Pain Control for Breast Cancer Patients Receiving Injection of Radioactive Tracer

Optimizing Topical Pain Control for Breast Cancer Patients Undergoing Pre-operative Radiotracer Injection for Sentinel Lymph Node Mapping

The purpose of this study is to compare the effectiveness four different pain treatments for the injection of radioactive tracer that women with breast cancer receive for sentinel lymph node biopsies.

This study will include women who have been diagnosed with breast cancer and who will be undergoing sentinel lymph node biopsy with a standard injection of radioactive tracer before surgery.

A participant's active participation will take place on two separate occasions. In the first occasion, a participant will complete a brief pain assessment on the day of enrollment. The rest of a participant's active participation will take place on one day (the day of surgery) and last approximately 20 minutes, after which active participation will end.

Primary Objective: To test the effectiveness of four alternative approaches to topical anesthesia on pain associated with radiotracer injection for women diagnosed with breast cancer undergoing sentinel lymph node mapping.

Secondary Objectives:

1. To assess patient satisfaction with pain control modality for radiotracer injection.
2. To identify barriers to implementation of the different pain control interventions.

Inclusion Criteria:

• greater than or equal to 18 years of age
• biopsy proven breast cancer
• standard radiotracer injection (intradermal injection in the upper outer quadrant of the involved breast)
• radiotracer injection occurs on the same day as sentinel lymph node surgery

Exclusion Criteria:

• males

• pregnancy

• local anesthetic allergy or active use of the following medications:

  • Abametapir (risk X)
  • Conivaptan (risk X)
  • Fusidic Acid (risk X)
  • Idelalisib (risk X)
  • Mifepristone (risk D)
  • Stiripentol (risk D)
  • Amiodarone (risk C)
  • Dofetilide (risk C)
  • Dronedarone (risk C)
  • Ibutilide (risk C)
  • Sotalol (risk C)
  • Vernakalant (risk C)

• Non-English speaking/reading

• Unable to provide informed consent

• Unable to participate with surveys

• Undergoing radiotracer injection the day prior to surgery or intra-operatively at the time of initial surgical scheduling

  • If patients are initially scheduled for same-day preoperative injection, complete all enrollment procedures (including randomization), and surgery is re-scheduled for a day prior to surgery or for intra-operative injection, they will be excluded if:

    • randomized to a lidocaine patch arm (Arms C or D)
    • re-scheduled for an intra-operative injection • Planned non-standard radiotracer injection site