Date of Award

Winter 1999

Document Type


Degree Name

Doctor of Psychology (PsyD)



Committee Director

Barbara Winstead

Committee Member

Michelle Kelley

Committee Member

J. D. Ball

Committee Member

Janis Sanchez-Hucles

Committee Member

Joseph Dane


The needle localization procedure for breast biopsy (NLP) can be painful and distressing for some women. This study was carried out to learn what factors might increase or decrease NLP pain and distress, and to gain insight into possible interventions to make the procedure more comfortable for all patients. One hundred and thirty-eight women were surveyed following breast needle localization at two central Virginia hospitals. The influence of eight variables (lidocaine, self-regulation, anxiety, worry about breast cancer, breast tenderness, finding mammography painful, difficulty with surgery, and distress of blood drawing) on four outcome variables (pain incidence, pain intensity, pain unpleasantness, and distress) was evaluated. The unpleasantness and intensity of pain proved to be highly correlated and were collapsed into one combined variable, painfulness.

The results suggest that although lidocaine did not eliminate all pain, women who were given lidocaine were less likely to experience pain than those who were not given lidocaine. Although self-regulation did not appear to reduce the incidence of pain, the use of self-regulation strategies, particularly social support, did appear to reduce the intensity and unpleasantness of pain (painfulness) experienced during the breast needle localization procedure. Experiencing pain increased distress, with no statistically significant alleviation of distress from lidocaine or self-regulation. Regression analysis revealed significant relationships between generally finding mammography painful and ratings of NLP painfulness, and between prior anxiety about the NLP and finding the experience distressing.

These results are discussed in light of their treatment implications. It appears that women undergoing breast needle localization should be given lidocaine, and should be encouraged to practise some form of self-regulation. Patients may especially benefit from the presence of a friend or relative, or the kindness, encouragement, considerate touch, or clear information offered by clinic staff. It may be wise to identify women who generally find mammography painful or who are anxious about the NLP before the procedure for special support.


A Dissertation Submitted to the Faculties of The College of William and Mary, Eastern Virginia Medical School, Norfolk State University, and Old Dominion University in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology in Clinical Psychology through the Virginia Consortium Program in Clinical Psychology.