Effectiveness of acupuncture in the treatment of cyclic mastalgia: a study protocol for a randomized controlled trial

Chuan Yu, Jun Wang, Bin Shen, Xiang Li, Rui Zhang, Yan Qin, Guofan Jian, Jing Guo, Chuan Yu, Jun Wang, Bin Shen, Xiang Li, Rui Zhang, Yan Qin, Guofan Jian, Jing Guo

Abstract

Background: About 68% of women aged 18-44 years have experienced cyclic mastalgia (CM), which occurs during the luteal phase of the menstrual cycle when elevated hormone levels induce greater breast gland thickness. CM has a moderate-to-severe impact on a woman's quality of life. Prior research has suggested that acupuncture may be beneficial for breast pain relief. In this study, we investigate the effectiveness of manual acupuncture (MA) in the treatment of CM compared with that of sham acupuncture (SA).

Methods: This is a multicenter, randomized, controlled trial. A total of 108 eligible CM patients will be randomly assigned to either MA (n = 54) or SA (n = 54) group using a 1:1 ratio and a stratified, blocked randomization. Acupuncture will be performed two weeks prior to menstruation and discontinued when menses begins. In both the MA and SA group, participants will be given acupuncture three times per week for 2 weeks per menstrual cycle for three consecutive menstrual cycles, encompassing a total of 18 sessions. The primary outcome will be the change in the average daily Breast Pain Visual Analog Scale (VAS-BP) over the first two weeks of menstruation from baseline to endpoints. The number of nominal days of breast pain (NDBP) two weeks before menstruation, World Health Organization Quality-of-Life Scale-Short Form scores, global patient assessment, breast glandular-section thickness, and breast-duct width three days before menstruation will also be measured as secondary outcomes.

Discussion: This prospective randomized trial will help evaluate the efficacy of acupuncture in treating CM. The results of this study will provide evidence of the therapeutic effectiveness of acupuncture on CM.

Trial registration: ClinicalTrials.gov Identifier: NCT05408377 , registered on June 7, 2022.

Keywords: Acupuncture; Cyclic mastalgia; Protocol; Trial.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of participants throughout the proposed trial

References

    1. Dixon J, Thomas J. Symptoms, assessment and guidelines for referral. In: Dixon J, edtor. ABC of breast diseases. Chichester: Wiley-Blackwell; 2012. p. 1–11.
    1. Salzman B, Fleegle S, Tully AS. Common breast problems. Am Fam Physician. 2012;86:343–349.
    1. Ader DN, South-Paul J, Adera T, Deuster PA. Cyclical mastalgia: prevalence and associated health and behavioral factors. J Psychosom Obstet Gynecol. 2001;22:71–76. doi: 10.3109/01674820109049956.
    1. Olawaiye A, Withiam-Leitch M, Danakas G, Kahn K. Mastalgia: a review of management. J Reprod Med. 2005;50:933–939.
    1. Milligan D, Drife JO, Short RV. Changes in breast volume during normal menstrual cycle and after oral contraceptives. Br Med J. 1975;4:494–496. doi: 10.1136/bmj.4.5995.494.
    1. Weaver M, Stuckey A. Benign breast disorders. Obstet Gynecol Clin North Am. 2022;49:57–72. doi: 10.1016/j.ogc.2021.11.003.
    1. Peters F, Diemer P, Mecks O, Behnken LJ. Severity of mastalgia in relation to milk duct dilatation. Obstet Gynecol. 2003;101:54–60. doi: 10.1016/S0029-7844(02)02386-4.
    1. Khan SA, Apkarian AV. The characteristics of cyclical and non-cyclical mastalgia: a prospective study using a modified McGill Pain Questionnaire. Breast Cancer Res Treat. 2002;75:147–157. doi: 10.1023/a:1019685829799.
    1. Johnson KM, Bradley KA, Bush K, Gardella C, Dobie DJ, Laya MB. Frequency of mastalgia among women veterans. Association with psychiatric conditions and unexplained pain syndromes. J Gen Intern Med. 2006;21 Suppl 3:S70-S5. 10.1111/j.1525-1497.2006.00378.x.
    1. Hafiz SP, Barnes NLP, Kirwan CC. Clinical management of idiopathic mastalgia: a systematic review. J Prim Health Care. 2018;10:312–323. doi: 10.1071/hc18026.
    1. Gumm R, Cunnick GH, Mokbel K. Evidence for the management of mastalgia. Curr Med Res Opin. 2004;20:681–684. doi: 10.1185/030079904125003377.
    1. Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clin Proc. 2004;79:353–372. doi: 10.4065/79.3.353.
    1. Fan YH, Li HL, Jin YR, Zhang Q. Network meta-analysis of acupuncture treatment for mammary gland hyperplasia. Med Data Min. 2018:19–29.
    1. Yu G-H, Zou L-Y, Liu J-G. Combination of acupuncture with medication for treatment of hyperplasia of mammary glands in 46 cases. J Tradit Chin Med. 2010;30:232–234. doi: 10.1016/S0254-6272(10)60047-7.
    1. Wang Y. Acupuncture for treatment of hyperplasia of mammary gland and its effects on images and hemodynamics in the mammary gland. Zhongguo Zhen Jiu. 2005;25:619–621.
    1. Thicke LA, Hazelton JK, Bauer BA, Chan CW, Huntoon EA, Novotny PJ, et al. Acupuncture for treatment of noncyclic breast pain: A pilot study. Am J Chinese Med. 2011;39:1117–1129. doi: 10.1142/s0192415x11009445.
    1. Sun M. Effect of acupuncture on relieving periodic breast pain - randomized controlled trial. Beijing University of traditional Chinese Medicine; 2018.
    1. Zhang X. Preliminary evaluation on the effect of acupuncture in relieving moderate and severe periodic breast pain. Beijing University of traditional Chinese Medicine; 2020.
    1. Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586. doi: 10.1136/bmj.e7586.
    1. Association WM. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–2194. doi: 10.1001/jama.2013.281053.
    1. Rosolowich V, Saettler E, Szuck B, Lea RH, Levesque P, Weisberg F, et al. RETIRED: Mastalgia. J Obstet Gynaecol Can. 2006;28:49–57. doi: 10.1016/S1701-2163(16)32027-8.
    1. Hubbard T, Sharma A, Ferguson D. Breast pain: Assessment, management, and referral criteria. Br J Gen Pract. 2020;70:419–420. doi: 10.3399/bjgp20X712133.
    1. Li SY, Gang WJ, LX H. WHO standard acupuncture point locations in the Western Pacific Region. Beijing: People’s Medical Publishing House; 2010.
    1. Zhou K, Fang J, Wang X, Wang Y, Hong Y, Liu J, et al. Characterization of de qi with electroacupuncture at acupoints with different properties. J Altern Complement Med. 2011;17:1007–1013. doi: 10.1089/acm.2010.0652.
    1. Yt H, Jq F. The introduce and usage of WHOQOL instrument in Chinese. Chin J Tissue Eng Res. 2000;4:1127–1129.
    1. The WHOQOL Group Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551–558. doi: 10.1017/s0033291798006667.
    1. Wang L, Wang R, Yao Y, Bai X, Sheng G. The effects of acupuncture on psychological symptoms in patients with insomnia: study protocol for a randomized controlled trial. Trials. 2022;23:152. doi: 10.1186/s13063-022-06078-2.
    1. Pirotta M, Ee C, Teede H, Chondros P, French S, Myers S, et al. Acupuncture for menopausal vasomotor symptoms: study protocol for a randomised controlled trial. Trials. 2014;15:224. doi: 10.1186/1745-6215-15-224.
    1. Maddox PR, Mansel RE. Management of breast pain and nodularity. World J Surg. 1989;13:699–705. doi: 10.1007/bf01658417.
    1. Gautam S, Srivastava A, Kataria K, Dhar A, Ranjan P, Kumar J. New breast pain chart for objective record of mastalgia. Indian J Surg. 2016;78:245–248. doi: 10.1007/s12262-016-1492-z.
    1. Kataria K, Dhar A, Srivastava A, Kumar S, Goyal A. A systematic review of current understanding and management of mastalgia. Indian J Surg. 2014;76:217–222. doi: 10.1007/s12262-013-0813-8.
    1. Scurr J, Hedger W, Morris P, Brown N. The prevalence, severity, and impact of breast pain in the general population. Breast J. 2014;20:508–513. doi: 10.1111/tbj.12305.
    1. Zhou YZ, Jiang YX, Sun Q, Zhang SQ, Zhang Y, Chen FL, et al. Features of breast ultrasound image and its correlation with estradiol and progesterone level in different phases of menstrual cycle in normal women. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2001;23:609–613.

Source: PubMed

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