Use of Virtual Reality to Reduce Procedural Anxiety During Breast Biopsy: A Randomized Controlled Trial.

Abstract

Background/significance: Breast biopsies are essential for cancer diagnoses and are often accompanied by heightened procedural anxiety. While local anesthesia addresses procedural pain, it does not lessen psychological distress. Virtual reality (VR) has been explored as a distraction-based intervention that may reduce procedural anxiety.

Aims: This study evaluated the effects of standard care plus VR compared to standard care alone on patient anxiety, pain, and satisfaction during ultrasound-guided breast biopsy.

Methods: A single-site, two-arm randomized controlled trial (n = 80) compared standard care to standard care plus the use of VR during the ultrasound-guided breast biopsy procedure. Data were collected between 9/2024 and 5/2025. Study participants were randomized 1:1 to receive either standard care (control group) or standard care plus VR use (intervention group). Anxiety and pain were assessed pre- and post-procedure using 11-point numeric rating scales; satisfaction was measured post-procedure. Open-ended responses from the intervention group were analyzed thematically.

Results and findings: Study participants in the intervention group demonstrated significantly greater anxiety reduction compared to the control group (p < 0.001). Pain scores did not differ significantly between groups (p = 0.37). Satisfaction was uniformly high in both groups. Thematic analysis of open-ended responses from the intervention group identified themes related to anxiety reduction, distraction, and perceptions of VR use during the breast biopsy procedure.