Ductal endoscopy of the breast: more painful at the luteal phase?

Purpose:  To assess the putative predictors that may influence the pain experienced during ductal endoscopy of the breast. Methods:  The pain experienced was evaluated in 19 consecutive premenopausal women with bloody nipple discharge scheduled for ductal endoscopy. The visual analog scale (VAS) was used to estimate the degree of pain. The duration of the procedure, the history of lactation, and the phase of the menstrual cycle were evaluated with respect to pain experienced. Statistical analysis followed. Results:  The average reported pain (VAS score, mean ±  standard deviation) was 5.79 ± 1.51 while the maximum pain was 8.26 ± 0.99. The average reported pain was marginally associated with the duration of the procedure in contrast to the maximum. Women who were at the luteal phase of their menstrual cycle exhibited a higher average reported pain. The history of breastfeeding was not associated with the average reported pain, but it was associated with less intense maximum pain. Conclusions:  Pain during ductal endoscopy of the breast is influenced by a host of factors: some immutable (such as history of lactation) and others variable (day of menstrual cycle). The latter (ie, avoidance of the luteal phase) may be targeted for the minimization of pain.