Mastalgia: Nursing management

Murugalakshmi^1*, Angel Roselin S²

¹Nursing Supervisor, Kauvery Hospital, Tirunelveli, Tamil Nadu

²Deputy Nursing Supervisor , Kauvery Hospital, Tirunelveli, Tamil Nadu

*Correspondence

Abstract

Mastalgia (breast pain) is a common clinical complaint among women and is usually benign, although it requires careful assessment to exclude serious breast pathology. This case report describes the nursing management of a female patient who presented with breast tenderness and uncontrolled diabetic mellitus. On assessment, the patient’s GRBS: 329mg/dl, and her pain score was 4/10. Following clinical evaluation, the patient was referred to the general surgeon and advised to undergo Fine Needle Aspiration Cytology (FNAC) for further diagnostic evaluation.

Key words: Mastalgia; Nursing care; Diabetes Mellitus; Comparative study; I & D; FNAC; Culture; Genexpert; Breast pain;

Introduction

Nursing care focused on pain assessment, blood glucose monitoring, patient education, emotional support, and timely referral. This case highlights the importance of comprehensive nursing assessment, multidisciplinary collaboration and early investigation to ensure appropriate diagnosis and management.

Case presentation

A female patient presented with complaints of breast tenderness. Pain assessment revealed a pain score of 4/10. GRBS- 329 mg/dl, indicating uncontrolled diabetic mellitus. Physical examination was performed, and the patient was referred to the General Surgeon for further evaluation. FNAC was advised to determine the underlying cause of breast tenderness.

Image Source: Clevel and clinic; Mastitis; 02/06/2023

Image Source: Dreamstime; Mastalgia (Breast Pain)

Nursing Assessment

Chief complaint	Breast Tenderness
Pain Score	4/10
GRBS	329 mg/dl
LMP	16.07.2026
General condition	Stable
Referral	General surgeon
Investigation advised	FNAC
Procedure performed:	Incision and drainage (I&D) with 30ml pus drained.

Diabetic mellitus x 6years
Normal bowel and bowel pattern.
Sample sent for: culture and genexpert

Local Examination

Right breast warmth – Present

–Tenderness over lower medial and lateral aspect
-No nipple discharge
-No nipple retraction
-No axillary lymph node enlargement.

Comparative case presentation

Nursing care
Mastalgia is usually benign but needs evaluation	Patient presented with breast tenderness and were assessed for severity and underlying cause.
Pain is assessed clinically using standard scales.	Pain score recorded as 4/10 using Numeric Rating scale.
Diabetes Mellitus complicates infection and healing	GRBS found to be 329mg/dl indicating uncontrolled diabetes; monitoring initiated.
Imaging and cytology (FNAC) may required	FNAC was advised and patient referred to general surgeon.
Abscess requires drainage if present.	Incision and drainage performed with 30ml pus removed.
Targeted Antibiotics	Inj.Piptaz,
	Inj.Metrogyl
	Inj.Linezolid.
	Antibiotic escalation done.
	Inj.Dalacid
	At discharge T.Dalacid.
Infection confirmation requires lab testing.	Pus sample sent for culture and Genexpert testing.
Early intervention improves recovery	Patient remained stable post-procedure.
Infection control prevents complications	Adequate drainage achieved and samples sent for testing.
Glycemic control supports healing	Patient counselled for diabetes management.
Multidisciplinary care ensures better outcomes	Follow-up with general surgeon ensured.

S.No	Medication chart	Dosage
1	Inj. Linezolid	600mg IV 1-0-1
2	Inj.Metrogyl	500mg IV 1-1-1
3	Inj.Pipatz	4.5gms 1-1-1
4	Inj.Pantocid	40mg 1-0-1
5	Inj.Neurobion Forte	0-0-1
6	Inj.Paracetamol	1-0-1
7	T.Rutonil	1-0-1
8	T.Ultracet	1-0-1
9	T.Vit.E	1-0-0
10	T.Chymoral Doote	1-0-1
11	Inj.Fortwin	HS
12	Inj.Phenargan	HS
13	Inj.Merogram	1 gm 1-1-1
14	Inj.Dalacin	300mg 1-0-1
15	Inj.Human Mixtard	28 U -0-10 U

USG scan report

An ill defines hypoechoic area measuring 2.4 x 1.5 cm in the 7 o Clock position of right breast with posterior acoustic shadowing. Moderate surrounding edema noted.

Diagnosis: Right breast abscess

Details of surgical procedure.

Under GA parts painted and draped.
Circum circular incision made over 6 O clock to 7 O clock position and deepened. About 150ml of pus drained
Incision extends at 7 O clock position radially.
Loculated pus collection noted in the lower medial, lateral quadrant of right breast, pus drained.
Thorough wash given
Compressive sterile dressing applied.

Condition at discharge

General condition is good.
Diabetic diet
Physical activity -Walking – 20 to 30 minutes daily.

Nursing Practice

This case demonstrates that effective outcomes are achieved when theoretical knowledge is applied through systematic nursing assessment, timely surgical intervention, infection control, glycemic monitoring and patient education. The patient showed clinical stability following I & D, escalation of the antibiotics on time, with appropriate diagnostic sampling and planned follow-up care, reflecting safe and holistic management.

Conclusion

This case emphasizes the significance of comprehensive nursing assessment, timely surgical intervention, effective infection control, and optimal glycemic management in the successful treatment of a breast abscess. A multidisciplinary approach, combined with evidence-based nursing care and patient education, contributed to favorable clinical outcomes and highlights the essential role of nursing in ensuring safe, holistic, and patient-centered care.

Mastalgia: Nursing management

Mastalgia: Nursing management

Murugalakshmi1*, Angel Roselin S2

Nightingale Journals

Murugalakshmi^1*, Angel Roselin S²