, lidocaine, methotrexate and infliximab, interferon α-2b, corticosteroids, calcium-channel modulators and rapid cycling hypobaric pressure. As none of the treatments have led to long lasting complete pain reduction and revolutionary results, we propose that Dercum's disease should be treated in multidisciplinary teams specialised in chronic pain. Prognosis: The pain in Dercum's disease seems to be relatively constant over time.

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Section: Definition and Clinical Descriptionmentioning

confidence: 99%

Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

Hansson

Svensson

Brorson

2012

Orphanet J Rare Dis

105

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“…The use of EMG to obtain information about muscle response or electrical activity to a nerve's stimulation of a muscle provides information to the clinician regarding many conditions such as muscle aches, muscle weakness, anomalies related to muscle movements, and muscle atrophy (24,29). Although many studies have evaluated the relationship between fibromyalgia and the nociceptive flexion reflex, we did not find any study evaluating the relationship of nociceptive flexion reflex with mastalgia (30,31). Furthermore, only a few studies have evaluated the relationship between fibromyalgia and CSP, and we found no study investigating the relationship between mastalgia and CSP (25)(26)(27).…”

Section: Discussionmentioning

confidence: 83%

“…For example, both are more prevalent in the female population, both are believed to develop due to stress, and both include clinical similarities (30,32). In their study including 50 patients with mastalgia and 50 with fibromyalgia, Genc et al (31) reported that 36% of mastalgia patients met fibromyalgia criteria, and 42% of fibromyalgia patients had mastalgia complaints. In another study by Sen et al (30), 47.2% of 53 patients with fibromyalgia had mastalgia and 37.7% of 61 patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome (30).…”

Section: Discussionmentioning

confidence: 99%

The Importance of Electromyographic Findings in Determining the Etiology of Mastalgia

Kaya¹,

İdiz²,

Bozkurt³

et al. 2019

Haseki

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The etiology of mastalgia is not fully understood. We evaluated the relationship between electromyography (EMG) measurements of the pectoralis major (PM) muscle and mastalgia in patients with non-cyclic unilateral mastalgia. Methods: Thirty-one patients who were admitted to the breast surgery outpatient clinic due to the complaints of intermittent or continuous unilateral non-cyclic mastalgia for at least one month were included in the study. Data on age, family history, age of menarche, body mass index (BMI), physical examination, breast ultrasonography and mammography findings and amplitudes, latency and cutaneous silent period (CSP) in EMG of the right and left PM muscles were noted. Results: The mean age of the patients was 43.3 (20-65) years; mastalgia affected the left breast and the right breast in 22 (71%) and nine (29%), respectively. Twenty-three patients (74.1%) had a BMI of ≥25 kg/m 2. There was a size difference between the two breasts in eleven patients. The EMG results of PM muscles in healthy and mastalgia sides were compared and there was no significant difference observed between the amplitude and resistance parameters. The mastalgia side had significantly higher CSP values. Conclusion: Prolonged CSP suggests that unilateral mastalgia may be associated with pain modulating mechanisms of the central nervous system.

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“…Despite these limitations, one of the main outcomes of their study was the finding of a possible association between a common form of mastalgia and unexplained pain syndromes. The second study to demonstrate a link between mastalgia and FMS was reported by Genc et al in 2011 21 . In that study, the BPQ was used as a relatively objective assessment tool for evaluating mastalgia.…”

Section: Discussionmentioning

confidence: 91%

“…Similarly, 13 out of 61 mastalgia patients in our study had been previously treated for a psychiatric disorder. To the best of our knowledge, only two clinical studies on the relationship between mastalgia and FMS have been reported to date 1 , 21 . One is the 2006 study by Johnson et al, which demonstrated the association between mastalgia and various chronic pain disorders, including irritable bowel syndrome, chronic pelvic pain and FMS 1 .…”

Section: Discussionmentioning

confidence: 99%

Can mastalgia be another somatic symptom in fibromyalgia syndrome?

Şen¹,

Kılıç²,

Cemeroglu³

et al. 2015

Clinics

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OBJECTIVE:The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome.METHODS:Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to all participants in the mastalgia group and to those in the fibromyalgia syndrome group who had experienced mastalgia during the past three months. The patients in the fibromyalgia syndrome group were evaluated using the 2010 preliminary American College of Rheumatology classification criteria. All of the patients in the mastalgia group were evaluated for the diagnosis of fibromyalgia syndrome by a single physiatrist. The coexistence and pain patterns of mastalgia and fibromyalgia were assessed statistically.RESULTS:Approximately half of the patients with fibromyalgia syndrome (47.2%) reported having mastalgia at the time of admission and 37.7% of the patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome. The patients with mastalgia in the fibromyalgia syndrome group had significantly higher total breast pain scores compared with the women in the mastalgia group. In addition, the patients with fibromyalgia syndrome in the mastalgia group had significantly higher Widespread Pain Index and Symptom Severity Scale scores than the patients with fibromyalgia syndrome.CONCLUSIONS:We suggest that mastalgia can be an aspect of the central sensitivity syndrome and can be added to the somatic symptoms of fibromyalgia.

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Is there an association between mastalgia and fibromyalgia? Comparing prevalence and symptom severity

Cited by 17 publications

References 23 publications

Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

The Importance of Electromyographic Findings in Determining the Etiology of Mastalgia

Can mastalgia be another somatic symptom in fibromyalgia syndrome?

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