Cyclical mastalgia usually affects younger women, with the median age being 35 years. The mastalgia is related to the menstrual cycle and is commonly described as a fullness, heaviness, discomfort or pain (of varying degrees of severity), felt particularly for the few days prior to the onset of menstruation. The mastalgia is often described as occurring in the upper and outer quadrant of the breast, and may be bilateral. In some cases the pain/discomfort may be referred to the upper arm or axilla. The mastalgia usually abates after the onset of menstruation, only to return as the menstrual cycle progresses. Physical examination may reveal no overt clinical abnormality apart from some tenderness. Examination, on the other hand, may demonstrate associated breast nodular-ity (localised, diffuse, uni- or bilateral).
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