Local anaesthetic and steroid combined injection therapy in the management of non-cyclical mastalgia

Aims: We aimed to assess the effectiveness of a local anaesthetic and steroid combination injection therapy in the management of non-cyclical mastalgia. Methods: Patients with non-cyclical mastalgia were assessed for rib tenderness (lateral chest wall tenderness—LCWT). The tenderest spot was injected with a combined preparation of 1 ml 2% lignocaine and 1 ml 40 mg depomedrone. Those who declined injection therapy were advised on topical or oral NSAIDs or reassurance. All patients were reassessed 6 weeks later. A successful outcome was taken as either a complete response (CR) or partial response (PR), i.e. pain although present is tolerated. Results: One hundred and thirty eight women were diagnosed with LCWT. One hundred and four women were injected. Thirty-four women declined and were managed appropriately. At assessment 83 injected cases were successful (83%; CR n=61, PR n=22) compared to 13 non-injected cases (44.8%; CR n=5, PR n=8, P<0.0001). No side effects were recorded. Sixteen cases recurred and were successfully re-injected. Conclusions: A steroid and local anaesthetic injection is an effective and safe treatment for LCWT.