Objective: Mastalgia originated from the breast itself, as well as diseases occurring in the muscles, joints and bones around the breast. The objective of current study is to investigate the frequency of chronic pain syndromes, thoracic wall and vertebral pathologies in patients with mastalgia.

Materials and Methods: Women aged 18-60 years, who presented to the outpatient clinic with non-cyclical breast pain and had normal breast examination, breast ultrasound and/or mammography were included in the study. Patients were evaluated for Fibromyalgia Syndrome (FMS), Myofascial Pain Syndrome (MFPS), pain related vertebral pathologies, thoracic wall pathologies. Cervical and thoracic vertebraes were evaluated with magnetic resonance imaging (MRI).

Results: The study included 54 female and mean age was 44.2±10.5 years. Forty-five (75%) patients were diagnosed with FMS, 22 (40.7%) with MFPS. Frequency of vertebral disc pathology was 31 (59.3%), thoracic disc pathology was 14 (23.3%). Only 6 (11%) patients had costochondritis. MRI evaluation revealed cervical syrinx, thoracic spondylosis and hemangioma in T4 vertebra in 1 (2%) patients. Only 5 (9.3%) of these patients had no musculoskeletal pathology. There was a significant difference between the ages of patients with MFPS and the ages of patients without MFPS, and patients with MFPS formed the younger group (P<0.001). Mean age was significantly higher patients with cervical disc hernias compared to those without (P=0.037).

Conclusion: Pain which originated from adjacent musculoskeletal structures is frequent in patients with mastalgia. We consider that young patients with mastalgia should be investigated for FMS and MFPS, and older patients should be investigated for vertebral disc pathologies.