Dilemma of mastalgia

ABSTRACT

To determine whether instances of mastalgia labelled as refractory were truly refractory to treatment or whether they were merely instances of inadequate treatment, by observing their response to non-pharmacological treatment. A prospective observational study carried out from 2003 to 2005. The study was undertaken in an Out-patient Breast Clinic setting at Sarfaraz Rafiquee Shaheed Hospital and Tahir Medical Centre, Karachi. Fifty-eight patients with "refractory mastalgia" were evaluated. The patients were treated by reassurance, low-fat, methyl xanthine restricted diet and dietary supplementation with 500 mg/day of evening primrose oil. The response was assessed at three and six months after begining the treatment. There was a 94.3% overall response to non-pharmacological treatment, which indicated that they were all instances of inadequately treated mastalgia and not refractory mastalgia. Cases of mastalgia labelled as refractory are usually due to inadequacy of treatment