MedicalResearch.com Interview with:
Mary Scott Soo, M.D. FACR
Associate professor of Radiology
Duke Cancer Institute
Medical Research: What is the background for this study?
Dr. Soo: Imaging-guided needle breast biopsies for diagnosing suspicious breast lesions have been performed for many years and have definite advantages as a diagnostic tool over surgical biopsies. These biopsies are performed in outpatient settings, which decrease costs and reduce delays, and are highly accurate and less invasive than surgical procedures, requiring only local anesthesia. However, performing biopsies in this outpatient setting limits the use of intravenous sedation and pain medication that could address commonly experienced patient anxiety and occasional associated pain. Anxiety and pain can negatively impact the patient’s experience and could possibly affect the biopsy outcome due to patient movement, and could potentially even alter patients’ adherence to follow-up recommendations. Prior studies have explored methods to reduce anxiety, using interventions such as music, hypnosis and anxiolytics. Although hypnosis and anxiolytics are effective, these are a little more complicated to implement due to training costs for administering hypnotherapy, and costs, potential side effects, and need for an adult driver to take the patients home when anxiolytics are used. Other research has shown that meditation-based interventions can lead to positive psychological and physical outcomes, and may be helpful for decreasing anxiety, pain and fatigue.
Loving-kindness mediation is a type of mediation that focuses on relaxation and developing positive emotions, by silently repeating phrases encouraging compassion and goodwill towards oneself and others, while also reducing negative emotions. Previous studies have shown that even a 7-minute loving-kindness meditation can be effective for increasing positive emotions, so my co-authors Rebecca Shelby PhD, a clinical psychologist at Duke’s Pain Prevention and Treatment Research Program,clinical psychologist Anava Wrenn PhD, who has used loving-kindness meditation in a different practice setting, and breast imaging radiologist Jennifer Jarosz MD and I put together a team to study whether an audio-recorded, lovingkindness meditation could reduce anxiety, fatigue and pain during the imaging-guided breast biopsy time frame. We consulted with Mary Brantley, MA, LMFT, who teaches loving-kindness meditation at Duke’s Integrative Medicine, to develop an audio-recorded loving-kindness mediation used specifically in the breast biopsy setting, and compared this to using music during biopsies or standard care (supportive dialogue) from the technologist and radiologist performing the biopsy.
Medical Research: What are the main findings?
Dr. Soo: Our audio-recorded, loving-kindness meditation and music interventions during imaging-guided core needle breast biopsies reduced patient anxiety and fatigue compared to standard care (supportive dialogue from the radiologist and technologist), without any apparent interference in radiologist-patient communication. Interestingly, the loving-kindness meditation also resulted in significantly lower biopsy pain, compared to the music group.
Medical Research: What should clinicians and patients take away from your report?
Dr. Soo: Lovingkindness meditation and music interventions appear safe, inexpensive, and easy to incorporate into clinical practice, and (particularly the loving-kindness meditation) may improve women’s experiences during imaging-guided core needle breast biopsies.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Soo: We are hoping to test the loving-kindness meditation intervention in a multi-institutional study, to see if our findings can be generalized across a range of practice settings, in both private practices and academic institutions. In addition, the lovingkindness meditation may be helpful during other outpatient medical procedures, and we might consider testing its usefulness during breast MRI scans and MRI-guided breast biopsies.
Mary Scott Soo, Jennifer A. Jarosz, Anava A. Wren, Adrianne E. Soo, Yvonne M. Mowery, Karen S. Johnson, Sora C. Yoon, Connie Kim, E. Shelley Hwang, Francis J. Keefe, Rebecca A. Shelby. Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue.
Journal of the American College of Radiology, 2016;
Mary Scott Soo, M.D. FACR (2016). Meditation May Improve Experience with Imaging-Guided Needle Breast Biopsy