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

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 (21G, n=85), core biopsy (14G, 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, 11G) 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.

[1]  P. Burrowes,et al.  Vacuum-assisted large-core breast biopsy: complications and their incidence. , 2000, Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes.

[2]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[3]  Diagnosing non-palpable breast disease: short-term impact on quality of life of large-core needle biopsy versus open breast biopsy. , 2002, Surgical oncology.

[4]  A Isnard,et al.  [Stereotactic 11-gauge directional vacuum-assisted breast biopsy: experience with 249 patients]. , 2002, Journal de radiologie.

[5]  S. Parker,et al.  Performing a breast biopsy with a directional, vacuum-assisted biopsy instrument. , 1997, Radiographics : a review publication of the Radiological Society of North America, Inc.

[6]  M. Pellegrini,et al.  Advantages and limits of percutaneous breast core biopsy with Mammotome and stereotactic equipment in upright seated patient. , 2004, La Radiologia medica.

[7]  D. Dershaw,et al.  Imaging-Guided Interventional Breast Techniques , 2011, Springer New York.

[8]  M. Michell,et al.  Image-guided breast biopsy: analysis of pain and discomfort related to technique. , 1999, Breast.

[9]  P. Drew,et al.  Vacuum-assisted biopsy device-diagnostic and therapeutic applications in breast surgery. , 2004, Breast.

[10]  M. Michell,et al.  An Audit of Pain/Discomfort Experienced during Image‐Guided Breast Biopsy Procedures , 2005, The breast journal.

[11]  J. Litherland.  The role of needle biopsy in the diagnosis of breast lesions. , 2001, Breast.

[12]  D. England,et al.  Mammotome biopsy: impact on preoperative diagnosis rate. , 2006, Clinical radiology.

[13]  R. Brem,et al.  Local Anesthesia in Stereotactic, Vacuum‐Assisted Breast Biopsy , 2001, The breast journal.

[14]  M. Michell,et al.  The impact of image guided needle biopsy on the outcome of mammographically detected indeterminate microcalcification. , 2006, Breast.

[15]  Z. Fan,et al.  Eleven years of experience reveals that fine-needle aspiration cytology is still a useful method for preoperative diagnosis of breast carcinoma. , 2007, Breast.