Psychological Symptoms and Health Related Quality of Life in Patients with Mastalgia Sociocultural differences in patient with mastalgia

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Gizem Oner
Zeynep Sener Bahce
Nazmiye Kocaman Yıldırım
Fatih Yanar
Bedia Silahsızoğlu
Adnan Haslak
Yıldız Gokalp Argun
Heybet Semur
Beyza Ozcinar


mastalgia, psychological symptoms, SCL-90-R, SF-36.


Background: Mastalgia is common among women and its aetiology is still not fully understood. Studies are conducted to reveal the relationship between breast pain and psychosomatic disorders. The goals of the project are to compare the interaction of psychological symptoms and health related quality of life (HRQL) in patients with mastalgia between East and West of Turkey.

Materials and Methods: Seventy-four women from the General Surgery Clinic of Diyarbakır Ergani Hospital (Eastern group) (n=39) and Istanbul University, Istanbul Faculty of Medicine (Western group) (n=35) were included in the study. The symptom checklist-90-revised (SCL-90-R) scales was used to evaluate physiological findings and Short Form-36 (SF-36) scales was used for evaluating health related quality of life (HRQL).

Results: Median age of patients from Eastern group was 27.54 (18-39) years and 35.57 (18-70) years in Western group (t=-4.585, P<0.0001). Average Global Severity İndex (GSI) scores of the eastern group were statistically significantly higher than the western group (P<0.01). When the SCL-90-R values ​​of the eastern and western groups are compared, somatization, interpersonal sensitivity, phobic anxiety, psychoticism, depression and anxiety in the eastern group are higher than the western group. According to SF-36 results, the mean scores in the eastern group tended to be lower than in the western group.

Conclusion: The results revealed that psychological symptoms differ between east and west of Turkey. This may indicate that socio-economic differences may also have effects on psychological symptoms. In addition, mastalgia negatively affects women's quality of life.


1. Tejwani PL, Srivastava A, Nerkar H, Dhar A, Hari S, Thulkar S, et al. Centchroman regresses mastalgia: a randomized comparison with danazol. Indian J Surg.2011; 73(3): 199–205. doi: 10.1007/s12262-010-0216-z.
2. Ader DN, South-Paul J, Adera T, Deuster PA. Cyclical mastalgia: prevalence and associated health and behavioral factors. J Psychosom Obstet Gynaecol. 2001; 22: 71–6. doi: 10.3109/01674820109049956.
3. Ader DN, Browne MW. Prevalence and impact of cyclic mastalgia in a United States clinic-based sample. Am J Obstet Gynecol. 1997; 177:126–32. doi: 10.1016/s0002-9378(97)70450-2.
4. Kataria K, Dhar A, Srivastava A, Kumar S, Goyal A. A systematic review of current understanding and management of mastalgia. Indian J Surg. 2014. 76(3): 217–22. doi: 10.1007/s12262-013-0813-8.
5. Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clin Proc. 2004; 79: 353–72. doi: 10.4065/79.3.353.
6. Srivastava A, Mansel RE, Arvind N, Prasad K, Dhar A, Chabra A. Evidence- based management of mastalgia: A meta-analysis of randomised trials. Breast. 2007; 16: 503–12. doi: 10.1016/j.breast.2007.03.003.
7. Stachs A, Stubert J, Reimer T, Hartmann S: Benign breast disease in women. Dtsch Arztebl Int 2019; 116: 565–74. doi: 10.3238/arztebl.2019.0565.
8. Kanat BH, Atmaca M, Girgin M, Ilhan YS, Bozdağ A, Ozkan Z, et al. Effects of Mastalgia in Young Women on Quality of Life, Depression, and Anxiety Levels. Indian J Surg. 2016; 78(2): 96–9. doi: 10.1007/s12262-015-1325-5.
9. Preece PE, Mansel RE, Hughes LE. Mastalgia: psychoneurosis or organic disease? Br Med J. 1978; 1: 29–30. doi: 10.1136/bmj.1.6104.29.
10. Jenkins PL, Januil N, Gateley C, Mansel RE. Psychiatric illness in patients with severe treatment-resistant mastalgia. Gen Hosp Psychiatry. 1993; 15: 55–7. doi: 10.1016/0163-8343(93)90092-3.
11. Colegrave S, Holcombe C, Salmon P. Psychological characteristics of women presenting with breast pain. J Psychosom Res. 2001; 50: 303–7. doi: 10.1016/s0022-3999(01)00196-9.
12. Johnson KM, Bradley KA, Bush K, Gardella C, Dobie DJ, Laya MB. Frequency of mastalgia among women veterans. Association with psychiatric conditions and unexplained pain syndromes. J Gen Intern Med. 2006; 21 (3): 70-5. doi: 10.1111/j.1525-1497.2006.00378.x.
13. Saib MS, Caudeville J, Carre F, Ganry O, Trugeon A, Cicolella A. Spatial relationship quantification between environmental, socioeconomic and health data at different geographic levels. Int J Environ Res Public Health. 2014; 11(4):3765-86. doi: 10.3390/ijerph110403765.
14. Suzuki E, Kashima S. Kawachi I, Subramanian SV. Geographic Inequalities in All-Cause Mortality in Japan: Compositional or Contextual? PLoS ONE 2012; doi:10.1371/journal.pone.0039876.
15. Celebioglu F, Dall’erba S. Spatial disparities across the regions of Turkey: an exploratory spatial data analysis. Ann Reg Sci. 2010; 45: 379-400. doi: 10.1007/s00168- 009-0313-8.
16. Derogatis LR, Rickels K, Rock AF. The SCL-90 and the MMPI: a step in the validation of a new self-report scale. Br J Psychiatry.1976; 128: 280-9. doi: 10.1192/bjp.128.3.280.
17. Schmitz N, Hartkamp N, Kiuse J, Franke GH, Reister G, Tress W. The Symptom Check List–90-R (SCL-90–R): a German validation study. Qual Life Res. 2000; 9(2): 185-93. doi: 10.1023/a:1008931926181.
18. Gabrysh C, Fritsch R, Priebe S, Mundt PA. Mental Disorders and Mental Health Symptoms During Imprisonment: A Three-Year Follow-Up Study. PLoS ONE 2019; 14(3): e0213711. doi: 10.1371/journal.pone.0213711.
19. Ware JE (2004) SF-36 health survey update. In: Maruish ME (ed) The use of psychological testing for treatment planning and outcomes assessment, 3rd edn. Lawrence Erlbaum Associates, USA, 693–71.
20. Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. Kısa. Form-36 KF-36'nın Türkçe Versiyonunun Güvenilirliği ve Geçerliliği. İlaç ve Tedavi Dergisi. 1999;12:102–106.
21. Ministry of Health of Turkey. Turkey National Health Accounts Household Health Expenditures 2002– 2003. Ministry of Health of Turkey, Refik Saydam Hygiene Center Presidency, School of Public Health, Ankara. 2006. http:// health-expend-.html Accessed 10.09.2013
22. Unlu A. An Analysis On The TRC3 Region in Creation of Gross Domestic Product Of Turkey And The Comparison of “Locomotive Cities”. Dergipark, Ekonomi Finans İşletme Dergisi, 2019; 2(1):1-12.
23. Sözmen K, Baydur H, Simsek H, Unal B. Decomposing socioeconomic inequalities in self-assessed health in Turkey. Int J Equity Health. 2012; 11:73. doi: 10.1186/1475-9276-11-73.
24. Sen M, Kılıc MO, Cemeroglu M, Icen D. Can mastalgia be another somatic symptom in fibromyalgia syndrome? CLINICS. 2015; 70(11): 733-7. Doi: 10.6061/clinics/2015(11)03.
25. Barros AC, Mottola J, Ruiz CA, Borges MN, Pinotti JA. Reassurance in the treatment of mastalgia. Breast J.1999; 5:162–5. doi: 10.1046/j.1524-4741.1999.98089.x.
26. Balleyguier C, Arfi-Rouche J, Haddag L, Canale S, Delaloge S, Dromain C. Breast pain and imaging. Diagn Interv Imaging 2015; 96: 1009–16. doi: 10.1016/j.diii.2015.08.002.
27. Kosoglu D, Kursun S, Akın B, Altıntug K. Mastalgia and associated factors: a cross-sectional study. Agri. 2017; 29(3): 100–8. doi: 10.5505/agri.2017.91069.

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