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Breast. 2007 Oct;16(5):503-12. Epub 2007 May 16.

Evidence-based management of Mastalgia: a meta-analysis of randomised trials.

Srivastava A, Mansel RE, Arvind N, Prasad K, Dhar A, Chabra A. University Department of Surgery, Cardiff University, UK.

Several agents have been utilised for therapy of mastalgia based on data from small trials.

Study was restricted to randomised controlled trials comparing Bromocriptine, Danazol, Evening primrose oil (EPO) and Tamoxifen with placebo.

Weighted mean difference in the pain score in favour of Bromocriptine was - 16.31(95% CI -26.35 to -6.27).

Danazol produced a significant benefit with a mean pain score difference - 20.23(95% CI -28.12 to -12.34).

EPO did not offer any advantage over placebo in pain relief, mean pain score difference being -2.78 (95% CI -7.97 to 2.40).

Tamoxifen achieved a relative risk (RR) of pain relief of 1.92 (95% CI 1.42- 2.58).

Tamoxifen is associated with least side effects and should be the drug of first choice.

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