Cyclic and non-cyclic breast-pain: A systematic review on pain reduction, side effects, and quality of life for various treatments

The number of studies reported the use of commonly prescribed medications (danazol and bromocriptine) for cyclic and non-cyclic breast-pain, but they were often poorly tolerated and provide temporary relief. In this review, author describe all the various treatment regimen and reported that pain reduction in patients with breast-pain could be achieved with analgesics, hormonal-regimen and possibly surgery as a last resort.

The systematic-review on all the several therapies for (Non-) cyclical-breast-pain are still not clear. This analysis intended to evaluate certain kinds of treatment to alleviate breast-pain and the evidence for their efficacy.

The terms 'mastalgia' and 'therapy' or 'psychotherapy' or 'NSAID' or 'hormones' or 'surgery' or 'analgesia' and synonyms were used during the search. Information was obtained employing the standardised tables and included the type of breast-pain and therapies, number of subjects, the efficiency of treatment and clinical adverse effects. Pro-/retrospective studies and RCT's describing the regimens of breast-pain were accepted. No pooling of information could be obtained due to heterogeneity within the studies. The analysis was performed as per the Approved Reporting Items for Systematic-reviews and Meta-Analysis guidelines. Minimum sample-size criteria and follow-up were ten patients and six months, respectively.

A total of 23 studies comprising 2100 patients were chosen for the analysis. The cyclical and non-cyclical-breast-pain reduced by 58.7 and 63.3 VAS scores by applying the topical Diclofenac, respectively. Severe cyclical-breast-pain can be managed within 2-6 months with either Danazol or Bromocryptine as long as advantages outweigh the adverse effects. Last choices for severe and unresponsive debilitating breast-pain were the bilateral mastectomy with reconstruction.

Breast-pain can be alleviated with the use of hormonal-regimen, analgesics, and apparently surgery as a last option. Further studies are required with well-illustrated patient-features, strong study set-up, and extended follow-up times.