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 .
The effect of decreased caffeine consumption on benign proliferative breast disease: a randomized clinical trial.
A single-blind , r and omized clinical trial of 56 female subjects was conducted to determine whether decreased consumption of caffeine decreases  breast pain/tenderness or nodularity in patients with suspected benign proliferative breast disease . The subjects were r and omly assigned to one of three groups -- a control group ( no dietary restrictions ) , a placebo group ( cholesterol-free diet ) , and an experimental group ( caffeine-free diet ) . At the initial examination , the subjects reported on the presence of breast pain , the degree to which pain affects daily activities , the frequency of pain , the degree of pain associated with breast examinations , and the degree of pain associated with close-fitting clothing . Subjects were then examined and the four quadrants of each breast were rated on a scale of 0 to 3 ( 0 = normal , fatty tissue , 1 = little seedy bumps or fine nodularity , 2 = discrete nodules or ropy tissue , 3 = confluent areas , hard or soft masses ) . Subjects in all three groups returned for 2- and 4-month follow-up examinations . Total nodularity scores , degree of pain/tenderness , and compliance with dietary restrictions were analyzed . The data showed that decreased caffeine consumption did not result in a significant reduction of palpable breast nodules or in a lessening of breast pain/tenderness
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 .