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Federación Mexicana de Ginecología y Obstetricia, A.C.

2009, Número 12

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Ginecol Obstet Mex 2009; 77 (12)


Guías de práctica clínica 2008. Colegio Mexicano de Especialistas en Ginecología y Obstetricia. Trtamiento de la mastalgia

Mainero RFE, Aguilar GUI

Idioma: Español
Referencias bibliográficas: 55
Paginas: 371-390
Archivo PDF: 652.84 Kb.


RESUMEN

Introducción: la mastalgia es la causa más común de consulta en el área de la mastología. Su manejo es diverso y más apegado a costumbres y tendencias que a evidencia científica. La etiología no es bien conocida, ya que intervienen diversos factores y sus características de presentación son muy diversas.
Objetivo: revisar la utilidad de las diversas intervenciones en el tratamiento actual de la mastalgia en mujeres.
Material y métodos: se integró un grupo de expertos y por consenso se establecieron los temas de interés relacionados con la mastalgia. Se establecieron las palabras clave para su búsqueda electrónica (MeSH). Se realizó una revisión de la literatura publicada en inglés vía la utilización de las bases de datos electrónicas, con información de 1982 a 2007. Se encontraron y fueron evaluados tres guías de práctica clínica, cuatro revisiones sistemáticas y 43 estudios originales sobre tratamiento de la mastalgia.
Resultados: las publicaciones disponibles reportan una amplia diversidad en intervenciones médicas formales y otras derivadas de prácticas tradicionales, también con resultados contradictorios. La mejor evidencia señala que la educación y la información son una parte integral del manejo de la mastalgia y debe ser la primera línea de tratamiento. El manejo con medicamentos será una opción en algunos casos y los mejores fármacos son tamoxifeno y danazol. Se requiere más información de la efectividad real de los antiinflamatorios.
Conclusiones: en el tratamiento de la mastalgia existen pocos estudios clínicos controlados que avalen algunas opciones terapéuticas y, por otro lado, evidencian la inutilidad de otras. La evidencia es escasa pero aceptable para la inocuidad y eficacia de algunas intervenciones, mientras para otras simplemente no existe evidencia.


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