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 .
DOUBLE-BLIND CONTROLLED TRIAL OF TAMOXIFEN THERAPY FOR MASTALGIA
60 patients with severe mastalgia of more than 6 months ' duration were r and omly selected for treatment with either tamoxifen 20 mg daily or placebo for 3 months . As measured by linear analogue scoring , pain relief was achieved in 22/31 ( 71 % ) of those receiving tamoxifen and 11/29 ( 38 % ) of those taking placebo . Patients who did not respond to the first course of treatment were allocated to the alternative treatment for 3 months . Pain control was achieved in 8/12 ( 75 % ) of those receiving tamoxifen and 2/6 ( 33 % ) of those receiving placebo . The commonest side-effects were hot flushes ( 27 % of patients receiving tamoxifen and 11 % of those receiving placebo ) and vaginal discharge ( 17 % tamoxifen , 7 % placebo ) . Side-effects caused 6 patients in each group to discontinue treatment . Tamoxifen is of value in the management of severe cyclical and non-cyclical mastalgia , and relief can be achieved without undue side-effects in the majority of patients
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 .