Discussion
anxiolytic medication-related reduction, breast lesion, anxiety, pain
The lower STAI-S at T2 compared to T1 for both the CG and the IG suggests that having completed the biopsy reduces anxiety. More specifically, our data show that post-procedural (T2) anxiety was reduced to a larger extent in the IG, which had received a brochure and support during the diagnostic procedure by a physician trained in empathic communication. In line with the intervention, patients in the IG felt they were well informed. Moreover, compared to the CG, patients of the IG perceived less pain during the biopsy. Nearly all patients agreed that a brochure should be distributed to all patients requiring a breast biopsy although considering all 4 timepoints of anxiety assessment (T1–T4), an impact of handing out a brochure and physician support on patient anxiety was not apparent.Our data collected at four time points suggest that the diagnostic period has a defined dynamic trajectory of anxiety (Fig. The dynamic trajectory of anxiety (Fig. As we anticipated and was shown by others [The patients’ worries immediately before, during and immediately after the biopsy were lower in the IG compared to the CG. The worries did not differ between women with BBL and BC, most likely because women do not know the histology of their breast lesion at this time point. An anxiolytic medication-related reduction in self-reported anxiety during the procedure was reported by Bugbee and coworkers, but was not evident before and 24 h post-procedure [The median VAS for anticipated pain was 4 in both groups, which is in line with previously reported findings [Immediately before and immediately after the biopsy the IG perceived less pain than the CG, suggesting that the intervention could have a positive impact on pain perception. The results were similar to those from studies of other interventions with the aim to reduce anxiety. For example, patients receiving structured empathic attention or performing self-hypnotic relaxation were reported to perceive less pain than patients receiving standard care [All participants rated their comprehension of the procedure to be excellent. This data is in line with Brandon et al. [It is well accepted that an illustrated brochure explaining a procedure is an effective tool to provide standardized information [Most physicians are not specially trained in communication [Our study included a large number of participants (n = 250) compared to the majority of studies in the literature. A further strength of our study is that it provides data over the entire diagnostic period, from the pre-procedure (T1) to the post-histology (T4) time point. However, our study faced an important limitation. To rule out that differences in the outcome of our study are related to different physicians, the IG was treated by the same physician as CG. This sequential study design made randomization to study condition and blinding unfeasible.