Mastalgia is a common complaint associated with disorders of the breast. The management of mastalgia consists of exclusion of malignancy, classification into its various patterns, reassurance, drug therapy for severe cases, and, rarely, surgery.
Differentiation into cyclical and noncyclical patterns is useful for objective assessment of pain severity and for selection of appropriate drug therapy and subsequent monitoring of response. About 85% of new patients will be satisfied with
adequate
reassurance, but some 15% will have persistent pain and warrant medical treatment. Noncyclical pain has a lower response rate compared to cyclical mastalgia. Some drugs have been demonstrated to be more effective than placebo ; these are danazol,
bromocriptine, and tamoxifen. No ideal agent exists and the choice of drug will depend on efficacy, side effects, and cost.
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