Abstract
Objectives
Tamoxifen is prescribed for chronic mastalgia at a dosage of one 10- or 20-mg tablet
for 3–6 months. A topical preparation of this drug has recently been approved. The
aim of this study was to meta-analyze the effectiveness of tamoxifen and its different
regimens for the treatment of mastalgia. We also sought to summarize the side effects
and the follow-up results of these treatments.
Data Sources
We searched the databases of PubMed/ MEDLINE, Central, Embase, and EBSCO from August
2021 to September 2021.
Study Selection
Articles on the effects of tamoxifen in mastalgia were searched, and randomized controlled
trials were retrieved for inclusion in this study. PRISMA guidelines were followed,
and we selected 9 articles for the meta-analysis.
Data Extraction and Synthesis
A proforma was prepared for data collection. RevMan 5.4 software was used for methodological
quality assessment, statistical analysis, and preparation of forest plots. Oral tamoxifen
performed better than placebo (risk ratio [RR] 2.04; 95% CI 1.49–2.78, P < 0.001). No significant difference in efficacy was seen between the 10- and 20-mg
dosages (RR 1.08; 95% CI 0.97–1.21, P = 0.18) when used for 3 months.
Conclusion
Oral tamoxifen is helpful in long-standing mastalgia. It is safe and effective at
an oral dose of 10 mg.
Résumé
Objectifs
Le tamoxifène est prescrit pour la mastalgie chronique à raison d’un comprimé de 10
ou 20 mg pendant 3 à 6 mois. Une préparation topique de ce médicament a récemment
été approuvée. Cette étude avait pour objectif de réaliser une méta-analyse de l’efficacité
du tamoxifène et de ses différents schémas posologiques pour le traitement de la mastalgie.
Elle visait également à résumer les effets indésirables et les résultats de suivi
de ces traitements.
Sources de données
Nous avons effectué des recherches dans les bases de données PubMed, Medline, CENTRAL,
Embase et EBSCO pour recenser des articles publiés en août et en septembre 2021.
Sélection des études
Nous avons cherché des articles sur les effets du tamoxifène dans le traitement de
la mastalgie. Les essais cliniques randomisés ont été retenus pour cette étude. Nous
avons suivi la stratégie PRISMA et sélectionné 9 articles aux fins de méta-analyse.
Extraction et synthèse des données
Nous avons préparé une grille normalisée pour la collecte de données. Le logiciel
RevMan 5.4 a été utilisé pour l’évaluation de la qualité méthodologique, l’analyse
statistique et la préparation de graphiques en forêt. Le tamoxifène oral a donné de
meilleurs résultats que le placebo (RR : 2,04; IC à 95 % : 1,49–2,78; p < 0,001). Aucune différence significative n’a été observée quant à l’efficacité entre
les doses de 10 et de 20 mg (RR : 1,08; IC à 95 % : 0,97–1,21; p = 0,18) en cas d’utilisation pendant 3 mois.
Conclusion
Le tamoxifène oral est efficace dans le traitement de la mastalgie de longue date.
Il est sécuritaire et efficace à une dose de 10 mg par voie orale.
Keywords
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References
- Cyclical mastalgia: prevalence and associated health and behavioral factors.J Psychosom Obstet Gynaecol. 2001; 22: 71-76
- A systematic review of current understanding and management of mastalgia.Indian J Surg. 2014; 76: 217-222
- Natural history of breast pain.Lancet. 1983; 2: 672-674
- Thyroid hormones in benign breast disease. Normalization of exaggerated prolactin responsiveness to thyrotropin-releasing hormone.Cancer. 1985; 56: 1082-1085
- Mastalgia and total body water.Br Med J. 1975; 4: 498-500
- Mastalgia: psychoneurosis or organic disease?.Br Med J. 1978; 1: 29-30
- Evaluation and management of breast pain.Mayo Clin Proc. 2004; 79: 353-372
- Pharmacokinetics of selective estrogen receptor modulators.Clin Pharmacokinet. 2003; 42: 361-372
- PharmGKB summary: tamoxifen pathway, pharmacokinetics.Pharmacogenet Genom. 2013; 23: 643-647
- Oral low dose and topical tamoxifen for breast cancer prevention: modern approaches for an old drug.Breast Cancer Res. 2012; 14: 214
- Oral versus topical tamoxifen in cyclical mastalgia-A randomized controlled trial.Breast J. 2020; 26: 743-747
- Treatment of premenstrual mastalgia with tamoxifen.Acta Obstet Gynecol Scand. 1988; 67: 307-309
- Tamoxifen therapy for cyclical mastalgia: dose randomized trial.The Breast. 1997; 6: 212-213
- Centchroman vs tamoxifen for regression of mastalgia: a randomized controlled trial.Int J Surg. 2015; 15: 11-16
- Effective regression of mastalgia with centchroman and tamoxifen: a randomised comparison.Indian J Surg. 2019; 81: 271-276
- A comparative study of centchroman vs tamoxifen in the management of mastalgia and fibroadenoma Dr. Debasis Sarkar RMO cum clinical tutor, Murshidabad medical college Prof. Sushil kumar Paira.(Available at:) (Accessed October 29, 2021)
- Comparison of tamoxifen with danazol for treatment of cyclical mastalgia.Gynecol Endocrinol. 1997; 11: 393-397
- Double-blind controlled trial of tamoxifen therapy for mastalgia.Lancet. 1986; 1: 287-288
- Dosage and duration of tamoxifen treatment for mastalgia: a controlled trial.Br J Surg. 1988; 75: 845-846
- Higgins J.P.T. Thomas J. Chandler J. Cochrane handbook for systematic reviews of interventions version 6.1. John Wiley & Sons, Ltd, Hoboken, New Jersey2020
Article info
Publication history
Published online: June 22, 2022
Accepted:
June 3,
2022
Received:
March 2,
2022
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated they meet the journal’s requirements for authorship.
Identification
Copyright
© 2022 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
