A Randomized Controlled Trial of Brief Mindfulness Meditation for Women Undergoing Stereotactic Breast Biopsy
Open accessAbstract
Purpose Stereotactic breast biopsy (SBB) is a common, anxiety-producing procedure. Nonpharmacologic methods to manage acute anxiety are needed.Methods In this single-blind trial, women were recruited before SBB and randomized in a 2:2:1 ratio to a single session of guided mindfulness-based meditation (GM; n = 30), focused breathing (FB; n = 30), or standard care (SC; n = 16). Anxiety and pain were assessed at baseline after a 10-min prebiopsy group-specific activity (GM, FB, or SC), every 4 min during SBB, and after biopsy. Electroencephalographic activity in the medial prefrontal cortex, insula, anterior cingulate cortex, and precuneus was collected throughout the study.Results Women in the GM group reported a steeper reduction in anxiety than women in the FB and SC groups (P < .001 for all, Cohen's d > 0.4 for all). There were no group differences in pain ratings during the biopsy. Women in the GM group experienced increased beta activity during biopsy in the insula (P = .006, Cohen's d = 1.4) and anterior cingulate cortex (P = .019, Cohen's d = 1.0) compared with women in the SC group, and there was a trend toward the same effect compared with women in the FB group (P < .10 for both). Women in the GM and FB groups experienced a nonsignificant decrease in delta activity in the precuneus during biopsy compared with those in the SC group (P < .40 for both, Cohen's d > 0.6 for both), which was associated with a steeper reduction in anxiety during the biopsy (r = 0.51, P < .01).Conclusions Brief, guided meditation may provide effective anxiety relief during an acute medical procedure and affect neuronal activity in regions associated with attention, self-awareness, and emotion regulation.
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Of 45 interventions incorporating both human-guided training and multiple sessions, only four were ineffective [44,47,50], likely due to taxing clinical situations, inadequate training/experience, and practice discontinuation.
“Of the 45 interventions in any population that incorporated both of these components, only four were ineffective [44,47,50], but this was likely due to taxing clinical situations [47], inadequate training or experience for a more technical practice [44], and practice discontinuation [50].”
From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [47]
The Results (page unavailable) report that guided mindfulness produced a steeper reduction in anxiety during biopsy than either control condition. The Discussion (page unavailable) calls it effective for reducing anxiety; it found no significant pain difference, but suggests local anesthesia and low pain ratings as possible explanations—not a taxing clinical situation. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredDeep or diaphragmatic breathing may provide minimal benefit when voluntary full diaphragmatic movement is lacking, such as during a breast biopsy.
“Deep or diaphragmatic breathing may provide minimal benefit when voluntary full diaphragmatic movement is lacking, such as during a breast biopsy [47].”
From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [47]
The Methods describe slow diaphragmatic breathing during breast biopsy, and the Results (Intervention Effect on Anxiety; page unavailable) found no significant difference in anxiety reduction between that group and standard care. The paper does not say that participants lacked voluntary full diaphragmatic movement or that restricted movement explains the result. (LLM, conf=0.85)
Experimental — accuracy not yet measuredWomen guided in mindfulness-based meditation for 10 minutes before and throughout stereotactic breast biopsy reported a quicker reduction in anxiety during biopsy than women guided in a breathing task or receiving standard care.
“and another found that women guided in mindfulness-based meditation for 10 minutes before and then throughout SBB reported a quicker reduction in anxiety during the biopsy compared to their counterparts guided in a breathing task or receiving standard care (Ratcliff et al., 2019).”
From Who Benefits Most from a Brief Mindfulness Intervention to Reduce Anxiety During Stereotactic Breast Biopsy: the Moderating Effect of Trait Mindfulness, Spiritual Well-being, and Distress Tolerance (2021) · cites this paper as Ratcliff et al., 2019
The current study is a secondary analysis of a previously reported single-blind randomized controlled trial that compared guided mindfulness meditation, focused breathing, and standard care on anxiety during stereotactic breast biopsy.
“The goal of the current study was to examine moderators of a previously reported single-blind randomized controlled trial comparing the effect of guided mindfulness meditation (GM) to focused breathing (FB) and standard care (SC) on anxiety reported during SBB (Ratcliff et al., 2019).”
From Who Benefits Most from a Brief Mindfulness Intervention to Reduce Anxiety During Stereotactic Breast Biopsy: the Moderating Effect of Trait Mindfulness, Spiritual Well-being, and Distress Tolerance (2021) · cites this paper as Ratcliff et al., 2019
More human guidance may be needed in situations of clinical stress, for learning more technical practices, or for high-anxiety populations.
“More human guidance may be needed in situations of clinical stress, such as undergoing a breast biopsy [47], for learning more technical practices, such as ANB and UNB, or for high-anxiety populations.”
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- Authors
- Ratcliff, C. G., Prinsloo, S., Chaoul, A., Zepeda, S. G., Cannon, R., Spelman, A., Yang, W. T., & Cohen, L.
- Affiliations
- Baylor College of Medicine (US)
- The University of Texas MD Anderson Cancer Center (US)
- Our Lady of the Lake University (US)
- Corresponding author
- Ratcliff, Chelsea G.
- Venue
- Journal of the American College of Radiology
- Publisher
- Elsevier BV
- Published
- 2019-05
- Volume
- 16
- Issue
- 5
- Pages
- 691-699
- ISSN
- 1546-1440 (ISSN-L)
- PMC
- PMC11771814
- OpenAlex
- W2896179172
- Cited by
- 35
- References
- 29
- Citations by year
- 2025: 3 · 2024: 10 · 2023: 7 · 2022: 7 · 2021: 2 · 2020: 4 · 2019: 2
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American College of Radiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R25T CA057730, A016672)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- mindfulness meditation, stereotactic breast biopsy, procedural anxiety, EEG, insula, anterior cingulate cortex, precuneus, medial prefrontal cortex, beta activity, delta oscillations, breast pain
- MeSH terms
- Anxiety, Breast Neoplasms, Electroencephalography, Female, Humans, Middle Aged, Pain Measurement, Single-Blind Method, Meditation, Biopsy, Large-Core Needle, Mindfulness
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