Non-pharmacological methods in the relief of pain related to the screening and diagnosis of breast cancer: scope review




Mammography; Biopsy needle; Pain; Pain management; Analgesia; Complementary therapies.


Objective: to map non-pharmacological therapies used in the literature to relieve pain in women undergoing breast cancer screening and diagnosis. Methodology: Scope review study carried out in nine data sources using the descriptors mammography, needle biopsy, complementary therapies and pain. Two independent researchers performed the search for the studies and one researcher applied the inclusion and exclusion criteria and performed the analysis. Studies that answered the research question were included, totaling twelve publications. The extraction of research data was performed using instruments built by the authors that allowed the categorization of the information presented. Results: among the final sample of twelve studies, the non-pharmacological methods used were music therapy, meditation, hypnosis, physical exercise, nursing interventions and therapeutic touch. It was observed that music therapy, physical exercises and nursing interventions were used to reduce pain during mammography, and the other methods found were tested in the biopsy procedure. Conclusion: it was shown that non-pharmacological methods used to relieve pain during screening and diagnosis of breast cancer are effective and can contribute to changes in care protocols as they are an easy-access, low-cost, creative, safe and that provides benefits to women.


Abdel-Hadi, M., Abdel-Hamid, G. F., Abdel-Razek, N., & Fawzy, R. K. (2010). Should fine-needle aspiration cytology be the first choice diagnostic modality for assessment of all nonpalpable breast lesions? The experience of a breast cancer screening center in Alexandria, Egypt. Diagnostic Cytopathology, 38(12), 880–889.

Akın, M. E. (2021). Effect of music on anxiety and pain during ultrasound-guided core needle breast biopsy: a randomized controlled trial. Diagn Interv Radiol, 27, 360–365.

Almeida, T. C. (2015). Avaliação do impacto de exercícios físicos na redução da dor em mulheres submetidas à mamografia. Tese de Doutorado, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil.

Almeida, L. S., Santana, J. B., Silva, S. O., & Melo, M. I. B. (2017). Acesso Ao Exame De Mamografia Na Atenção Primária. Rev enferm UFPE on line, 11, 4885–94.

Domar, A. D., Eyvazzadeh, A., Allen, S., Roman, K., Wolf, R., Orav, J., Albright, N., & Baum, J. (2005, Fev). Relaxation techniques for reducing pain and anxiety during screening mammography AJR Am J Roentgenol, 184(2), 445-7.

Chelsea Gilts Ratcliff, M.A. (2015). Brief Guided Mindfulness Meditation for Women Undergoing Stereotactic Breast Biopsy: Effects on Patient Self-Report, EEG Activity, and Physiological Measures. Tese de Doutorado, University of Houston, Texas, Estados Unidos.

Fayanju, O. M., Kraenzle, S., Drake, B. F., Oka, M., & Goodman, M. S. (2014). Perceived barriers to mammography among underserved women in a Breast Health Center Outreach Program. American Journal of Surgery, 208, n425–434.

Field, A. S., Raymond, W. A., Rickard, M., & Schmitt, F. (2020, March–April). Breast fine needle aspiration biopsy cytology: the potential impact of the International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology and the use of rapid on-site evaluation. Journal of the American Society of Cytopathology, 9, 103-111.

Frank, L. S., Frank, J. L., Marc, D., Makari-Judson, G., Barham,, R. B., & Mertens, W, C. (2007). Does therapeutic touch ease the discomfort or distress of patients undergoing stereotactic core breast biopsy? A randomized clinical trial. Pain Med, 8 (5), 419-24.

Freitas-junior, R., Martins, E., Metran-Nascente, C., Carvalho, A. A., Silva, M. F., Soares, L. R., & Ximenes, C. A. (2018). Double-blind placebo-controlled randomized clinical trial on the use of paracetamol for performing mammography. Medicine (United States), 97 (13).

Gioia, S., Lima, S., & Maiato, A. P.A. (2017). Biópsia percutânea de mama: quando indicar?. Sociedade Brasileira de Mastologia.

Hamlin, A. S.; & Robertson, T. M. (2017). Pain and Complementary Therapies. Critical Care Nursing Clinics of North America, 29, 449–460.

Instituto Nacional do Câncer José Alencar Gomes da Silva Atualização em mamografia para técnicos em radiologia / Instituto Nacional do Câncer José Alencar Gomes da Silva. (2a ed.), INCA.

Kitaoka, H.; & Kawashima, H. (2018). Influence of the menstrual cycle on compression-induced pain during mammography: correlation with the thickness and volume of the mammary gland. Radiological Physics and Technology, 11, 20–26.

Lang, E. V., Berbaum, K, S., Faintuch, S., Hatsiopoulou, O., Halsey, N., Li, X., Berbaum, M. L., Laser, E., & Baum, J. (2006). Adjunctive self-hypnotic relaxation for outpatient medical procedures: a prospective randomized trial with women undergoing large core breast biopsy. Pain, 126(1-3),155-64.

Le danseur, M., Crow, A. D., Stutzman, S. E., Villarreal, M. D., & Olson, D. M. (2019). Music as a Therapy to Alleviate Anxiety during Inpatient Rehabilitation for Stroke. Rehabilitation Nursing, 44, 29–34.

Leandro, R. I. S. (2016). Efeito de um programa de atividade física na redução da dor durante à mamografia. Dissertação, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.

Oxford Centre for Evidence-Based Medicine [Internet]. (2009, March). Levels of Evidence

Pang, E., Crystal, P., Kulkarni, S., Murphy, K., & Menezes, R. J. (2016, Agosto). An Audit of Pain Experienced During Image-Guided Breast Biopsy Procedures at an Academic Center. Jornal da Associação Canadense de Radiologistas, Volume 67, edição 3, páginas 250-253.

Peters, M.D.J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A.C., & Khalil, H. (2020). Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer´s Manual, JBI.

Satchithananda, K., Fernando, R. A., Ralleigh, G., Evans, D. R., Wasan, R. K., Bose, S., Donaldson, N., & Michell, M. J. (2005, Nov-Dez). Uma auditoria da dor / desconforto experimentado durante procedimentos de biópsia de mama guiada por imagem. Mama J., 11 (6): 398-402.

Sánchez-Jáuregui, T., Téllez, A., Juárez-García, D., García, C. H., & García, F. E. (2019). Clinical Hypnosis and Music In Breast Biopsy:A Randomized Clinical Trial. Am J Clin Hypn, 61(3), 244-257.

Sharaf, A. Y., & Hafeez, N. A. A. A. E. (2019, September – December). Effect of Nursing Interventions on Pain and Anxiety among Women undergoing Screening Mammography. International Journal of Novel Research in Healthcare and Nursing, 6, 454-469.

Soo, A. E., Shelby, R. A., Miller, L. S., Balmadrid, M. H., Johnson, K. S., Wren, A. A., Yoon, S. C., Keefe, F. J., & Soo, M. S. (2014, Jul). Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies. J Am Coll Radiol, 11(7):709-16.

Soo, M. S., Jarosz, J. A., Wren, A. A., Soo, A. E., Mowery, Y. M., Johnson, K. S., & Shelby, R. A. (2016). 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, 13(5), 526–534.

Tricco, AC., Lillie E., Zarin, W., O’Brien, K.K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson M. G., Garritty, C., Lewin, S., Godfrey C. M., Macdonald, M. T., Langlois, E. V., Soares-Weiser, K., Moriarty, J., Clifford, T., Tunçalp, O., & Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med.; 169(7):467-73.

Wren, A. A., Shelby, R. A., Soo, M. S., Huysmans, Z., Jarosz, J. A., & Keefe, F. J. (2019). Preliminary efficacy of a lovingkindness meditation intervention for patients undergoing biopsy and breast cancer surgery: A randomized controlled pilot study. Support Care Cancer, 27(9), 3583-3592.

Yangfan, X., Li, L., Xie, Y., Xu, J., & Liu, Y. (2018). Effects of aroma therapy and music intervention on pain and anxious for breast cancer patients in the perioperative period. Journal of Central South University (Medical Sciences), 43, 656–661.

Zagouri, F., Sergentanis, T. N., Gounaris, A., Koulocheri, D., Nonni, A., Domeyer, P., & Zografos, G. C. (2008). Dor em diferentes métodos de biópsia mamária: Ênfase na biópsia mamária assistida a vácuo. The Breast, 17 (1), 71-75.

Zavotsky, K. E., Banavage, A., James, P., Easter, K., Pontieri-Lewis, V., & Lutwin, L. (2014, Jun). The effects of music on pain and anxiety during screening mammography. Clin J Oncol Nurs,18(3), E45-9.



How to Cite

FRANCO, C. L.; SANTOS, E. S. .; RIBEIRO , C. J. N.; SANTOS , K. O. C. A.; SANTOS, M. da S.; OLIVEIRA, M. I. N. .; NUNES , M. da S. .; ALVES, J. A. B.; RIBEIRO, M. do C. de O. Non-pharmacological methods in the relief of pain related to the screening and diagnosis of breast cancer: scope review . Research, Society and Development, [S. l.], v. 10, n. 10, p. e446101019173, 2021. DOI: 10.33448/rsd-v10i10.19173. Disponível em: Acesso em: 20 oct. 2021.



Health Sciences