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 .
Efficacy of topical nonsteroidal antiinflammatory drugs in mastalgia treatment.
BACKGROUND The aim of the study was to investigate the effects of topical nonsteroidal antiinflammatory drugs ( NSAIDs ) on mastalgia . STUDY DESIGN A prospect i ve , r and omized , blinded , placebo-controlled study was performed to evaluate the effects of topical NSAIDs on cyclic and noncyclic mastalgia . A total of 108 patients , 60 with cyclic ( group I ) and 48 with noncyclic ( group II ) breast pain were enrolled . Patients within each group were r and omly assigned to receive either topical NSAIDs or placebo three times daily for at least 6 months . Severity of pain was measured before and after 6 months of treatment . RESULTS The pain score decreased significantly when the mean initial breast pain score was compared with the sixth-month breast pain score of the treatment or the placebo group of cyclic ( p = 0.0001 and p = 0.0001 , respectively ) or noncyclic mastalgia ( p = 0.0001 and p = 0.0001 , respectively ) . Significant differences were found when the mean within-person change in pain values in each treatment group were compared with the change in the respective placebo group for either cyclic or noncyclic mastalgia ( p = 0.0001 and p = 0.0001 , respectively ) . Changes in pain within treatment groups or placebo groups for cyclic versus noncyclic mastalgia were not found to be statistically different ( p = 0.53 and p = 0.96 , respectively ) . No side effect was seen in any group . CONCLUSIONS Topical application of NSAIDs was effective in both cyclic and noncyclic mastalgia with minimal side effects
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 .