title: Local anaesthetic and steroid combined injection therapy in the management of non-cyclical mastalgia.
abstract: OBJECTIVE
  We aimed to assess the effectiveness of a local anaesthetic and steroid combination injection therapy in the management of non-cyclical mastalgia.
  
  
  METHODS
  Patients with non-cyclical mastalgia were assessed for rib tenderness (lateral chest wall tenderness-LCWT). The tenderest spot was injected with a combined preparation of 1 ml 2% lignocaine and 1 ml 40 mg depomedrone. Those who declined injection therapy were advised on topical or oral NSAIDs or reassurance. All patients were reassessed 6 weeks later. A successful outcome was taken as either a complete response (CR) or partial response (PR), i.e. pain although present is tolerated.
  
  
  RESULTS
  One hundred and thirty eight women were diagnosed with LCWT. One hundred and four women were injected. Thirty-four women declined and were managed appropriately. At assessment 83 injected cases were successful (83%; CR n = 61, PR n = 22) compared to 13 non-injected cases (44.8%; CR n = 5, PR n = 8, P < 0.0001). No side effects were recorded. Sixteen cases recurred and were successfully re-injected.
  
  
  CONCLUSIONS
  A steroid and local anaesthetic injection is an effective and safe treatment for LCWT.
authors.affiliation: Breast Department, Nottingham City Hospital, Nottingham NG5 1PB, UK. haimi@dsl.pipex.com
authors.forename: H N
authors.initials: HN
authors.lastname: Khan
authors.forename: R
authors.initials: R
authors.lastname: Rampaul
authors.forename: R W
authors.initials: RW
authors.lastname: Blamey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001941:Breast Diseases / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008775:Methylprednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000077555:Methylprednisolone Acetate; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D059408:Pain Management
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D000077555:Methylprednisolone Acetate; D008012:Lidocaine; D008775:Methylprednisolone