Kornguth P J, Keefe F J, Conaway M R
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Pain. 1996 Aug;66(2-3):187-94. doi: 10.1016/0304-3959(96)03057-6.
Reports of pain during mammography show that there is great variability in both the incidence of reported pain (0.2-62%) and the intensity of that pain. Much of that variability may be due to the measures used to rate mammography pain. This is the first study that has examined the incidence, quality and intensity of mammography pain using a variety of pain measures. A sample of 119 women undergoing screening mammography was studied using four pain scales, three well-validated measures frequently used in the pain research literature as well as a pain/discomfort measure frequently reported in the radiology literature. A large proportion (up to 91%) of women report having some degree of pain during mammography. The intensity of that pain was typically in the low to moderate range, but a small proportion of women (< 15%) reported intense pain. The incidence of reported pain was related to the pain measure used. Pain measures that provided a woman with many options for reporting pain were associated with a higher incidence of pain than a scale that provided only one or two options. Thus, some of the variability in reported incidence of pain during mammography can be explained by the pain scale used in the study. Demographic and medical variables could explain 18-20% of the variance in mammography pain. Two of the variables that were shown to consistently predict a painful mammographic experience were (1) average pain at the last mammogram and (2) breast density. This study demonstrated that the pain measure selected for use in a particular study may depend on the population being studied. A college education was found to be an important predictor of pain scores on the McGill Pain Questionnaire. Thus, this pain measure may be of limited usefulness in studying a population of women with little formal education.
关于乳腺钼靶检查时疼痛的报告显示，报告的疼痛发生率（0.2%-62%）和疼痛强度都存在很大差异。这种差异很大程度上可能归因于用于评估乳腺钼靶检查疼痛的方法。这是第一项使用多种疼痛评估方法来研究乳腺钼靶检查疼痛的发生率、性质和强度的研究。对119名接受乳腺钼靶筛查的女性样本使用了四种疼痛量表进行研究，其中三种是疼痛研究文献中常用且经过充分验证的量表，还有一种是放射学文献中经常报告的疼痛/不适量表。很大比例（高达91%）的女性报告在乳腺钼靶检查时有一定程度的疼痛。疼痛强度通常处于低到中度范围，但一小部分女性（<15%）报告有剧烈疼痛。报告的疼痛发生率与所使用的疼痛评估方法有关。为女性提供多种疼痛报告选项的疼痛评估方法与较高的疼痛发生率相关，而提供一两种选项的量表则不然。因此，乳腺钼靶检查时报告的疼痛发生率的一些差异可以用研究中使用的疼痛量表来解释。人口统计学和医学变量可以解释乳腺钼靶检查疼痛差异的18%-20%。两项被证明能持续预测痛苦的乳腺钼靶检查体验的变量是：（1）上次乳腺钼靶检查时的平均疼痛程度和（2）乳腺密度。这项研究表明，在特定研究中选择使用的疼痛评估方法可能取决于所研究的人群。研究发现，大学教育是麦吉尔疼痛问卷疼痛评分的一个重要预测因素。因此，这种疼痛评估方法在研究受正规教育较少的女性人群时可能用处有限。
