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You should get a breast USG done.
If you have felt a nodule in the breast, it is better to show it to a Breast Surgeons a Surgical oncologist. They would take a detailed history and examine you and if need be, ask for an ultrasound examination. Fibrocystic changes are very common cause of breast pain especially cyclical. Some times the cysts may enlarge causing a lot of pain, which need to be aspirated. Also they need to rule out other causes of pain like ill fitting bra, trauma, abscess and rarely cancer amongst a few. Spontaneous resolution is seen in around 20-50 % patients and may sometimes be related to pregnancy or menopause. Evening Primrose oil (EPO) capsules contains Gamolenic acid (GLA, which is an essential fatty acid needed to regulate the tissue response to hormones. The dosage required is 240-360 mg of GLA daily (2000-3000 mg EPO. The capsule contains 40 or 80 mg GLA. Thus the no of capsules can range from 4-8 per day taken orally. Few patients (<5%) report nausea, loose motions or headaches. It is to be avoided if you are pregnant, planning to conceive or have a history of epilepsy. You need to continue the primrose oil for atleast 2-3 months to see any improvement in symptoms. If symptoms improve then you can halve the dose of primrose oil and continue for further 3 months. Some people are able to stop the capsules altogether without return of problem. Vitamin E 800 to 1200 I.U. (2-3 capsules) Daily also has been shown to work in cyclical mastalgia. The other treatment options are NSAIDS like Combiflam or enzoflam which provide symptomatic relief till the pain settles spontaneously and Antiandrogens like Danazole and anti estrogens i.e. SERM like Tamoxifen. The last 2 are quite effective but come with a lot of side effects. If you still have any queries, you may contact me directly.
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