THE ROLE OF REASSURANCE IN THE MANAGEMENT OF PATIENTS WITH NONORGANIC MASTALGIA

Abstract

We prospectively assessed the correlation between the severity of mastalgia and psychological factors. The effect of reassurance on mastalgia was also evaluated. All consecutive patients with complaint of mastalgia were within the scope of study. Patients with organic causes were excluded. All patients with mastalgia which is not related to any organic etiology were asked to answer the questionarres of Beck’s depression index, SCL-90-R test, and self evaluation test state trait anxiety index (STAI). The patients were asked to mark their severity of mastalgia, daily, on a 10 cm-visual analogue scale (VAS) for consecutive 30 days. Average pain scores were calculated from the forms. At this stage the results of their examinations were discussed with the patients and they were reassured if they are free of any organic disease. Following this stage, the patients were asked for further daily VAS assessment whilst next consecutive 30 days. The correlation between the severity of mastalgia and each psychometric test was tested. The impact of reassurance on the severity of pain were assessed. 28 patients completed their initial VAS forms. The mean score for pain severity was 26.7 (0-100). There was a strong and positive correlation between VAS scores and Beck’s depression index and as well as STAI-I. %85 of patients reported that their pain severity is improved following reassurance. In conclusion, there seems a correlation between pain level and depression - anxiety levels. Reassurance seems to be an effective measure as the first line management in patients with non-organic breast pain.