What role do lifestyle modifications play in the management of breast pain, and which should I recommend to my patients?

Role of lifestyle modifications in managing breast pain: Lifestyle modifications play a supportive role in the management of cyclical breast pain primarily through reassurance and non-pharmacological measures that can reduce discomfort.

Recommended lifestyle modifications:

• Advise women to wear a well-fitted, supportive bra during the day, a more supportive bra during exercise, and a soft support bra at night to help relieve breast pain. This is based on expert opinion and evidence showing significant pain relief with supportive bras and no side effects compared to pharmacological treatments like danazol NICE CKS.
• Encourage the use of simple oral analgesics such as paracetamol or ibuprofen as needed for pain relief NICE CKS.
• Recommend keeping a breast pain diary to monitor the severity, timing, and response to treatment, which can help tailor management NICE CKS.
• Reassure patients that cyclical breast pain is common and not associated with serious pathology, which can reduce anxiety and improve symptom perception NICE CKS.

Not routinely recommended lifestyle or dietary changes: There is limited or no good-quality evidence supporting the benefit of evening primrose oil, flaxseed, low-fat or low-caffeine diets, vitamin B6, vitamin E supplementation, or changing contraceptive methods solely for breast pain relief NICE CKS.