Hypnosis helps women cope with breast biopsy

CHICAGO -- Radiologists are using an unusual approach, hypnosis, to ease patient pain and anxiety during breast biopsy procedures. A new study from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston found that women who were guided into a state of hypnotic relaxation during biopsy experienced less pain and anxiety during the procedure. The study was presented today at the annual meeting of the Radiological Society of North America (RSNA).

Finding a breast lump or receiving abnormal or inconclusive mammogram results can be highly stressful for a woman. Large-core needle biopsy (LCNB) is an effective diagnostic tool. However, most LCNB procedures are performed in outpatient settings, limiting the use of intravenous drugs to reduce pain and anxiety.

“Hypnosis can greatly help women cope with the stress of breast biopsy,” said Elvira V. Lang, M.D., associate professor of radiology at Harvard. “This is a consumer-driven movement. Already we are seeing the beginning of it.”

Dr. Lang and colleagues studied 236 women undergoing LCNB at a university-affiliated medical center. The patients were randomly assigned three types of care during the procedure. Seventy-six women received standard care, 82 women received structured empathetic attention with a person specifically assigned to be responsive to their needs, and 78 women induced self-hypnotic relaxation under instruction from a trained research assistant.

The assistant read a standardized hypnotic induction script that, among other things, instructed patients to roll their eyes upwards, close their eyes, breathe deeply, focus on a sensation of floating and invoke a pleasant setting of their choice with all of their senses.

The researchers then compared several factors, including levels of pain and anxiety and procedure time and cost. All of the patients presented with elevated anxiety. Anxiety increased significantly in the standard care group, did not change in the empathy group and decreased significantly in the hypnosis group. All three groups reported pain during the procedure, but the empathy and hypnosis groups reported significantly less pain than the standard care group.

Procedure time and cost did not differ significantly among the groups even though the empathy and hypnosis groups had an additional assistant. The hypnosis group had the shortest procedure time and the lowest cost.