title: Randomized clinical trial of the effect of needle gauge and local anaesthetic on the pain of breast fine-needle aspiration cytology.
abstract: BACKGROUND
  Breast fine-needle aspiration cytology (FNAC) is an invasive investigation which can be uncomfortable or distressing. This randomized study investigated the discomfort of breast FNAC and the effect of different techniques.
  
  
  METHODS
  Some 116 FNAC samples were taken from 98 women with a palpable breast mass. Each patient was randomized to one of four study groups; aspiration was performed using a green-hub (21 G) or blue-hub (23 G) needle, either with or without local anaesthetic. Each patient scored the pain of the whole procedure using a visual analogue scale.
  
  
  RESULTS
  A green-hub needle caused significantly more discomfort (mean(s.e.m.) pain score 5.1(0. 4) cm) than a blue-hub needle (2.9(0.4) cm), or either a blue- or green-hub needle with local anaesthetic (3.0(0.4) and 2.1(0.4) cm respectively) (F = 10.28, 3112 d.f., P < 0.01, analysis of variance).
  
  
  CONCLUSIONS
  The discomfort of breast FNAC is dependent upon the gauge of the needle and the use of local anaesthetic. A blue-hub needle without local anaesthetic should be first choice for breast FNAC.
authors.affiliation: Department of Surgery, The Royal Surrey County Hospital, Guildford, UK.
authors.forename: I R
authors.initials: IR
authors.lastname: Daltrey
authors.forename: M W
authors.initials: MW
authors.lastname: Kissin
mesh_terms: D000772:Anesthesia, Local / Q000379:methods*; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology*; D005260:Female; D006801:Humans; D009339:Needles; D010146:Pain / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement; D011446:Prospective Studies