Imaging-Guided Core Needle Biopsy of the Breast: Study of Psychological Outcomes

Abstract

The objective of this study was to evaluate and document pain and psychological distress related to imaging-guided core needle biopsy (CNB) of the breast. This prospective study of 52 consecutive patients undergoing CNB of the breast assessed anxiety, pain, acute stress disorder, and activities of daily living both preprocedure and at 24 hours, 5 days, and 30 days postprocedure. Survey instruments included the State-Trait Anxiety Inventory (STAI), a visual analog pain scale, the SF-36 Physical Functioning Scale, and DSM IV criteria for acute stress disorder. Preprocedure the mean scores for self-reported levels of state and trait anxiety were 47.11 (SD = 13.53) and 37.71 (SD = 11.24), respectively. At 24 hours postprocedure, the mean score for self-reported state anxiety was 38.74 (SD = 17.77), a significant reduction from the preprocedure level reported by patients (p < 0.005). Further reductions in state anxiety levels were reported at 5 and 30 days postprocedure. The mean scores for state anxiety fell within the normal range at 30 days postprocedure (mean 32.75, SD = 10.97). However, at 5 days post-CNB, patients with confirmed malignancies reported significantly more anxiety than patients without malignancies (p = 0.002). This difference was not present at 30 days post-CNB (p = 0.17). Patients reported average pain scores of 2.0 (on a scale of 0-10) during the biopsy. This decreased to 1.3 at 24 hours, 0.3 at 5 days, and 0.2 at 30 days. Reported symptoms of acute stress related to the procedure significantly increased over the period between the 5-day interview and the 30-day interview. One (2%) patient reported avoidance of thoughts about CNB 5 days postprocedure and 5 (12%) patients reported this at 30 days postprocedure (p < 0.05). Patients undergoing CNB reported significant levels of state anxiety which were greatest at the time of biopsy. A significant decrease was observed at 24 hours postprocedure, despite the fact that biopsy results were not available to the patients. Self-reported levels of anxiety for the group, regardless of biopsy results, fell within the normal range by 30 days. Further research and interventions are recommended to address the management of anxiety for patients undergoing CNB.

Effects on short-term quality of life of vacuum-assisted breast biopsy: comparison between digital breast tomosynthesis and digital mammography

“…9 Percutaneous breast biopsies, under ultrasound, core needle or VABB guidance, are linked to pain and emotional distress of the patient especially at the time of biopsy. 10,11 To the best of our knowledge, there are no data on short-term QoL comparing VABB under DBT guidance or MMx guidance. Therefore, the purpose of our study was to compare the effects of DBT-guided and MMxguided VABB on short-term QoL.…”

Ultrasound Can Accurately Diagnose Fibroadenomas in Women Less Than 35 Years

“…The negative predictive value for a sonographic benign classification is 99.5% when strict criteria are used [8]. There are criteria as proposed by Maxwell, et al [9] where biopsy of breast masses can be avoided. This includes; age less than 25 years; no known risk factors for breast cancer; mass not increasing significantly in size; clinical findings of a smooth dis- present with fibroadenoma and/or benign lump to seek prompt referral for further assessment should they notice any increase in size of other change in the mass.…”

“…In fact, the anxiety levels for a breast biopsy have been reported to exceed the anxiety levels for patients who undergo elective surgery [16]. Clinically significant levels of anxiety have been reported in a sample of women who were anticipating, undergoing, and remembering breast needle biopsy [9]. Anxiety can also be caused by having to wait (usually a week, in our department) for histology results and then waiting for a follow-up appointment for the results to be relayed to the patient.…”

Early mammographic screening after breast conserving surgery and radiotherapy: Is it necessary?

“…On the other hand, the patients experience some degree of pain during MG and early mammographies are more painful (22). Additionally, it is well known that frequent radiological evaluations after surgery increases the patients' anxiety (23,24). It was also stated that the microtrauma caused by early MG in the presence of seroma, might contribute to cellulitis (25).…”