Another cause of researched mastalgia in non-lactating women (that should
also be considered during lactation) that I forgot to mention in my previous
post, is duct dilatation.


Peters F. Diemer P. Mecks O. Behnken L LJ.
Severity of mastalgia in relation to milk duct dilatation.
Obstetrics & Gynecology. 101(1):54-60, 2003 Jan.

Abstract
OBJECTIVE: The etiology of mastalgia is poorly understood. Histology cannot
detect any distinct characteristics. This investigation therefore applied
ultrasonography to mastalgia patients to investigate morphological
structures and to obtain further insights into the pathophysiology of
mastalgia. The aim of the study was to analyze the significance of milk duct
dilatation in patients with mastalgia. METHODS: A total of 335 premenopausal
women participated in a genital and breast cancer screening program. Of
these, 123 women were asymptomatic and 212 complained of breast pain (136
had cyclical mastalgia; 76 reported the noncyclical type). The width of milk
ducts was measured by ultrasonography and correlated with the intensity of
breast pain. The site of the pain was correlated with duct dilatation.
Statistical analysis was performed using the t test, the chi(2) test,
analysis of variance, and Pearson correlation. RESULTS: In asymptomatic
women, the maximum mean width of the milk ducts was 1.8 +/- 0.84 mm, in
cyclical mastalgia 2.34 +/- 1.10 mm, and 3.89 +/- 1.26 mm in noncyclical
mastalgia (P <.001). The intensity of pain showed a significant, positive
correlation with the width of the milk ducts (r =.5008, P <.001).
Noncyclical mastalgia patients located the pain at the site where dilated
ducts were detected ultrasonographically (P <.001). CONCLUSION: The results
of this study demonstrate that duct ectasia is a major factor in mastalgia.
The degree of duct dilatation correlates positively with the intensity of
breast pain. In the noncyclical type of pain, there is a positive
correlation between the site of duct dilatation and the site of pain.

Cathy Fetherston
Perth, Western Australia

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