Preoperative needle localization in the breast: utility of local anesthesia

Eighty-nine consecutive patients undergoing needle localization at two facilities were alternately assigned to "local-anesthesia" (n = 46) and "no-local-anesthesia" (n = 43) groups. Those in the local-anesthesia group received 1-2 mL lidocaine hydrochloride 1% subcutaneously at the expected site of insertion of the localizing needle. All patients were asked to rate the level of pain they experienced from the procedure as a whole by using a 10-cm horizontal visual analog pain scale. Data about patient age, menopausal and menstrual status, average daily caffeine intake, and whether the patients considered mammography to be a painful procedure were collected. Patients who did not receive local anesthesia had a lower mean pain score (2.52) than those who did (3.27, P = .18). Premenopausal patients in the second half of their menstrual cycle at the time of the procedure had a significantly higher pain score than those in the first half (3.54 vs. 1.70, P = .05). Patients who considered mammography a painful procedure reported a higher level of pain than those who did not (3.79 vs 2.38, P = .012). There was no relationship between age, caffeine intake, or menopausal status and pain experienced.