Pain in different methods of breast biopsy: Emphasis on vacuum-assisted breast biopsy

• Published in: Breast (Edinburgh) 2008-02, Vol.17 (1), p.71-75
• Main Authors: Zagouri, Flora, Sergentanis, Theodoros N, Gounaris, Antonia, Koulocheri, Dimitra, Nonni, Afroditi, Domeyer, Philip, Fotiadis, Constantine, Bramis, John, Zografos, George C
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anesthetics, Local - administration & dosage; Biopsy, Needle - adverse effects; Biopsy, Needle - methods; Breast Neoplasms - pathology; Core biopsy; Female; Fine needle aspiration; Greece; Hematology, Oncology and Palliative Medicine; Humans; Lidocaine; Lidocaine - administration & dosage; Middle Aged; Open biopsy; Pain; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Ultrasonography, Interventional; Vacuum; Vacuum-assisted breast biopsy
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2007.07.039

Abstract This study examines pain (visual analog scale 0–10) in women undergoing breast biopsy. Two hundred and twenty-seven patients with a palpable lesion underwent FNA (21 G, n =85), core biopsy (14 G, n =86) or open biopsy under local anesthesia ( n =56). One hundred and twenty-six women presented with a non-palpable lesion, and underwent vacuum-assisted breast biopsy (VABB, 11 G) under mammographic guidance, prone position ( n =72) or hook-wire localization followed by open surgery ( n =54). The techniques sampling non-palpable lesions were the most painful: hook-wire (9.15±0.74) and VABB (4.35±1.70). Larger needle diameter was associated with more intense pain. Concerning VABB, an S-shape curve of pain (third-order pattern) was documented. A second dose of lidocaine just before the rapid increase phase was then adopted ( n =61), and reduced the total/maximum pain. In conclusion, although VABB is less painful than hook-wire, the pain experienced in VABB is significant; however, it can be attenuated by a second dose of lidocaine.