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

Flora Zagouri, Theodoros N. Sergentanis, Antonia Gounaris, Dimitra Koulocheri, Afroditi Nonni, Philip Domeyer, Constantine Fotiadis, John Bramis and George C. Zografos
The Breast Volume 17, Issue 1, February 2008, Pages 71-75
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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 (21 G, n=85), core biopsy (14 G, 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, 11 G) 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.