American Board of Internal Medicine (ABIM) Certification Practice Exam

What initial treatment is typically recommended for cyclical breast pain?

1. Use of hormone replacement therapy

2. Application of cold compresses

3. Education and support garments

4. Prescription of antidepressants

The correct answer is: Education and support garments

Cyclical breast pain, also known as cyclical mastalgia, is often linked to hormonal fluctuations during the menstrual cycle. The initial treatment approach typically emphasizes non-invasive and supportive therapies. Education about the condition and the reassurance that it is usually benign are crucial first steps. This helps patients understand their symptoms and reduces anxiety associated with them. Supportive garments, such as well-fitted bras, can provide comfort and alleviate some of the discomfort associated with cyclical breast pain. These garments help stabilize the breast tissue, potentially reducing tenderness and the sensation of pain. Hormone replacement therapy may be used in certain situations for women experiencing more severe symptoms, but it is not the first-line treatment for cyclical breast pain. Cold compresses can offer temporary relief but are not a long-term solution or standard initial therapy. Antidepressants are generally prescribed for chronic pain or severe symptoms that do not respond to first-line treatments, rather than as a primary approach to cyclical breast pain. Thus, the initial treatment focusing on education and the use of supportive garments is both practical and aligns with the general management practices for cyclical breast pain.