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, double-blind, placebo-controlled trial of ormeloxifene in breast pain and nodularity.
BACKGROUND Breast pain and non-discrete breast nodularity are common in women . METHODS We did a r and omized , double-blind , placebocontrolled trial of oral ormeloxifene 30 mg , a selective oestrogen receptor modulator ( SERM ) or placebo twice a week for 3 months in 20 - 50-year-old women with breast pain with or without lumpiness . Women with a discrete benign lump or cancer were excluded from the study . Serial assessment s of pain on a visual analogue scale and nodularity grade on a 5-point ordinal Lucknow-Cardiff scale were done . A total of 151 patients were r and omly allocated to two interventions using a block size of 4 . RESULTS Of the 151 patients , 121 ( active 57 , placebo 64 ) were available for efficacy analysis . The mean pain level showed a systematic downward trend over five visits ( F=105.23 , p<0.0001 ) that significantly reduced in the active group compared to that in the placebo group ( F=18.66 , p<0.0001 ) . The patterns of variation in pain over time for the individual groups differ from the overall mean pattern for the two groups and thus from one another ( F=44.43 , p<0.0001 ) . Cumulative frequencies of breast nodularity grade s during successive visits showed significant improvement ( p=0.001 ) compared to placebo at the end of the third month . The effect of the active drug persisted till the completion ( 6 months ) of treatment ( p<0.001 ) . At the last visit , 93.3 % of women in the active group had grade 2 or lower nodularity as compared to 71.1 % in the placebo group . Oligomenorrhoea alone was reported by 12 patients . CONCLUSION Ormeloxifene showed significant efficacy for treating breast pain and nodularity
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 .