microcalcification questions

leaf

Well, I wouldn't say you have a significant history of breast cancer with your Mom's mom's sister.  In my genetics evaluation, even though my paternal grandmother had bc, they ended up saying I had a low risk for having a genetically-linked breast cancer.  They didn't ask about other people in my grandparents' generation.  (So they only counted your first degree relatives-parents, siblings, children, and 2nd degree relatives - aunts, uncles, neices, nephews, grandparents.)  Here's the USPTF about BRCA guidelines for genetic screening:  http://www.uspreventiveservicestaskforce.org/uspstf05/brcagen/brcagenrs.htm#clinical

I've had 2 stereotactic biopsies, and 1 mammo-guided wire insertion  before my excision.  (My first stereotactic showed LCIS, and the wire-guided excision was to remove the area around the LCIS biopsy to make sure there wasn't anything 'worse' going on.)  

One thing I didn't realize before they did the wire insertion:  I told them to 'go all over my breast-make sure I don't have bc', and they did.  I didn't realize that this would cause scar tissue throughout my breast and make it harder to read mammograms in the future.  One 2nd opinion said MRIs were out of the question because I had so much scar tissue.  I had a biopsy inches away from my wire-insertion scar, and they said it was scar tissue.

Most people find the pain of wire insertion was 'tolerable' (<=4/10 pain score) in my survey many years ago (2006) here. 

38 people responded to my survey.  People were able to choose only one of the 4 following responses.
1) I had injectable anesthesia before wire insertion and my pain was tolerable (<=4/10 on a scale of 1-10)   19 people, 50%
2) I had injectable anesthesia before wire insertion and my pain was NOT tolerable (>4/10 on a scale of 1-10)  7 people, 18%
3) I did NOT have injectable anesthesia before wire insertion and my pain was tolerable (<=4/10 on a scale of 1-10)  3 people , 8%
4) I did NOT have injectable anesthesia before wire insertion and my pain was NOT tolerable (>4/10 on a scale of 1-10.) 9 people, 24%.

I had a horrible time with wire insertion. HOWEVER, I had pre-existing reasons to have a worse time with a wire insertion.  As you can see from the survey, most people have a tolerable time with wire insertion.  I had a much better time with my stereotactic months BEFORE I had the wire insertion, but I had a bad time with the stereotactic a year after my wire insertion.   This was a big part I think due to my horrible wire insertion.

Stereotactics cost less and are less invasive (cause less scar tissue) than stereotactics.  But wire insertions are more likely to remove the 'area of interest' since they remove more tissue.

So I can't make your choice for you, but am just offering some pros and cons which may or may not help you choose.

GreenMonkey

I never heard of wire localization, but I'm going to research it now.  Regular meaning, they put me under, take a chunk of tissue out surgically, then sew me up.  I was told sometimes, they don't get the answers they need from a stereotactic biopsy but 90% of the time they do.  I was told the stereotactic is less envasive and anytime you can avoid being put under the better. To make matters worse, my procedure is monday and I'm pms ing. By breasts are killing me!  I've decided I'm going to take a valium.  I was told I can't because I can't sign the release forms if I'm in a medicated state, but ...well, DUCT them.  I never take meds, rarely take an asprin, I was prescribed the valium almost 2 years ago for another "office procedure" and didn't take them.  Well, I'm taking them on Monday.  If they think I am acting loopy I'll tell them I had a sleepless night and I've been crying.  

GreenMonkey

I'm in that "angry" prediagnosis, prementral stage.  guess I'm PDPMsing

Kris2011

I have had both ultrasound guided needle biopsy and the wire localization with excisions-- essentially lumpectomy. I have also had two MRIs and about what truly seems like 50 mammograms total ...all in the past year for ADH.



I found the ultra sound/needle biopsy to be the worst, followed by the MRIs. I wasn't thrilled about being put under for the excisional biopsies, but the recovery (aside from the nasty reaction to tegaderm) was a cinch. The surgeon fills the cavities with a long lasting anesthetic to aid in recovery. I felt far less pain afterwards (2 separate excisions, about a pingpong ball and a golf ball, from right breast done during one procedure, deep, on the chest wall) from the surgery than I did with the needle.



I don't want to scare anyone, but I wish I had known more, so to that end, I will come out with it. It's not a 'needle' in a traditional sense, like those used for a blood draw. It's similar in gauge to a meat thermometer. It takes a core tissue sample that is similar in size and shape to a short 'strand' of ground beef. Sorry, but it is what it is. They pull a little trigger to capture the sample and it's like a sharp snap inside the breast. They numb you up of course and it helps but if you can take a Valium too, do it. (I took Xanax for the MRIs and it was useless.)



I personally have very large breasts, so there was a bit of fishing around involved to get to the right spot for the needle biopsy. It was all i could do to not start bawling. I hated it. That's why I went ahead with the excisions, so as to lessen odds of any more of dealing with that needle.



I have to admit that having the pre-op mammograms with the wires hanging out of my breast was not fun. To make matters worse, I got my period early from all the stress and had to wear those god awful mesh underpants from the hospital with their old school maxi pads they make you use, and during those wire loc mamms, my gown fell to the floor, rendering me, honestly, hideous and trapped in the mamm machine. I started laughing-crying. I mean honestly: really, god? Sanitary napkins circa 1952? Visible along with my cellulite butt through mesh granny pants? Like I said, not fun, but I'd still take that whole debacle over the needle biopsy.



And what brings me here tonight, correction, 2:22 AM, is that with my 1 year-ish follow up, they said it was all clear except for microcalcifications. I declined tamoxifen last year for all kinds of reasons. If ADH or other shows up again, I'm going all in with prophylactic mastectomy, much to the dismay of my oncologist. But I can't take all these procedures. I can't. I'd rather have it all over with than be up all night every night. I came on the board here to find out if there were any discussions of Vandy or Mayo...

Good luck with your decisions. It's scary and stressful, but it helps to laugh if you can find a way. Prayer helps, too.

amy13

Green Monkey, your surgical (regular) biopsy sounds like how the 'wire localization' was described to me....

did you have your stereotactic biopsy today?  if so, how did it go? 

 I am thinking I may be going that route, even though Kris2011's horror story scares the beejebus out of me.... but I don't want to be put under.  I also have fairly large breasts, and am hopeful they won't have the problems with fishing around in there, like they had with you, Kris2011...  eek! 

 I called this morning to have the surgeon's office schedule it, and wouldn't you know it, the surgeon and his nurse are out all week....  BUT, the person who answered the phone said I could call this afternoon to talk with the OTHER surgeon's nurse to see if they could schedule it for me... if not, I guess I'll have to wait until next week to get it scheduled....  grrrr.....

cycle-path

Amy, I'm sure what happened to Kris is real -- it actually did happen to her as she described it -- but I think it's pretty unusual anyone to have anything like that kind of trauma with a needle biopsy. Most of the women here report that the needle biopsies are a piece of cake. Mine was completely uneventful.

GreenMonkey

Hello everyone! 

 I had the stereotactic core needle biopsy today and it went well!  I'm sort of shocked.  I broke down in tears going in and then the valium kicked in.  It really helped.  After more mammograms, and marking of the calsifications, I was put on the table where my breast was compressed for 15 to 20 minutes.  The compression helped numb my breast and I barely felt the lydocane needle and had no idea when they inserted the core needle.  After being awarded an icepack I was sent home.  I just woke up after a 3 hour nap and I feel fine.  okay, a bit sore, but nothing terrible.  I am so glad I took the valium, and I strongly recommend it.  The only reason they won't let you take one is for legal reasons when signing the release papers.  Why not explain the procedure, sing the papers, take your pill, wait 20 minutes and then have the procedure?  The staff seemed suprised that I could relax and wasn't complaining about my neck or any discomfort....and I wanted to shout.....YES, BECAUSE I TOOK A VALIUM!     I should know by Wednesday.  Thanks for being here everyone.  It really helped to know you were out there.  My advice to those who experience the same.... 1.  join a discussion group.  2. take a valium  3. give yourself permission to feel vulnerable and scared.   

GreenMonkey

oh... and can you believe the producer can be found on YOUTUBE.  

http://www.youtube.com/watch?v=69cNo1h5pzc

I had everyone in the room watch it  (2 nurses and the doctor).  

whats next?  where there be an app for that? 

marie5890

Green Monkey,

SO glad it went well and is behind you.

Here is waiting with you and sending B9 thoughts.. 

Lifeafter

I wish I had thought of taking a Valium or something for core-needle biopsy!  Mine was the absolute worst also.  They 'numbed' me with lidocaine but it didn't work.  They stuck me with lidocaine 3 times.  They said I had very dense breasts, had no idea what that meant at the time.  They just kept throwing that at me like it was my fault it hurt like an MF.  Anyway, luckily it was over in about 15 minutes.  I wouldn't say it was comparable to child birth but it was like I rammed my toe into the corner of a door opening, you know that feeling.  This isn't to scare you but if you are afraid of needles (and there is nothing wrong with that) or get nervous in those situations, take something to chill you out like greenmonkey did.

Like marie5890 said...B9 thoughts!

Michelle :-)

leaf

I'm so glad too that its over, and hopefully you will never have to have another one.

I'm so glad that, just as you say, you were able to ask here and that you gave yourself

permission to feel vulnerable and scared.  Sending you hopes for Boringly Benign findings.

You did good!

GreenMonkey

ohhh you guys are the BEST!!!!   when I was getting the pre stereotactical mammo - I was rambing about how degrating mammograms and the stereotactical biopsy is..my favorite line being "they would never do this to testicles"  and the one tecnician said to me, well, for prostate procedures they shove a camera up your ass. Call me crazy but still that sounds better!

GreenMonkey

(since we don't have "like" buttons... "LIKE" the uncensored love and support here!) 

marie5890

GreenMonkey,

when I read, " for prostate procedures they shove a camera up your ass."----I choked on my coffee....seriously...

Thanks for the first laugh of the morning!!!  

Lifeafter

Love where this thread is going! lol Shoving a camera up your ass?  Correct me if I'm wrong but it's not like a handheld camcorder they are 'shoving' up the portal!  I would have to think that procedure is pretty similiar to a rectal enema.  Am I wrong?

Either way...big fat core needle being punched into your boob over and over (in my case 20 samples!) or a camera being shoved up my ass?  I'll take the camera!

Michelle

amy13

Well.... I am scheduled for this Thursday morning at 10.... at least I hope I am...... long story, but we'll go with I am scheduled for now...

 so... I certainly wish I had access to something like valium... but I don't...  I think I have some way old Tylenol #3 around, but sadly it tends to hype me up instead. 

I guess I'll have to be a brave soldier...  but gawd how I hate pain.  I'm the biggest wimp I know...  and just the thought of sitting/laying/standing (?) there with no shirt on for 20 or so minutes does NOT sound pleasant...  I'm considering taking an old long sleeved shirt and cutting a hole where my left boob is, taking it with me and asking them if I'm allowed to wear it to keep the rest of me covered with just my breast exposed.... hmmmm...... 

Kris2011

Amy13- you could probably call your ordering physician and get the Rx for Valium in time. You will have to have to have someone drive you, though. Don't worry about having your shirt off. They do what they can to make you calm, comfortable, preserve your dignity. They have seen it all, seriously. Good luck!

GreenMonkey

mrochon, 20 samples!!!  does that mean 20 punctures?  ugh...

yes, Amy call your doctor! I only took 5mg and it really helped. But you can't tell the hospital that you took it because of the concent form.    

I am a blogger, yesterdays post was about the procedure itself: 

http://greenmonkeytales.blogspot.com/2012/01/morning-after.html

I'm waiting for the call.  It supposed to come this afternoon.  I offered the Dr. $20.00 bucks if she called me before noon. Lets see if she takes the bait!

Let's all form a mental circle and hold hands (mine is the sweaty one). 

GreenMonkey

Oh, and you guys are number two on my notification list.  Yes, I've made a list (I'm weird like that).  After I hear - good or bad - the first person I call is my neighbor Jay. I know I can count on him to get a big reaction - big happy or big sad.  Next is all of you, on this thread because... well, you get it.  and third is my husband.  He's great but he is a noncommunicator and I can almost guarantee that he will say the wrong thing.  Yesterday, when I picked him up from the train he told me how his boss got fired and how their reorganizing the company and he might be out of a job.  THAT is not the thing you tell your wife when your job is responsible for the insurance!  Why did he have to share that with me?  Why couldn't he have saved it ?  At that point I pulled the car over and started to cry and he could NOT understand why I was so "emotional"...  

GreenMonkey

If he wasn't so cute, and good at opening bottles of wine...  I might reconsider the "til death do us part" clause.

GreenMonkey

oh sorry, one more thing.  If you go to my blog you'll notice I don't use the word "cancer" instead I refer to it as "catstir"  -  when I did my first cancer post called Chaos, I was immediately bombarded with advertisements for cancer this or that... google gobbles up everything you write and targets you accordingly.  Now, instead of cancer ads, I get pictures of kittens in a wok, or cats chasing mice.  THAT is so much better!

marie5890

"catstir"....Love that!!!

Will read...and holding your sweaty hand....

(at least your hubby is good at opening the wine bottle...that certainly counts for something  ) 

marie5890

GreenMonkey---reading your blog (well starting too)

Im from the Hartford area. Howdy  neighbor!!! 

Jimandtrishp

I went yesterday for a surgical biopsy because they could not do the stereotactic because of the positioning of the clusters.  Also, I have had BOTH types of these before, needle localization and stereotactic.  If they can do it as a stereotactic I would recommend that because you do not have to be put under anesthesia.  It is uncomfortable but worth it I believe.  BUT they were not able to do the needle localization yesterday and consequently no surgery because the calcifications only showed up clearly under the magnified mammograms and they could not do the needle localization that way.  So now my option is to wait 6 months for a follow up mammo and find out if they have increased.  

Lifeafter

Greenmonkey - yes...ugh.  But let me say for me the problem was that I still had (I instinctly typed 'have'...I don't 'have' anymore! lol), young boobs which is why they were dense.  This is what was later explained to me.  The denser your boobs the harder it is to do a local numbing on the area.

Someone mentioned laying or standing?  I was on my tummy on a table with a hole in it for my boob to hang through. They then squished it in a 'vice to hold it for the core needle to grab samples.

Michelle

har1old

I am a 54 year old  female diagnosed with microcalcifications.  I have had regular mammograms for the last 20 years and thi is my first abnormality.  The ultrosound was done and   I was recommended for biopsy on both breasts that have the microcalfications..  My question is they want to do a stereotactic with me lying on my stomach and the surgeon wants to do 4 biopsys.  My question is that seems like a lot of biopsys done at the same time.  Is this normal to have 4 done at the same time?

GreenMonkey

dear group... I'm now officially in.  I have catstir!!!

francksgirl

I'm a newbie here too.....going in for a lumptectomy on Friday. Just found out my news last Thursday. Been on an emotional rollercoaster ride. I'm steering towards getting a mastectomy done, because they are removing 1 1/2 inch x 1 1/2 inch in diameter of tissue. I will have no breast after that, cuz I'm verrrrrrrrrrrrry small!!! Also, this Friday they have to test me for another area that they didn't get enough tissue when they did my biopsy to see if it invasive or non invasive. I'm sorry for your bad news......there are many of us out there. Just want to make sure I make a good decision....that's the toughest part!!! UGGGGGGGGGGGGGH

amy13

GreenMonkey!  what was your actual diagnosis?????? 

leneza

hi har1old..

I will be having 4 biopsies tomorrow...all on the left breast  between 8 oclock and 12 oclock...3 needle biopsies (on three small lumps) and 1 stereo on calcifications...i'm not sure how normal that is also...good luck!