American Board of Internal Medicine (ABIM) Certification Practice Exam

Which conservative measures are recommended for the treatment of cyclic mastalgia?

1. Medication therapy and ultrasound

2. Education, reassurance, and support garments

3. Surgical intervention and pain relievers

4. Hormonal therapy and physical therapy

The correct answer is: Education, reassurance, and support garments

Cyclic mastalgia, a common condition characterized by breast pain that correlates with the menstrual cycle, is primarily addressed through conservative measures. The recommended approach focuses on education, reassurance, and the use of support garments. Education plays a crucial role in helping patients understand the nature of cyclic mastalgia, emphasizing that the condition is usually benign and closely tied to hormonal fluctuations during the menstrual cycle. This understanding can alleviate anxiety and fears about breast cancer or other serious conditions, which is often a concern for patients experiencing breast pain. Support garments, such as well-fitted bras, can provide physical comfort and reduce movement of the breast tissue, which may exacerbate discomfort. This practical measure can help patients feel more at ease during daily activities and is often an effective and non-invasive way to mitigate symptoms. In contrast, options involving medication therapy, ultrasound, surgical intervention, or hormonal therapy are not the first-line treatments for cyclic mastalgia, particularly because the condition often resolves on its own and does not usually require invasive measures. Therefore, the combination of education, reassurance, and supportive clothing is the most appropriate and effective conservative approach for managing cyclic mastalgia.