Lambertz et al. (2008) Premedication to reduce discomfort during screening mammography. Radiology 248: 765–772

Fear of pain is a factor that affects many women who participate in screening mammography and little research has been conducted into how to reduce the discomfort associated with mammograms. Lambertz et al. carried out a prospective study in women who expected a high level of pain to investigate whether premedication with acetaminophen, ibuprofen and/or 4% lidocaine gel could reduce discomfort and improve satisfaction with screening mammography.

A total of 418 women aged between 32 and 89 years completed this double-blind, placebo-controlled study. The patients were randomly divided into 12 study groups, which covered all combinations of the study medications. A visual analog scale was used to rate discomfort and satisfaction.

Discomfort during mammography was significantly reduced with application of 4% lidocaine gel before the procedure. An experience of discomfort significantly decreased patients' satisfaction with their mammography and plans to undergo future mammograms were significantly affected by satisfaction levels. Interaction with the mammographic technologist and nurse examiner significantly affected discomfort and satisfaction.

Use of premedication with 4% lidocaine gel could reduce the fear of pain that leads patients to avoid screening mammography, and could potentially improve patients' willingness to undergo regular screening. In turn, the authors suggest that improved adherence to regular screening could lead to earlier detection of breast cancer.