Needle wire localization for nonpalpable breast lesions: sensations, anxiety levels, and informational needs

To determine the sensations that women most frequently report during needle wire localization (NWL) for nonpalpable breast lesions, to rate preprocedure anxiety, and to describe what preparation women consider desirable for the procedure.

Outpatient breast center in a large, not-for-profit hospital in a major city in Texas.

Prospective, descriptive design.

Nonprobability sample of 56 women who were an average of 57 years old (range = 30-87 years). Forty-three (77%) underwent single wire localization. Nine (16%) of the women were subsequently diagnosed with breast cancer.

Subjects provided demographic information preprocedure. Postprocedure, subjects described and rated intensity of sensations on a 0-10 verbal, numeric rating scale. Preprocedure anxiety was also rated. Subjects responded to the question "What would you have liked to have been told before NWL to best prepare you for the procedure?"

Most frequently reported sensations were pressure, stinging, and pain, which averaged 6, 4, and 7, respectively, in intensity. Mean anxiety score was 5.3 on a scale of 10 with 10 subjects rating their anxiety as 10. Five (9%) subjects fainted during the procedure. Subjects provided valuable suggestions about how to prepare patients for this procedure, such as providing brochures and pictures about the procedure.

Subjects are moderately or highly anxious before NWL of the breast and describe a variety of sensations. Risk factors for fainting during this procedure and strategies to prevent fainting must be determined.

Sensory information should be used to prepare women for NWL. Subjects' suggestions about how to prepare women for the procedure can be used to develop educational and sensory approaches to enhance preparation for the procedure and perhaps reduce anxiety.