Over-the-counter anesthetic gel reduces mammogram discomfort

The simple application of lidocaine gel may reduce the breast discomfort some women experience during mammography exams, according to the results of a clinical trial from Idaho.

Compression and the occasional discomfort and pain it brings in the breasts lead many women to avoid mammograms altogether. Serious clinical data suggest that as many as two-thirds of women do not follow established guidelines for mammography. By using lidocaine gel, mammographers can offer relief to women who otherwise expect a grueling ordeal, said principal investigator Colleen Lambertz, a nurse practitioner at St. Luke's Mountain States Tumor Institute in Boise.

"Breast tenderness, anxiety, and expectation of pain are all directly correlated with the amount of discomfort women experience with mammography," Lambertz said. "With a more positive experience, we hope women will undergo more regular mammography screening."

Lambertz and colleagues recruited 418 women ages 32 to 89 who expected significant discomfort with screening mammography. Fifty-four of the women reported that they had probably or definitely delayed their mammograms due to concern over possible discomfort.

The women were randomized to receive placebos or premedication with acetaminophen, ibuprofen, and/or a local anesthetic gel followed by mammography screening. The gel was applied to the skin of the breasts and chest wall and then removed 30 to 65 minutes before mammography. The gel had no effect on subsequent image quality.

Results showed that oral medication produced no significant differences in breast discomfort, nor did other factors such as breast density. Women who received a topical application of 4% lidocaine gel, however, reported significantly less breast discomfort during mammography.

The study will appear in the September issue of Radiology.

"We designed this study around safe and available over-the-counter products in order to put women more in control, so they may have a more comfortable and satisfactory experience," Lambertz said.

Eighty-eight percent of study participants indicated they would definitely get a mammogram the following year, and 10% said they would probably get a mammogram the following year.

"Women can now take charge of the situation," Lambertz said. "They can schedule a mammography appointment for a time in their cycle when their breasts are least tender, apply the gel at home, and travel to the appointment knowing they have taken steps toward a positive experience with this potentially life-saving procedure."

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