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Breast pain - cyclical - Management
Basis for recommendation
- This recommendation is based on expert opinion in review articles [Dixon and Mansel, 1994; Vaidyanathan et al, 2002; Bundred, 2007], and trial evidence when available.
- There is evidence from randomized controlled trials to suggest that danazol, tamoxifen, gestrinone, goserelin, and toremifene reduce cyclical breast pain compared with placebo.
- However, these treatments can cause unpleasant and serious adverse effects including: for danazol, weight gain, deepening voice, menorrhagia, and teratogenicity; for tamoxifen, vaginal bleeding, vaginal discharge, increased risk of thromboembolism, and endometrial cancer; for gestrinone, hirsutism, acne, and depression; for goserelin, vaginal dryness, hot flushes, acne, and depression; and for toremifene, deep vein thrombosis and teratogenicity.
- CKS therefore advises that these medications are limited to use by specialists or those with a specialist interest in the management of breast pain.
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