J Obstet Gynaecol Can. 2006 Jan;28(1):49-71; quiz 58-60, 72-4. Mastalgia.
Rosolowich V, Saettler E, Szuck B, Lea RH, Levesque P, Weisberg F, Graham J, McLeod L, Rosolowich V; Society of Obstetricians and Gynecologists of Canada (SOGC).
Breast Health Centre, Winnipeg Regional Health Authority, Winnipeg, Manitoba.
OBJECTIVE: To review the current management of women with breast pain. OPTIONS: The effect of various treatment modes and health practices, including medications, was considered for the management of both cyclical and noncyclical breast pain. OUTCOMES: Effective and timely management of the woman with breast pain and improved quality of...............................
Education and reassurance is an integral part of the management of mastalgia and should be the first-line treatment.
The use of a well-fitting bra that provides good support should be considered for the relief of cyclical and noncyclical mastalgia.
A change in dose, formulation, or scheduling should be considered for women on HRT. HRT may be discontinued if appropriate.
Women with breast pain should not be advised to reduce caffeine intake.
Vitamin E should not be considered for the treatment of mastalgia.
There is presently insufficient evidence to recommend the use of evening primrose oil (EPO) in the treatment of breast pain.
Flaxseed should be considered as a first-line treatment for cyclical mastalgia
Topical non-steroidal anti-inflammatory gel, such as diclofenac 2% in pluronic lethicin organogel, should be considered for pain control for localized treatment of mastalgia.
Tamoxifen 10 mg daily or danazol 200 mg daily should be considered when first-line treatments are ineffective.
Mastectomy or partial mastectomy should not be considered an effective treatment for mastalgia. (III E).