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 .
Comparison of Naproxen with Placebo for the Management of Noncyclical Breast Pain: A Randomized, Double-Blind, Controlled Trial
Background Breast pain is a common symptom in patients attending breast clinics . Although most patients experience mastalgia of mild to moderate severity , approximately 15 % of patients suffer from severe pain that causes significant distress and some disturbance in their daily life that lead them to seek treatment . Despite a considerable number of drugs suggested for decreasing the severity of mastalgia , there is no st and ard treatment for the complaint . In this study , we investigated the effect of naproxen on reducing the complaint of breast pain compared with placebo . Methods Eighty-one women suffering from noncyclic breast pain were recruited to a r and omized , double-blind , clinical trial between January 2002 and September 2004 . All patients were suffering from this complaint for at least 3 months before the study . Patients were r and omly assigned to two groups . Patients in the case group received naproxen 250 mg BD . Patients in the placebo group took placebo in a similar manner . The intensity of mastalgia was assessed before and twice after intervention by using a Visual Analogue Scale . Results Forty-two of 81 patients were recruited r and omly as cases and the remaining 39 were assigned placebo . Of these 24 and 22 patients fulfilled the study protocol respectively . The mean age of patients was 35 ( SD = 7.5 ; range , 19–55 ) years . The mean pain severity at the beginning of the study was 5.8 and 6.1 in naproxen and placebo groups , respectively . The severity of pain was decreased significantly at the end of the study in both groups ( 3.9 in patients and 3.7 in controls ( P = 0.005 and 0.0001 ) ) . Although the decrease in pain severity in each individual group was statistically significant , it was not significant compared with one another ( P = 0.64 ) . Conclusions Breast pain is a complex symptom that can be relieved significantly with reassurance . According to the result of this study , naproxen has no superiority over placebo in reducing noncyclic breast pain
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 .