title: Pain in different methods of breast biopsy: emphasis on vacuum-assisted breast biopsy.
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 (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.
authors.affiliation: Breast Unit, First Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens, Greece.
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.forename: Antonia
authors.initials: A
authors.lastname: Gounaris
authors.forename: Dimitra
authors.initials: D
authors.lastname: Koulocheri
authors.forename: Afroditi
authors.initials: A
authors.lastname: Nonni
authors.forename: Philip
authors.initials: P
authors.lastname: Domeyer
authors.forename: Constantine
authors.initials: C
authors.lastname: Fotiadis
authors.forename: John
authors.initials: J
authors.lastname: Bramis
authors.forename: George C
authors.initials: GC
authors.lastname: Zografos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006115:Greece; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology*; D018084:Ultrasonography, Interventional; D014618:Vacuum
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine