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Randomized clinical trial of the effect of needle gauge and local anaesthetic on the pain of breast fine-needle aspiration cytology

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Background: Breast fine-needle aspiration cytology (FNAC) is an invasive investigation which can be uncomfortable or distressing. This randomized study investigated the discomfort of breast FNAC and the effect of different techniques.

Methods: Some 116 FNAC samples were taken from 98 women with a palpable breast mass. Each patient was randomized to one of four study groups; aspiration was performed using a green-hub (21 G) or blue-hub (23 G) needle, either with or without local anaesthetic. Each patient scored the pain of the whole procedure using a visual analogue scale.

Results: A green-hub needle caused significantly more discomfort (mean(s.e.m.) pain score 5·1(0·4) cm) than a blue-hub needle (2·9(0·4) cm), or either a blue- or green-hub needle with local anaesthetic (3·0(0·4) and 2·1(0·4) cm respectively) (F = 10·28, 3112 d.f., P < 0·01, analysis of variance).

Conclusion: The discomfort of breast FNAC is dependent upon the gauge of the needle and the use of local anaesthetic. A blue-hub needle without local anaesthetic should be first choice for breast FNAC.
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Document Type: Research Article

Publication date: June 1, 2000

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