Pain experienced by patients during minimal-invasive ultrasound-guided breast biopsy: Vacuum-assisted vs core-needle procedure

• Published in: European journal of surgical oncology Vol. 37; no. 5; pp. 398 - 403
• Main Authors: Szynglarewicz, B, Matkowski, R, Kasprzak, P, Forgacz, J, Zolnierek, A, Halon, A, Kornafel, J
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2011
• Subjects: Adult; Aged; Biopsy, Needle - adverse effects; Biopsy, Needle - methods; Breast Diseases - diagnosis; Breast Diseases - surgery; Breast Neoplasms - diagnosis; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - surgery; Confounding Factors (Epidemiology); Core-needle biopsy; Early breast cancer; Female; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Minimal-invasive breast biopsy; Minimally Invasive Surgical Procedures; Pain - diagnosis; Pain - etiology; Pain Measurement; Palpation; Prospective Studies; Research Design; Surgery; Surveys and Questionnaires; Ultrasonography, Mammary; Vacuum; Vacuum-assisted biopsy; Vacuum-assisted biopsy; Core-needle biopsy; Early breast cancer; Minimal-invasive breast biopsy
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2011.02.002

Abstract Aims To evaluate comparatively the pain associated with ultrasound-guided core-needle (CN) and vacuum-assisted (VA) biopsy for non-palpable breast lesions. Methods 723 women undergoing ultrasound-guided breast biopsy for BIRADS IV and V lesions according to the same standardised protocol were prospectively studied. 14-gauge CN biopsy with an automated gun was performed in 321 patients. In 402 women biopsy was made using 11-gauge VA hand-held probe. Immediately after the procedure patients were interviewed about the pain experienced during the biopsy and were asked to indicate at the pain intensity on a eleven-point scale: from 0 (none) to 10 (extreme, worst possible pain). Results The median rate of pain experienced by women during biopsy was 4 (range 2–7). There were no significant differences between CN and VA groups with regard to age, body mass index, menopausal status, history of parity, hormone replacement therapy, menopausal status, breast parenchymal pattern (according to Wolfe’s classification), family history of breast cancer, lesion size and number of samples. CN biopsy with an automated gun was significantly more painful ( P  < 0.01) than procedure with VA hand-held device as evaluated by patients: median 6 (4–7) vs 3 (2–5), respectively. Conclusions Despite using the larger needle VA procedure results in less pain experienced by women in comparison to CN biopsy with automated gun. Reduced patient discomfort should be one of the reasons for the preferential use of VA biopsy in the assessment of non-palpable breast masses.