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, 526–534. 

To evaluate the effects of guided meditation and music on patients’ anxiety, pain, and fatigue during breast biopsy

Patients were randomly assigned to meditation, music, or standard care with supportive dialogue. Patients in the meditation and music groups were given headphones. During the procedure, patients in the meditation group listened to an audio recorded medication designed to help patients relax and focus on feelings of kindness and compassion. The music group listened to their choice of music. The standard care control group received supportive dialogue during the procedure. Biopsies were done with local anesthesia. Study assessments were done pre and post biopsy.

• N = 121   
• MEAN AGE = 52.96 years
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: Patients undergoing breast biopsy. Of these, 30% had previous breast biopsy.  
• OTHER KEY SAMPLE CHARACTERISTICS: The majority were Caucasian. The average education level was 15 years.

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: North Carolina

• PHASE OF CARE: Diagnostic

• Three-group, randomized, controlled trial

• State-Trait Anxiety Inventory (STAI)
• Numeric pain scale (0–10)
• Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F)
• Questionnaire on the Quality of Physician-Patient Interaction (QQPPI)
• 11-point numeric scale to assess engagement in the study interventions

Anxiety declined in all groups, while those in the meditation group (p = 0.04) and the music group (p = 0.03) had greater decline in anxiety compared to controls. Fatigue declined in all, with no significant differences between groups. Decline in pain differed among the study groups. The music group had greater increases in pain than the meditation group (p = 0.03), and pain increased in the control group. No difference in pain scores existed between the music and control groups. Overall post-procedure pain scores averaged 1.8.

The study findings suggest that a meditation intervention during biopsy may help to reduce patient anxiety and pain.

• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Very low pain scores suggest floor effects in measurement.
• Single point in time measurement of anxiety post-procedure—does not determine longer term effects on anxiety

This study showed that listening to a meditation intervention during breast biopsy was associated with lower anxiety postprocedure. This is a low-risk intervention that may be helpful for patients; however, whether this effect would have lasted for any length of time after the procedure is unknown.