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 .
A randomized multicenter study of gamolenic acid (Efamast) with and without antioxidant vitamins and minerals in the management of mastalgia.
In a double-blind , placebo-controlled , parallel group , multicenter study , 555 women with moderate to severe mastalgia were r and omized to one of the four treatment groups to receive ( a ) gamolenic acid ( GLA ) and antioxidants , ( b ) placebo fatty acids and antioxidants , ( c ) GLA and placebo antioxidants , or ( d ) placebo fatty acids and placebo antioxidants , for four menstrual cycles . This was followed by a further eight menstrual cycles of open treatment in which all patients received GLA , but continued to be r and omized to active or placebo antioxidants as in the preceding parallel phase . Diary pain cards and linear analog charts were used for assessment of response . A reduction in breast pain was seen in all four treatment groups during the blinded treatment phase . There was a substantial improvement in the placebo fatty acids groups ( response rate of 40 % ) , and there were no significant differences among the four treatment groups . During the open treatment phase , a further reduction in breast pain was seen in all groups , with no statistically significant differences between groups . This study showed that GLA ( Efamast ) efficacy did not differ from that of placebo fatty acids , regardless of whether or not antioxidant vitamins were present
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 .