title: Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies.
abstract: OBJECTIVE
  The purpose of this study was to evaluate pain experienced during imaging-guided core-needle breast biopsies and to identify factors that predict increased pain perception during procedures.
  
  
  METHODS
  In this institutional review board-approved, HIPAA-compliant protocol, 136 women undergoing stereotactically or ultrasound-guided breast biopsy or cyst aspiration were recruited and provided written informed consent. Participants filled out questionnaires assessing anticipated biopsy pain, ongoing breast pain, pain experienced during biopsy, catastrophic thoughts about pain during biopsy, anxiety, perceived communication with the radiologist, chronic life stress, and demographic and medical information. Procedure type, experience level of the radiologist performing the biopsy, number of biopsies, breast density, histology, and tumor size were recorded for each patient. Data were analyzed using Spearman's ρ correlations and a probit regression model.
  
  
  RESULTS
  No pain (0 out of 10) was reported by 39.7% of women, mild pain (1-3 out of 10) by 48.5%, and moderate to severe pain (≥4 out of 10) by 11.8% (n = 16). Significant (P < .05) predictors of greater biopsy pain in the probit regression model included younger age, greater prebiopsy breast pain, higher anticipated biopsy pain, and undergoing a stereotactic procedure. Anticipated biopsy pain correlated most strongly with biopsy pain (β = .27, P = .004).
  
  
  CONCLUSIONS
  Most patients report minimal pain during imaging-guided biopsy procedures. Women experiencing greater pain levels tended to report higher anticipated pain before the procedure. Communication with patients before biopsy regarding minimal average pain reported during biopsy and encouragement to make use of coping strategies may reduce patient anxiety and anticipated pain.
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Adrianne E
authors.initials: AE
authors.lastname: Soo
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Shelby
authors.affiliation: Riverside Radiology and Interventional Associates, Columbus, Ohio.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Miller
authors.affiliation: Seattle Radiologists, Seattle, Washington.
authors.forename: Melissa Hayes
authors.initials: MH
authors.lastname: Balmadrid
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Johnson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Anava A
authors.initials: AA
authors.lastname: Wren
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Sora C
authors.initials: SC
authors.lastname: Yoon
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, North Carolina. Electronic address: soo00002@mc.duke.edu.
authors.forename: Mary Scott
authors.initials: MS
authors.lastname: Soo
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000523:psychology; D058443:Catastrophization / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015984:Causality; D015897:Comorbidity; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010146:Pain; D010147:Pain Measurement / Q000706:statistics & numerical data; D011379:Prognosis; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology
keywords: Imaging-guided breast biopsy; anticipated pain; breast pain