title: Ductal endoscopy of the breast: more painful at the luteal phase?
abstract: OBJECTIVE
  To assess the putative predictors that may influence the pain experienced during ductal endoscopy of the breast.
  
  
  METHODS
  The pain experienced was evaluated in 19 consecutive premenopausal women with bloody nipple discharge scheduled for ductal endoscopy. The visual analog scale (VAS) was used to estimate the degree of pain. The duration of the procedure, the history of lactation, and the phase of the menstrual cycle were evaluated with respect to pain experienced. Statistical analysis followed.
  
  
  RESULTS
  The average reported pain (VAS score, mean +/- standard deviation) was 5.79 +/- 1.51 while the maximum pain was 8.26 +/- 0.99. The average reported pain was marginally associated with the duration of the procedure in contrast to the maximum. Women who were at the luteal phase of their menstrual cycle exhibited a higher average reported pain. The history of breastfeeding was not associated with the average reported pain, but it was associated with less intense maximum pain.
  
  
  CONCLUSIONS
  Pain during ductal endoscopy of the breast is influenced by a host of factors: some immutable (such as history of lactation) and others variable (day of menstrual cycle). The latter (ie, avoidance of the luteal phase) may be targeted for the minimization of pain.
authors.affiliation: Breast Unit, 1st Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens, Athens, Greece. gzografo@med.uoa.gr
authors.forename: George C
authors.initials: GC
authors.lastname: Zografos
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Oikonomou
authors.forename: Maria
authors.initials: M
authors.lastname: Fotou
authors.forename: Aphrodite
authors.initials: A
authors.lastname: Nonni
authors.forename: Effstratios
authors.initials: E
authors.lastname: Patsouris
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D002940:Circadian Rhythm / Q000502:physiology; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D007774:Lactation / Q000502:physiology; D008183:Luteal Phase / Q000502:physiology*; D042361:Mammary Glands, Human / Q000033:anatomy & histology / Q000503:physiopathology* / Q000601:surgery*; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D010147:Pain Measurement; D013997:Time Factors