Analgesic efficacy of pulsed radiofrequency in non-cyclic mastalgia: A randomized controlled trial

Background: Non cyclic-mastalgia is a challenge among women. We aimed to study the effects of adding pulsed radiofrequency to tamoxifen 10mg daily in treatment of non-cyclic mastalgia.

Methods: We conducted a randomized prospective open blinded end-point, level IV trial in outpatient pain clinic of a university-affiliated oncology center during the period from 2018 till 2019. Patients were randomly allocated into two groups. Group A (n=13) received tamoxifen 10mg tablet once daily and group B (n=13) received tamoxifen 10mg tablet once daily and pulsed radiofrequency of the 2nd, 3rd and 4th thoracic dorsal root ganglia. We monitored numerical rating scale (NRS) and quality of life (QOL) before and at intervals of 2 weeks, 1, 2 and 3 months after treatment; complications; side effects of tamoxifen; and number of patients who needed analgesia.

Results: Numerical rating scale significantly decreased in group B compared to group A at 2 weeks (P = 0.002) and 1, 2 and 3 months (P< 0.001). Group B showed marked improvement in QOL at 2 weeks, 1, 2 and 3 months (P< 0.001). No complications were reported in both groups. Patients who needed analgesia were more in group B than group A (P=0.018).

Conclusions : Combined usage of pulsed radiofrequency and tamoxifen 10mg daily is a safe line of treatment of non-cyclic mastalgia and markedly improves QOL.