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

Breast. 2008 Feb;17(1):71-5. doi: 10.1016/j.breast.2007.07.039. Epub 2007 Sep 14.


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 (21G, n=85), core biopsy (14G, 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, 11G) 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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / administration & dosage
  • Biopsy, Needle / adverse effects*
  • Biopsy, Needle / methods
  • Breast Neoplasms / pathology*
  • Female
  • Greece
  • Humans
  • Lidocaine / administration & dosage
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology*
  • Ultrasonography, Interventional
  • Vacuum


  • Anesthetics, Local
  • Lidocaine