RESULTS Reassurance plus bra-fitting advice provides relief for most women .
There is some benefit in reducing dietary coffee and fat intake .
Dopamine agonists are useful , but less effective than endocrine treatments such as Danazol or Tamoxifen .
Of the Selective Oestrogen Receptor Modulator drugs , Ormeloxifene appears most effective , but is not licenced in the United Kingdom .
Relaxation therapy , acupuncture and kinesiology may be useful but currently lack good evidence of effectiveness .
Subsequent drug therapy should be balanced against its side-effects ; topical NSAIDs and Ormeloxifene show greatest benefit with least side-effects .
INTRODUCTION Idiopathic mastalgia ( benign breast pain of unknown origin ) is often poorly managed because of its subjective nature and unclear aetiology .
Mastalgia is a reason for up to 50 % of breast outpatient referrals .
Existing systematic review s discuss date d treatment options that provide limited symptomatic relief .
Management of cyclical mastalgia in oriental women: pioneer experience of using gamolenic acid (Efamast) in Asia.
BACKGROUND In most Western countries gamolenic acid is the first-line treatment for women with cyclical mastalgia . METHODS A prospect i ve study was carried out in the breast referral clinic of the Department of Surgery , University of Hong Kong to evaluate the treatment of cyclical mastalgia using gamolenic acid provided in evening primrose oil ( Efamast , Scotia Pharmaceuticals Ltd , Scotia House , Stirling , Scotl and ) as a pioneer experience in Asia . In addition , the features of cyclical mastalgia in Oriental women were studied by conducting a survey using anonymous question naires . RESULTS Sixty-six women with disturbing cyclical mastalgia seen by one breast surgeon were followed up with a breast pain diary . Thirty-four women had persistently disturbing mastalgia and were commenced on Efamast . Responses were measured at 3 and 6 months according to a st and ardized protocol . An overall useful response rate of 97 % was observed at 6 months . Side-effects were found in 12 % but all were insignificant . CONCLUSIONS Efamast may be recommended as a first-line specific treatment for Oriental women with disturbing cyclical mastalgia
RESULTS Reassurance plus bra-fitting advice provides relief for most women .
There is some benefit in reducing dietary coffee and fat intake .
Dopamine agonists are useful , but less effective than endocrine treatments such as Danazol or Tamoxifen .
Of the Selective Oestrogen Receptor Modulator drugs , Ormeloxifene appears most effective , but is not licenced in the United Kingdom .
Relaxation therapy , acupuncture and kinesiology may be useful but currently lack good evidence of effectiveness .
Subsequent drug therapy should be balanced against its side-effects ; topical NSAIDs and Ormeloxifene show greatest benefit with least side-effects .
INTRODUCTION Idiopathic mastalgia ( benign breast pain of unknown origin ) is often poorly managed because of its subjective nature and unclear aetiology .
Mastalgia is a reason for up to 50 % of breast outpatient referrals .
Existing systematic review s discuss date d treatment options that provide limited symptomatic relief .