RT Journal Article
SR Electronic
T1 Effect of patient age, breast density, and topical anesthetic cream on perceived pain with sentinel lymph node scintigraphy
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 2303
OP 2303
VO 52
IS supplement 1
A1 Chandler, Kim
A1 Hunt, Christopher
A1 Peller, Patrick
YR 2011
UL http://jnm.snmjournals.org/content/52/supplement_1/2303.abstract
AB 2303 Objectives While a useful technique for sentinel lymph node (SNL) identification in breast cancer, injections of technetium 99m-sulfur colloid can be quite painful. The purpose of this study is to determine if there is a correlation between perceived pain of injection and age, breast density, or timing of topical anesthetic cream (TAC) administration. Methods A retrospective review of women with breast cancer was conducted from 2008-2010. Women were asked to rank their pain after four unilateral, subcutaneous, periareolar injections using a comparative pain scale (CPS) (0=no pain, 10=unbearable pain). There were three categories based on length of time prior to injection that TAC (lidocaine 4%) was applied (one hour prior, 20 minutes prior, or no cream). In addition, other demographic information and breast density on mammogram was analyzed for correlation with CPS. Results Among the 82 women (age: mean, 58 yr.; range 32-87), a wide spectrum of CPS was recorded (mean, 4.0; SD, 2.6) with 35% attesting to significant pain, rated 5 or greater. The demographic information and breast density per BIRADS were retrospectively reviewed (density: fatty, 14.6%; scattered fibroglandular, 36.6%; heterogeneous, 39.0%; extremely dense, 9.8%). Using bivariate linear regression, no correlation between CPS and age (R2=0.0029, p=0.63) or breast density (R2=0.00049, p=0.84) was identified. The majority had TAC applied 20 minutes prior to injection (n=47, 57.3%) with 24 (29.3%) having TAC applied 1 hour prior. 11 women (13.4%) had no TAC applied due to patient preference or allergies. Again no correlation was found between CPS and time of application or use of TAC (Kruskal-Wallis: X2(2) =1.0, p=0.61). Conclusions A wide range of pain is experienced with SNL injections, but the severity of perceived pain does not correlate with age and breast density. There is no correlation between the timing of anesthetic cream or its use at all and perceived pain. The use of TAC may need to be reexamined and other means of pain control should be further investigated