Complete Estrogen Blockade in Recalcitrant Mastalgia: A Pilot Study

Mastalgia is the commonest cause of visit to the breast clinic. The present study was conducted to assess the efficacy of complete estrogen blockade (CEB) with centchroman and LHRH analog goserelin in the treatment of recalcitrant mastalgia. This is a prospective cohort study of 10 patients with recalcitrant mastalgia. Recalcitrant mastalgia was defined as bothersome breast pain with pain scores of six or more on breast pain chart, lasting for at least 7 days in a month even with therapy with first-line drugs for 3 months. The reduction of VAS to 3 or less at 4 weeks of initiation of treatment was the primary objective. Patients meeting the inclusion criteria received CEB for 3 months and were followed for 3 months to see for their symptom relief/recurrence. The pain scores were recorded. Side effects of the drug were noted. The mean pain score at start of study was 7.8. At 4 weeks of initiation of treatment, pain score became zero in five patients and reduced to less than three in three patients. These responders had maximum pain score of 3 during the follow-up period. None of the patients had adverse effect of the magnitude to request cessation of the treatment. There was no difference in characteristics of patients who responded from those who did not. No differences were seen among women with cyclical or noncyclical mastalgia. Complete estrogen blockade is safe and effective for treatment of recalcitrant mastalgia having a good post-treatment effect.