Applying a topical analgesic before a mammogram can reduce the breast discomfort some women experience during the exam, new research suggests.

The double-blind placebo-controlled clinical trial compared premedication with a 4% lidocaine gel and/or acetaminophen or ibuprofen pills. “We designed this study around safe and available over-the-counter products,” observes lead author Colleen Lambertz, MSN, MBA, FNP.

A nurse practitioner who works at St. Luke’s Mountain States Tumor Institute in Boise, Idaho, Lambertz and her team recruited 418 women, aged 32-89. All of them expected discomfort levels 40 on a 1-100 scale (median = 60), and 54 admitted that anxiety “probably or definitely” delayed their appointments.

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The women were randomly divided among 12 groups, allowing every combination of interventions and placebos to be analyzed. While the oral medications had little effect on pain, women who received the lidocaine gel reported significantly less breast discomfort during mammography. The gel was removed 30-65 minutes before the exams and had no effect on the quality of the images (Radiology. 2008;248:765-772).

In order to ensure consistency during the trial, an RN administered the lidocaine and placebo. The nurse applied the gels from the clavicles to the inferior costal margins and laterally to the midaxillary lines, then covered the area with plastic wrap.

But professional assistance is not necessary in the real world, Lambertz notes. “Women can apply the gel at home one hour prior to their appointment time and remove it right before undergoing the exam.”