title: A systematic review of current understanding and management of mastalgia.
abstract: Breast pain or mastalgia is the common symptom in the breast. The two most common concerns of patients presenting with mastalgia are: the fear that breast pain is a symptom of breast cancer and the presence of severe pain that affects a woman's quality of life. Breast pain requires thorough assessment and should be investigated in the same manner as any other breast symptom. We conducted a systematic review of treatment for breast pain. We searched various reviews, randomized controlled trial, and observational studies over Pubmed and Medline via internet. Searches were carried out on MEDLINE (1950-present), EMBASE (1980-present), and CINAHL (1981-present) using the NHS Evidence Healthcare Databases Advanced Search interface. A further search was also carried out on Cochrane Database of Systematic Reviews (issue 12 of 12, Dec 2011) and Central Register of Controlled Trials (issue 4 of 4, Oct 2011). If no abnormality is found in the breast on assessment, then a combination of reassurance, breast support brassiere, and topical NSAID gel massage are usually effective. Antiestrogen (centchroman/tamoxifen) therapy for 3 to 6 months is the second-line treatment of choice. Danazol may be used in resistant cases. Gamma-linolenic acid or evening primrose oil though commonly prescribed is not effective.
authors.affiliation: Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029 India.
authors.forename: Kamal
authors.initials: K
authors.lastname: Kataria
authors.affiliation: Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029 India.
authors.forename: Anita
authors.initials: A
authors.lastname: Dhar
authors.affiliation: Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029 India.
authors.forename: Anurag
authors.initials: A
authors.lastname: Srivastava
authors.affiliation: Department of Surgical Disciplines, All India Institute of Medical Sciences, Bhopal, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Derbyshire Breast Unit, Derbyshire, UK.
authors.forename: Amit
authors.initials: A
authors.lastname: Goyal
keywords: Centchroman; Cyclical mastalgia; Danazol; Diclofenac gel; Mastalgia; Noncyclical mastalgia