Clinical reference

Mastalgia (Breast pain)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

RCOG Guidelines on Management of Breast Pain 2018 · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)

Verified against3 documents

MSF Essential Drugs 2024 - paracetamol (oral)
Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)
Mastalgia - disease-level clinical article (mastalgia-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

Cyclic breast pain recurs on both sides, worsens before the period, and eases with menstruation [breast pain]
Noncyclic pain is one-sided, continuous or intermittent, and unrelated to the menstrual cycle [breast pain]
Extramammary pain sits at the outer edges of the breast and often comes on with activity

Signs — what you find (2)

Pressing on a specific chest-wall spot reproduces the pain in extramammary mastalgia [breast pain]
A very lateral or medial one-sided location in the breast points away from a true breast origin for the pain

Tests (7)

No imaging is needed for cyclic or diffuse noncyclic pain with a normal breast exam and no high-risk factors
Imaging is reserved for noncyclic focal pain or an abnormal finding on clinical examination
MRI is not indicated for evaluating mastalgia by itself
Women 40 and older start with mammography or tomosynthesis, adding ultrasound for BI-RADS 1 to 3 findings
Ultrasound also picks up about 40% of benign palpable masses that mammography alone misses
Women under 30 start with ultrasound because of denser breast tissue and lower cancer risk
Core biopsy is generally favored over fine-needle aspiration for its higher sensitivity and specificity

If not this — what else fits (7)

Referred pain from a musculoskeletal cause such as costochondritis
Structural causes such as an ill-fitting bra or macromastia
Medication side effects, including contraceptives, SSRIs, and digoxin
Referred cardiovascular pain, for example from ischemic heart disease
Referred gastrointestinal pain, for example from peptic ulcer disease
Referred respiratory pain, for example from pleuritis or pneumonitis
Breast cancer is a differential to exclude, though it rarely presents with pain

SourceStatPearls "Mastalgia" - disease-level clinical article

Presentation findings are traced to the source above.

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g 3 or 4 times daily (max. 4 g daily) - as needed during painful symptomatic days

Paediatric dose

Dose by age
Child 1 month and over:	15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily)

Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Simple analgesic offered first when reassurance and a properly fitted support bra alone do not control cyclical or non-cyclical breast pain.

Cautions

Reassurance and proper fitting support bra benefit up to 80% of cyclical mastalgia.
Examine for focal breast mass, skin changes, or nipple discharge.
Refer to specialist breast clinic if discrete mass or bloody nipple discharge is present.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
FEBRIMOL 500 MG 20 TAB.	PHARCO	3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.	MEMPHIS	8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.	MUP	13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.	EIPICO	24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.	UTOPIA	42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.	MISR	38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETS	JULPHAR	32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETS	AUG PHARMA	50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solid	PHARCO	4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solid	PHAROPHARMA	5.00 EGP

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose source

Mastalgia - disease-level clinical article (mastalgia-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions

RED FLAG - The physical exam red flags that mean the pain needs evaluation for malignancy rather than symptomatic analgesia are a lump, skin changes, nipple retraction or discharge, and ulceration.

IBUPROFEN

2nd line

Strength400 mg

Formoral.solid

Adult dose and duration

400 mg 3 times daily after food

Paediatric dose

(Adolescents >=12 years: 200-400 mg 3 times daily after food)

Dose by age
12 years and over:	200-400 mg three times daily after food

Dose source

Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)

Why

NSAID stepped up to when paracetamol alone does not control breast pain, targeting the inflammatory component of mastalgia.

Cautions

Topical NSAID gel applied to painful areas has fewer GI side effects than oral NSAIDs.
Evaluate relationship to menstrual cycle (cyclical vs non-cyclical).
Exclude musculoskeletal chest wall pain (Tietze syndrome).
Consult a doctor if symptoms persist or worsen, or if required for more than 10 days.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
DAJUANOFEN 400 MG 20 F.C. TABS.	COPAD PHARMA	5.00 EGP (0.25/unit)
FLABU 400MG 10 F.C.TAB.	DELTA PHARMA	3.75 EGP (0.38/unit)
NOVA-PROFEN 400MG 30 F.C. TABLETS	SANOFI	12.75 EGP (0.42/unit)
IBUPROFEN 400 MG 10 TAB.	SEDICO	6.00 EGP (0.60/unit)
MAFO 400 MG 30 F.C.TABS	EIPICO	42.00 EGP (1.40/unit)
BRUFEN 400 MG 30 TABS.	KAHIRA > ABBOTT LABORATORIES	78.00 EGP (2.60/unit)
PROFUSOL 400MG 20 S.G CAPS.	EUROPEAN EGYPTIAN PHARM. IND.	31.00 EGP
ANALGIPROF 400 MG 25 SACHETS	EVA PHARMA	37.50 EGP
NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML? strength differs? different route - not oral solid	SANOFI	2.25 EGP
BRUFEMOL-N SUSP. 60 ML? strength differs? different route - not oral solid	ARAB DRUG COMPANY (ADCO)	4.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.