-
Health Care For Women International Mar 2023The researchers' aims are to determine the effect of cold cabbage leaf application on breast engorgement and pain during the postpartum period through a systematic... (Meta-Analysis)
Meta-Analysis
The researchers' aims are to determine the effect of cold cabbage leaf application on breast engorgement and pain during the postpartum period through a systematic review and meta-analysis. Between June and September 2021, researchers systematically searched Turkish and English databases using a combination of keywords. We calculated individual and general effect sizes of the studies to evaluate effect sizes. We obtained 25,996 results with the databases search and we included a total of eight studies for analysis. According to the pooled results, we determined that cold cabbage leaf application caused a significant reduction in breast pain, though no significant reduction was seen in breast engorgement. In this systematic review and meta-analysis, we found that cold cabbage leaf application was effective in reducing breast pain, but that more experimental studies are needed to determine its effect on breast engorgement.CALLOUTSBreast engorgement is a common physiological problem for lactating mothers.Researchers state that the results of the eight studies included in the analysis suggested that cold cabbage leaf application was effective in reducing breast pain.More studies are needed to evaluate the effect of cold cabbage application on reducing breast engorgement.
Topics: Female; Humans; Brassica; Mastodynia; Lactation; Lactation Disorders; Postpartum Period; Plant Leaves
PubMed: 35766462
DOI: 10.1080/07399332.2022.2090567 -
Journal of Obstetrics and Gynaecology... Oct 2022Tamoxifen 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... (Meta-Analysis)
Meta-Analysis Review
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.
Topics: Humans; Mastodynia; Randomized Controlled Trials as Topic; Tamoxifen
PubMed: 35752405
DOI: 10.1016/j.jogc.2022.06.006 -
Computational and Mathematical Methods... 2022A case-control study was performed to explore the efficacy and adverse reactions of Mirena combined with hysteroscopy when treating AUB.
OBJECTIVE
A case-control study was performed to explore the efficacy and adverse reactions of Mirena combined with hysteroscopy when treating AUB.
METHODS
108 patients with perimenopausal AUB treated in our hospital from June 2019 to December 2021 were enrolled, and their clinical data were collected and analyzed retrospectively. According to the mode of treatment, the patients were assigned into control group (54 cases) and study group (54 cases). The therapeutic effects were compared. Visual analog score (VAS) was adopted to evaluate the degree of incision pain, Barthel index score was adopted to evaluate the ability of daily living, quality of life scale was adopted to investigate the quality of life before and after treatment, and the changes of sex hormone levels, endometrial thickness, and menstruation were detected before and after treatment. The incidence of adverse reactions was calculated.
RESULTS
In terms of the therapeutic effects, 46 cases were cured, 6 cases were effective, and 2 cases were ineffective in the study group, and the effective rate was 96.30%; in the control group, 32 cases were cured, 10 cases were effective, and 12 cases were ineffective, and the effective rate was 77.78%; the effective rate of the study group was higher than that of the control group ( < 0.05). In terms of VAS score, the VAS score decreased after treatment, and the VAS score in the study group was significantly lower than that in the control group at 1 week, 2 weeks, 1 month, and 3 months after treatment. With regard to the Barthel index scores after treatment, the Barthel index scores increased, and the Barthel index scores of the study group at 1 week, 2 weeks, 1 month, and 3 months after treatment were higher compared to the control group ( < 0.05). In terms of the Barthel index scores after treatment, the Barthel index scores increased, and the Barthel index scores of the study group at 1 week, 2 weeks, 1 month, and 3 months after treatment were higher compared to the control group ( < 0.05). Compared with those before treatment, the levels of FSH, LH, and E2 in both groups decreased remarkably (all < 0.05). In terms of the changes of endometrium and menstruation, the endometrial thickness, menstrual time, and menstrual volume were significantly improved after treatment ( < 0.05). After treatment, the endometrial thickness, menstrual time, and menstrual volume in the study group were better than those in the control group ( < 0.05). With regard to the scores of qualities of life, the scores of qualities of life decreased after treatment. Compared between the two groups, the scores of physiological function, psychological function, social function, and health self-cognition in the study group were lower compared to the control group. Regarding the incidence of adverse reactions, in the study group, there were 1 case of breast pain, 2 cases of vaginal bleeding, and no dizziness and nausea, and the incidence of adverse reaction was 5.56%; In the control group, there were 1 case of dizziness, 2 cases of breast pain, 4 cases of nausea, and 3 cases of vaginal bleeding, and the incidence of adverse reactions in the study group was 18.52%. The incidence of adverse reactions in the study group was lower compared to the control group ( < 0.05).
CONCLUSION
Hysteroscopy combined with Mirena when treating perimenopausal AUB can remarkably enhance the related symptoms, regulate the level of sex hormones, and remarkably reduce the amount of menstrual bleeding. The curative effect is better than hysteroscopy combined with dydrogesterone tablets, which is worth popularizing in clinic.
Topics: Case-Control Studies; Female; Humans; Hysteroscopy; Levonorgestrel; Mastodynia; Nausea; Pregnancy; Quality of Life; Retrospective Studies; Uterine Hemorrhage
PubMed: 35726229
DOI: 10.1155/2022/4082266 -
Journal of the American College of... Oct 2022
Topics: Contrast Media; Diagnosis, Differential; Humans; Mastodynia
PubMed: 35672239
DOI: 10.1016/j.jacr.2022.05.011 -
Eplasty 2022Breast implant illness (BII) is extramammary systemic symptoms that are caused by breast implants. The emergence of this controversial topic has spurred patients with...
BACKGROUND
Breast implant illness (BII) is extramammary systemic symptoms that are caused by breast implants. The emergence of this controversial topic has spurred patients with breast implants who are experiencing these symptoms to seek implant removal, hoping to feel better. This article presents novel outcomes and suggestions for plastic surgeons in managing BII using total capsulectomy and breast implant removal.
METHODS
In this retrospective cohort study conducted between 2016 and 2020, medical records of all patients undergoing breast implant removal were reviewed. Inclusion criteria consisted of all patients with history of breast implant placement presenting with mastodynia and capsular contracture on physical examination. Patients with history of implant-based reconstruction following mastectomy and patients who underwent implant exchange were excluded. All patients underwent bilateral implant removal and total capsulectomies.
RESULTS
A total of 200 patients who fulfilled the inclusion criteria were identified. Average age was 45.5 (range: 29-73) years and average body mass index was 26.28 (range: 19-36.8), with an average follow-up time of 5 months postoperatively. Of patients with a presentation of BII, 96% reported improved or complete resolution of their systemic symptoms after implant removal and total capsulectomy. A positive microbial culture was found in 68.5% of patients, and all culture-positive patients reported improvement post-treatment. The most common organisms found were (49.6%). There were no associations between implant characteristics and rate of positive microbiology findings.
CONCLUSIONS
Our study shows that implant removal with capsulectomy drastically improves BII symptoms. Further large prospective cohort studies are needed to better understand this entity.
PubMed: 35602522
DOI: No ID Found -
BMJ Open Quality Mar 2022Breast pain has no association with breast cancer yet is a frequent reason for referral from Primary to Secondary Care, often on an urgent (2-week wait) referral. The...
Breast pain has no association with breast cancer yet is a frequent reason for referral from Primary to Secondary Care, often on an urgent (2-week wait) referral. The referral often causes significant patient anxiety, further heightened by screening mammograms and/or ultrasound scans in the absence of an associated red flag symptom or finding by the patient or general practitioner. This paper reports the pilot implementation of a specialist Primary Care Breast Pain Clinic in Mid-Nottinghamshire where patients were seen, examined without any imaging and assessed for their risk of familial breast cancer: numerous studies have reported 15%->30% of patients with breast pain only have a family history of breast cancer.177 patients with breast pain only were seen in this clinic between March, 2020 and April, 2021 with a 6-month interim suspension due to COVID-19. The mean age of patients was 48.4 years (range: 16-86). 172/177 (97.2%) patients required no imaging although there were three (1.7%) inappropriate referrals and two additional abnormalities (1.1%-hamartoma, thickening/tethering) that were referred onward. There were no cancers. 21 (12.4%) patients were identified to have an increased familial risk of breast cancer and were referred to the specialist familial cancer service. 170/177 patients completed an anonymous questionnaire on leaving the clinic. 167/169 (99%) were reassured regarding their breast pain, 155/156 (99%) were reassured of the Familial Risk Assessment, 162/168 (96%) were reassured regarding their personal risk assessment while 169/170 (99%) were 'extremely likely/likely to recommend the service'.This specialist Primary Care Breast Pain Clinic provides service improvement across all levels of care (Primary, Secondary and Tertiary). Patients were successfully managed in the community with high levels of patient satisfaction and together this obviated referral to secondary care. The familial breast cancer risk assessment also helped identify unmet need in the community.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Breast Neoplasms; COVID-19; Female; Humans; Mastodynia; Middle Aged; Primary Health Care; Referral and Consultation; Young Adult
PubMed: 35289304
DOI: 10.1136/bmjoq-2021-001634 -
International Journal of Radiation... Jun 2022We investigated whether the use of chemotherapy before whole breast irradiation (WBI) using either conventional fractionation (CWBI) or hypofractionation (HWBI) is...
PURPOSE
We investigated whether the use of chemotherapy before whole breast irradiation (WBI) using either conventional fractionation (CWBI) or hypofractionation (HWBI) is associated with increased toxic effects or worse cosmetic outcome compared with WBI alone.
METHODS AND MATERIALS
We identified 6754 patients who received WBI alone (without a third field covering the superior axillary and supraclavicular nodal regions) with data prospectively collected in a statewide consortium. We reported rates of 4 toxic effects: physician-reported acute moist desquamation, patient-reported acute moderate/severe breast pain, a composite acute toxic effect measure (including moist desquamation and either patient- or physician-reported moderate/significant breast pain), and physician-reported impaired cosmetic outcome at 1 year after WBI. Successive multivariable models were constructed to estimate the effect of chemotherapy on these outcomes.
RESULTS
Rates of moist desquamation, patient-reported pain, composite acute toxic effects, and impaired cosmetic outcome were 23%, 34%, 42%, and 10% for 2859 patients receiving CWBI and 13%, 28%, 31%, and 11% for 3895 patients receiving HWBI. Receipt of chemotherapy before CWBI was not associated with higher rates of patient-reported pain, composite acute toxic effects, or impaired cosmetic outcome compared with CWBI without chemotherapy but was associated with more moist desquamation (odds ratio, 1.32 [1.07-1.63]; P = .01). Receipt of chemotherapy before HWBI was not associated with higher rates of any of the 4 toxic effects compared with HWBI alone.
CONCLUSIONS
In this cohort, use of chemotherapy before WBI was generally well tolerated. CWBI with chemotherapy but not HWBI with chemotherapy was associated with higher rates of moist desquamation. Rates of acute breast pain and impaired cosmetic outcome at 1 year were comparable in patients receiving chemotherapy before either CWBI or HWBI. These data support the use of HWBI after chemotherapy.
Topics: Breast Neoplasms; Dose Fractionation, Radiation; Female; Humans; Mastectomy, Segmental; Mastodynia; Radiation Dose Hypofractionation; Radiotherapy, Adjuvant
PubMed: 35157997
DOI: 10.1016/j.ijrobp.2022.02.004 -
Revue Medicale Suisse Jan 2022This article tries to facilitate the management of mastalgia. During their lifetime most women will experience breast pain. Many of them will visit a physician for this...
This article tries to facilitate the management of mastalgia. During their lifetime most women will experience breast pain. Many of them will visit a physician for this purpose, often led by the fear of cancer. However, in the absence of other clinical signs such as a lump or nipple discharge, the risk of malignancy remains low. In addition to the patient's medical history and physical examination, an imaging may be necessary. The absence of clinical or radiological abnormalities suffices to reassure patients in most cases. The management of mastalgia is based mainly on diet and life-style changes, the use of a well-suited bra and topical anti-inflammatory medication. In the case of mastalgia not responding to first line treatments, the patient should be referred to a breast-care unit.
Topics: Breast Diseases; Female; Humans; Life Style; Mastodynia; Physical Examination
PubMed: 35048586
DOI: 10.53738/REVMED.2022.18.764-65.83 -
The British Journal of General Practice... Apr 2022Women with breast pain constitute >20% of breast clinic attendees.
BACKGROUND
Women with breast pain constitute >20% of breast clinic attendees.
AIM
To investigate breast cancer incidence in women presenting with breast pain and establish the health economics of referring women with breast pain to secondary care.
DESIGN AND SETTING
A prospective cohort study of all consecutive women referred to a breast diagnostic clinic over 12 months.
METHOD
Women were categorised by presentation into four distinct clinical groups and cancer incidence investigated.
RESULTS
Of 10 830 women, 1972 (18%) were referred with breast pain, 6708 (62%) with lumps, 480 (4%) with nipple symptoms, 1670 (15%) with 'other' symptoms. Mammography, performed in 1112 women with breast pain, identified cancer in eight (0.7%). Of the 1972 women with breast pain, breast cancer incidence was 0.4% compared with ∼5% in each of the three other clinical groups. Using 'breast lump' as reference, the odds ratio (OR) of women referred with breast pain having breast cancer was 0.05 (95% confidence interval = 0.02 to 0.09, <0.001). Compared with reassurance in primary care, referral was more costly (net cost £262) without additional health benefits (net quality-adjusted life-year [QALY] loss -0.012). The greatest impact on the incremental cost-effectiveness ratio (ICER) was when QALY loss because of referral-associated anxiety was excluded. Primary care reassurance no longer dominated, but the ICER remained greater (£45 528/QALY) than typical UK National Health Service cost-effectiveness thresholds.
CONCLUSION
This study shows that referring women with breast pain to a breast diagnostic clinic is an inefficient use of limited resources. Alternative management pathways could improve capacity and reduce financial burden.
Topics: Breast Neoplasms; Cost-Benefit Analysis; Female; Humans; Mastodynia; Prospective Studies; Quality-Adjusted Life Years; State Medicine
PubMed: 34990395
DOI: 10.3399/BJGP.2021.0475 -
Iranian Journal of Nursing and... 2021More than half of the population of women suffer from cyclic mastalgia which can interfere with women's sexual function and affect their sexual satisfaction. The current...
The Effect of Sex Counseling Based on (Permission, Limited Information, Specific Suggestions, Intensive Therapy) Model on Sexual Satisfaction in Women with Cyclic Mastalgia: A Randomized Controlled Clinical Trial.
BACKGROUND
More than half of the population of women suffer from cyclic mastalgia which can interfere with women's sexual function and affect their sexual satisfaction. The current study was conducted to determine the effect of sexual counseling on sexual satisfaction in women with cyclic mastalgia.
MATERIALS AND METHODS
This randomized controlled trial study was performed on 81 women with cyclic mastalgia. The subjects were randomly divided into two groups of intervention ( = 40) and control ( = 41). Intervention was performed as Permission, Limited information, Specific suggestions, Intensive therapy (PLISSIT) sex counseling in four sessions for a maximum of 90 min in the intervention group. The demographic checklist and Index of Sexual Satisfaction (ISS) were used for data collection. Follow-up was performed 1 and 3 months after the intervention. The obtained data were analyzed using repeated-measures test.
RESULTS
The intervention and control groups were in good balance in terms of demographic characteristics and sexual satisfaction scores prior to the intervention and no statistically significant differences were observed. There was a statistically significant increase in the mean (SD) score of female sexual satisfaction in the intervention group: 93 (12.52), 101.15 (7.70),101.37 (5.31), ( = 27.4, < 0.001). We also observed a decrease in the mean (SD) score of sexual satisfaction in the control group: 93.39 (13.12), 90.68 (8.41), 90.85 (6.57), ( = 11.9, < 0.001) 1 and 3 months following the intervention.
CONCLUSIONS
This study revealed that individual counseling by PLISSIT sex counseling could lead to improvement in sexual satisfaction index in women with cyclic breast pain.
PubMed: 34900658
DOI: 10.4103/ijnmr.IJNMR_159_20