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. 1990 Mar;72(2):71–76.

A randomised controlled trial of medroxyprogesterone acetate in mastalgia.

P R Maddox 1, B J Harrison 1, J M Horobin 1, K Walker 1, R E Mansel 1, P E Preece 1, R I Nicholson 1
PMCID: PMC2499117  PMID: 2139769

Abstract

A double-blind crossover study giving 20 mg/day of medroxyprogesterone acetate during the luteal phase was carried out in 26 women with cyclical mastalgia. Symptomatic response to this progestogen supplementation or placebo was assessed objectively by clinical examination and subjectively by linear analogue scales and breast pain charts. No significant relief of pain or tenderness was found on placebo or active treatment, irrespective of treatment order, and breast nodularity was similarly unaltered. No evidence of progesterone deficiency or prolactin abnormality was found. Side-effects were incurred in 11 patients (five on placebo, five on active treatment and one while on both) and were mostly vague premenstrual symptoms. We conclude that the therapeutic response of medroxyprogesterone acetate in cyclical mastalgia is no better than placebo and that progestogen supplementation can no longer be recommended for routine use in the management of breast pain.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aitken R. C. Measurement of feelings using visual analogue scales. Proc R Soc Med. 1969 Oct;62(10):989–993. [PMC free article] [PubMed] [Google Scholar]
  2. Colin C., Gaspard U., Lambotte R. Relationship of mastodynia with its endocrine environment and treatment in a double blind trial with lynestrenol. Arch Gynakol. 1978 Feb 22;225(1):7–13. doi: 10.1007/BF00672829. [DOI] [PubMed] [Google Scholar]
  3. England P. C., Skinner L. G., Cottrell K. M., Sellwood R. A. Sex hormones in breast disease. Br J Surg. 1975 Oct;62(10):806–809. doi: 10.1002/bjs.1800621014. [DOI] [PubMed] [Google Scholar]
  4. Fentiman I. S., Caleffi M., Brame K., Chaudary M. A., Hayward J. L. Double-blind controlled trial of tamoxifen therapy for mastalgia. Lancet. 1986 Feb 8;1(8476):287–288. doi: 10.1016/s0140-6736(86)90825-1. [DOI] [PubMed] [Google Scholar]
  5. Hughes L. E., Mansel R. E., Webster D. J. Aberrations of normal development and involution (ANDI): a new perspective on pathogenesis and nomenclature of benign breast disorders. Lancet. 1987 Dec 5;2(8571):1316–1319. doi: 10.1016/s0140-6736(87)91204-9. [DOI] [PubMed] [Google Scholar]
  6. Kumar S., Mansel R. E., Hughes L. E., Woodhead J. S., Edwards C. A., Scanlon M. F., Newcombe R. G. Prolactin response to thyrotropin-releasing hormone stimulation and dopaminergic inhibition in benign breast disease. Cancer. 1984 Mar 15;53(6):1311–1315. doi: 10.1002/1097-0142(19840315)53:6<1311::aid-cncr2820530615>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  7. Kumar S., Mansel R. E., Wilson D. W., Read G. F., Truran P. L., Hughes L. E., Griffiths K. Daily salivary progesterone levels in cyclical mastalgia patients and their controls. Br J Surg. 1986 Apr;73(4):260–263. doi: 10.1002/bjs.1800730406. [DOI] [PubMed] [Google Scholar]
  8. Leinster S. J., Whitehouse G. H., Walsh P. V. Cyclical mastalgia: clinical and mammographic observations in a screened population. Br J Surg. 1987 Mar;74(3):220–222. doi: 10.1002/bjs.1800740324. [DOI] [PubMed] [Google Scholar]
  9. Lenton E. A., Weston G. A., Cooke I. D. Problems in using basal body temperature recordings in an infertility clinic. Br Med J. 1977 Mar 26;1(6064):803–805. doi: 10.1136/bmj.1.6064.803. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Malarkey W. B., Schroeder L. L., Stevens V. C., James A. G., Lanese R. R. Twenty-four-hour preoperative endocrine profiles in women with benign and malignant breast disease. Cancer Res. 1977 Dec;37(12):4655–4659. [PubMed] [Google Scholar]
  11. Mansel R. E., Preece P. E., Hughes L. E. A double blind trial of the prolactin inhibitor bromocriptine in painful benign breast disease. Br J Surg. 1978 Oct;65(10):724–727. doi: 10.1002/bjs.1800651015. [DOI] [PubMed] [Google Scholar]
  12. Mansel R. E., Wisbey J. R., Hughes L. E. Controlled trial of the antigonadotropin danazol in painful nodular benign breast disease. Lancet. 1982 Apr 24;1(8278):928–930. doi: 10.1016/s0140-6736(82)91932-8. [DOI] [PubMed] [Google Scholar]
  13. Nichols S., Waters W. E., Wheeler M. J. Management of female breast disease by Southampton general practitioners. Br Med J. 1980 Nov 29;281(6253):1450–1453. doi: 10.1136/bmj.281.6253.1450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Preece P. E., Mansel R. E., Bolton P. M., Hughes L. M., Baum M., Gravelle I. H. Clinical syndromes of mastalgia. Lancet. 1976 Sep 25;2(7987):670–673. doi: 10.1016/s0140-6736(76)92477-6. [DOI] [PubMed] [Google Scholar]
  15. Sitruk-ware L. R., Sterkers N., Mowszowicz I., Mauvais-Jarvis P. Inadequate corpus luteal function in women with benign breast diseases. J Clin Endocrinol Metab. 1977 Apr;44(4):771–774. doi: 10.1210/jcem-44-4-771. [DOI] [PubMed] [Google Scholar]
  16. Swain M. C., Hayward J. L., Bulbrook R. D. Plasma oestradiol and progesterone in benign breast disease. Eur J Cancer. 1973 Aug;9(8):553–556. doi: 10.1016/0014-2964(73)90144-8. [DOI] [PubMed] [Google Scholar]
  17. Walker K. J., Turkes A., Williams M. R., Blamey R. W., Nicholson R. I. Preliminary endocrinological evaluation of a sustained-release formulation of the LH-releasing hormone agonist D-Ser(But)6Azgly10LHRH in premenopausal women with advanced breast cancer. J Endocrinol. 1986 Nov;111(2):349–353. doi: 10.1677/joe.0.1110349. [DOI] [PubMed] [Google Scholar]
  18. Walsh P. V., Bulbrook R. D., Stell P. M., Wang D. Y., McDicken I. W., George W. D. Serum progesterone concentration during the luteal phase in women with benign breast disease. Eur J Cancer Clin Oncol. 1984 Nov;20(11):1339–1343. doi: 10.1016/0277-5379(84)90051-8. [DOI] [PubMed] [Google Scholar]
  19. Wang D. Y., Fentiman I. S. Epidemiology and endocrinology of benign breast disease. Breast Cancer Res Treat. 1985;6(1):5–36. doi: 10.1007/BF01806008. [DOI] [PubMed] [Google Scholar]
  20. Wisbey J. R., Kumar S., Mansel R. E., Peece P. E., Pye J. K., Hughes L. E. Natural history of breast pain. Lancet. 1983 Sep 17;2(8351):672–674. doi: 10.1016/s0140-6736(83)92543-6. [DOI] [PubMed] [Google Scholar]

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