Radioactive Injection into Nipple NOT TERRIBLE

sherryhuttRS

 I had the blue dye first that contained lidocaine as well, so it was painless. But the wire insertion was unbearable, staying squished in that F@%&$ machine while the pushed and pulled the wire to get it just so. I have a chronic pain conditoin and thought that the bc stuff would be easier, but not. OMG.

I just hope that there will clean magins and that the sentinel node will be negative. I find out next Wed. I'm so grateful for this website, communicating with women going through the same issues.

vlnrph

As I posted on the "Poll on Sentinel Node Biopsy Pain" thread last month, my hospital only uses 3 injections and, for me, they were not bad. Of course, my areola had little sensation since a previous excision a decade ago.

Rather than the stage or size of tumor, I think a determining factor in the amount of discomfort is probably the pH (acidity) of the sulfur complex used to transport the radioactive substance. Blue dye should be without the dramatic effects in most cases.  

virtual

I just returned from my injection and my experience was that it was practically painless.  I had one shot for the lidocaine with the tiniest needle that I did not feel the poke, I felt a little bee sting for a couple seconds only when the lidocaine went in, then he switched out the lidocaine with the injection material (same needle) and I was done. 

Tomorrow is my bmx and they will do the dye and test my sentinal node at that time. I feel a bit of itchiness on the breast with the radioactive injection now, but otherwise I am fine.  

TinaT

virtual:  Best wishes for an uneventful surgery tomorrow!

SuebeeBC

I have to agree...if I had one injection, I wouldve been laughing with delight too.  It was less than a bee sting.  But I had 4, no numbing cream and they got increasingly worse.  Like some others, the most excruciating pain Ive ever felt - including childbirth.  Thank GOD it was only for about 5 seconds but I never want to feel that kind of pain again and wouldnt wish it on anyone.  And I can really take pain!

But Im glad for those of you who were pleasantly surprised.  Thats fantastic.  I am sure the numbing cream and the number of injections changes everything.

Emaline

From what I've read, the blue dye hurts very badly and is why most doctors do it while you are under. I know from talking with other women about mole removal, some women find lidocain to be extremely painful, for me it is a quick  bee sting, about 10 seconds, and then it is fine.  My doctor gave me a huge shot of lidocain, which again, burned for a very short time, and then he did the 4 injections and I never felt a thing.  I had some time between that and my surgery, so we went walking to get things moving and it moved into 5 of my nodes, so my doctor did not have to use the dye.

ANA_424

I left a really long post in the "Poll on Sentinel Node Biopsy Pain" this weekend. This did not turn out to be painful for me at all, but it was by far the most stressful part because of all the things I had read. That is why I came back to post my experience. Everyone is different and so are the protocols at different hospitals. I gave some suggestions about who to talk to, questions to ask, what you can do to prepare. Best of luck to everyone.

Ann

GiGiL

My interventional radiologist used a small injection of lidocaine first.  I hardly felt that.  After that he did the radioactive injection.  It was almost completely pain free.  I was more worried about that part of it, than I was the lumpectomy surgery.  I worried for nothing.  When I woke up from surgery, I did have the most brilliantly blue breast I have ever seen.  My daughter took to calling me MaMa Smurf!  You've got to have a sense of humor.  Ten days after surgery, the blue is almost gone.  In time, it will be normal.  

riley702

I had the radioactive injection the day before, and there was lidocaine mixed in. It wasn't bad, but they did 5-6 injections around the nipple!

Easydancer

I had my radioactive injections yesterday about an hour before the surgery, 4 of them, and the one (#3) at the nipple was incredibly painful...fortunately the girls had told me it was going to be painful. It was not like a beesting or any other such thing...It was incredibly painful and the Dr. told me not to watch. I have never experienced such intense pain in one spot and even though it was over fairly quicky, I still get cold chills remembering it.  And yes, I had had local anesthesia before that when the put the needle and the wire in. After the third one hurting so much, I could hardly feel #4 which was at the site of my tumor.  I am Stage Ic...do have extremely sensitive breasts...always before considered that to be such a blessing! Okay now though...on my way to recover...no node involvement at all.  Yea, and guess I would have it done again to ensure good results...but with great trepidation...ohh, sooooooooo painful.

Chocolaterocks

ED,

I remember that. I agree- it was horribly painful.

Hang in there!

Tobyholicdeb

I am scheduled for this test on Thursday and I'm telling you.......I'm terrified. What other horrid procedure can they think of ?

Blessings2011

I'd been here on BCO for two months before my BMX, and to tell you the truth, the horror stories about the radioactive injection pain scared the pee out of me. It was the one thing I feared the most.

The day of my surgery, I was taken down to the room where I would get the shots. The Radiologist kept apologizing profusely, telling me how sorry he was that the shots were so painful, but necessary. The Tech was glued to my side, clenching my hand as if I were about to give birth.

I got no numbing cream at all, and while the shots (4? 5?) did sting, they were nothing compared to the huge cortisone shot I had recently gotten in the bottom of my heel that left me weeping and screaming for the doctor to stop.

So with that as my "10" on the pain scale, those shots in the breast didn't even come close.

This is not to minimize anyone's experience at all... we are all different in how we react to pain. (I think my foot doctor - who I love - said I was the worst patient he ever had...)

But I think it's important for newbies to know that while some women do have a horrific experience, others do not, and those women generally don't post about it.

nostrilb

I saw your post, and was surprised. Happy to hear you had such a great outcome. Going into my mastectomy, I was just happy I didn't have to do that shot again. Yup, I would rather have major surgery than have that shot. lol

AbbyTripleNegativeTN

The radioactive injection in my areola was very painful. I thought surely the technologist had given me the injection in the wrong location. I asked the surgeon if that injection had been placed in the correct area.  He said yes 'that's how we do that now'.  Then, just prior to surgery to install the port, I asked him again about it being the right location for the marker dye/radiation to show up in the sentinel nodes. My tumor was at 6 o'clock, deep in tissue and low in my breast and the injection was at 2 o'clock at the areola. He said 'you have already asked me about this and this is how we do things'.  I already had a second opinion appointment set up at Vanderbilt (TN), and I asked the same question of my Dr. there.  She explained to me quickly and exactly why I got that very painful injection in my areola and not near the tumor as has been done previously (and was referred to many times in my research). Finally I found truth!  She (the Dr. at Vanderbilt) was surprised that I had nothing for pain.  She said they provide pain relief for that procedure.  I found that injection to be very painful.  I wished it hadn't have happened that way.  After my Vanderbilt Dr. heard my tale of pain, she immediately prescribed a cream to cover my port for injections there. Unfortunately it wasn't offered for the areola radioactive injection. It was bad.  I wished it hadn't have happened that way. 

wendeeB

Another vote here for no big deal.

I too read the horror stories.  Was told by my BS, radiologist that did the injections, and the tech that helped that the pain was probably going to be bad.  My lesion was about 12:00 and about 1/2 above my nipple. 

On a scale of 1-10 (my home births were about a 7) these injections were 0.5 -1/10. I had no numbing cream.  

Blessing and good luck to all.

Ariom

Just thought I would mention that this is an old thread that hasn't had any posts for the past year. It may start up again with your posts.

Hi Abbey and Wendy and welcome to BCO. Sorry you have to be here.  You will find there will be lots of women who will help with support and will share their experiences.  

As you can see, there are very different opinions and experiences with the SNB. It has been debated many times on these boards. No one really knows why it affects some people so badly and others not at all.

When I spoke to my surgeon about the procedure, he was genuinely surprised that I was really concerned about it. He said he'd been doing this kind of surgery for many years and had never had any of his patients say it was a very painful procedure. 

I went into mine on the morning of my UMx surgery, full of fear and trepidation because I had heard so many horror stories about how bad it was going to be. My Surgeon had given the OK, for me to have a numbing injection if I wanted it, but when I arrived early in the morning at the imaging department, the tech wasn't authorized to give lidocaine for this procedure. He rang my Surgeon at home and my Surgeon offered to drive down to administer the shot himself. There was no way I would allow him to come in early on a day when he'd be spending long hours in surgery, just for that. I am actually glad it happened that way. The tech talked me through the procedure. I had 4 shots into the areola and when I asked him when it was going to be painful, he said it was all over. I felt nothing, not even the needle, in that sensitive area, much less the tracer. It took several goes, for the tracer to actually get to the Sentinel Node. I had to massage for 20 minutes and then have another scan, on the 3rd attempt and the tech woo-hooed and came out with the film, showing the SN. He high fived me and took me up to surgery.  

I have never experienced relief like that before, I felt like I was bulletproof and I breezed through the Umx, the blue dye was administered after I was anesthetized and I was out and home the following morning.

Just like everything else, this a very personal experience. I just wish it could be painless for everyone.

 

MsPharoah

This procedure varies across institutions.  The timing of the injection, the type of injection, delivery suspension and the pre injection prep all vary and contribute to the varied experiences.   It's true that everyone's pain threshold is different.  I have always had a high tolerance for pain and discomfort and feel fortunate about that.  My experience was horrendous!  The reason I know that my procedure was unnecessarily painful was that after this heinous act was over, the radiation tech came over and said that she "hates to be in the treatment area when they do this procedure because it causes so much pain. "

Despite trying to forget that this happened to me, I talked to my surgeon about the procedure and he told me that that he and other surgeons have been trying to change that hospitals procedures for years with no success.  I went into gear and started a letter writing campaign to the hospital.  I was and continue to be a thorn in their side.  I just won't allow this hospital to continue to torture breast cancer patients this way when it is NOT necessary.

I just want to make sure everyone knows that there are ways to administer this procedure in a less painful way or even painless.  This is not about the differences in people's pain tolerance. 

MsP

MsPharoah

Thank you Jo-Joy!!!

Ariom empathetically states that she wishes that this procedure could be painless for everyone.  Me too, which is why I continue my efforts to change the procedures at the hospital where I was "cared for".    I'm glad that you are of a like mind.  Maybe soon, all women will have a less painful or painless experience.

I urge everyone having this procedure to make sure they are getting proper pre-injection care and anesthesia.  Most hospitals these days are doing this procedure when the patient is under general anesthesia which is EVEN BETTER than Emla and lidocaine !  You would not believe all the excuses I heard about why the hospital continues to torture their breast cancer patients.....just inexcusable!!

Love to all.

MsP

knmtwins

I just asked my surgeon about this.  She said they can't do it under anesthesia as it introduces additional personnel and equipment into the sterile OR and that it only huts in 50% of people getting it.  Well, that is too much for me!  I'm going to ask about the Elma cream and ask if litocain is added to it.  

Ms. Pharoah - who are you speaking with at the hospital???  

angelia50

I did have the numbing cream, I was told to put it on before I left home that morning, which I did, and applied two more times when I got to the hospital. I can truthfully say, this procedure was the most pain of the entire mastectomy. I do agree it was short lived pain, only a few seconds, but for those seconds, it was bad and yes, the tech and person doing the injection said they knew it was painful and said they were sorry.  This was not for the wire guided, it was for the sentinel testing, so maybe some of these people are referring to injections given in the breast rather than the nipple area.

Ariom

I would really love to find out what the difference is, in the different Hospitals and different countries. I have been involved in every one of these threads, on this subject, since I started coming here almost 2 years ago.

My Surgeon was trained and worked in South Africa where he started breast clinics all over he country, he did the same in England and then came to the region where I live in Australia. He has been doing  breast and Mx surgeries for many years and was really surprised that I was stressed and worried about having this SNB done. I told him about the stories I had heard, about this horrific pain and he told me he had never had a patient tell him, they'd had a bad experience having it done. What the!!!!, How can that be!

I just don't get it! I certainly don't doubt the word of anyone who has had this test and felt extreme pain. I guess there must be some relevance to pain threshold, I have Rheumatoid Arthritis, so  I am used to extreme pain, but I really felt nothing, when I had my SNB. I went into it tense and afraid, which I would have thought, would just exacerbate pain. I had 4 shots, all in the areola, just like the others, who had such a bad experience.

I remember reading somewhere that there are solutions which have different PH levels, which may be something to consider.

My tech was very good, he did talk me through the whole procedure, he had a lovely personality and did everything to make me feel comfortable and relaxed.

One thing, I must say though, I don't agree with some of the really over the top, extreme descriptions, of this procedure, which I have seen in the past, on these boards. These do nothing, but strike fear into the hearts of newbies who may be facing the procedure and have come here for support. 

I really do wish this procedure could be painless for everyone.

MsPharoah

knmtwins,  check with your breast surgeon about your procedure.  They will know the procedure for the institutions they practice and help you prepare for it.  If you are having radio colloid injections in your nipple, ask for it to be done when you are under general and if that isn't possible, what are the alternatives...different hospital, etc?

when I complained, I heard every excuse in the book, including that they can't introduce additional personnel in the OR.  They also told me that the NRC forbids having the radioactive material in the OR.  Again, all Bull$hit.

Ariom, I am very happy for anyone who has a good experience with this procedure. I believe that an individual's pain threshold plays a role, but it is not the explanation for the varied experiences.  I will not apologize for expressing my experience.  It is not meant to frighten...but to encourage women to advocate for themselves and others with their medical community.  This procedure does not need to be painful for anyone, even the wimps!  LOL

MsP

slv58

one word ATIVAN! 

My surgeon wanted me to have it done the day before but being 2 hours away from the hospital meant a very long presurgery day, so we compromised and I went in very early the day of surgery to have it done along with wire localization. Apparently my surgeon wanted 4 hours for the dye to work it's way through system. Knowing how much my biopsy hurt probably because of the emotional nervousness I worked myself into, I asked for something to help calm me and am so happy I did. It really worked and although I felt stinging, I didn't care! My husband was with me and I saw him flinching, but I really didn't perceive the pain. I would say that if you are nervous about it, discuss how you feel with your surgeon, mine was very accommodating and honestly if there are meds to help make procedures less of an ordeal USE THEM! We go through enough with this disease.

jobur

This was the first procedure done on the day of my surgery.  When I asked about numbing, the nurse told me, oh, of course, it would be barbaric not to.  When it came time for the injection though, the radiologist gave me nothing. The injection was administered right into the center of my nipple.  It only lasted for a few minutes, but the pain was excruciating.  My surgeon told me prior to my lumpectomy and snl that the pain from the radioactive/dye injection to the nipple was along the line of a tetanus shot.  In fact, I found it to be incredibly painful, right up there around a 9 on the pain scale.  When I mentioned this at my after surgery appointment, he again shrugged it off, to which I responded, "Well, I'm going to bet you never had a tetanus shot in your nipple." 

After the shot, I had 3 wires placed (2 bracketing the tumor on the left and 1 to mark a spot for excisional biopsy on the right,)  I received a numbing agent prior to the wires being placed, and did not find that procedure painful.  I have now had 3 breast biopsies, surgery, and a bone biopsy.  None of this compared even remotely to the burning pain of that injection. 

It has bothered me ever since wondering if there was any medical necessity in the way the radioactive/dye injection was handled, or if it was done this way because the doctors find it easier and think it is "not that painful".  I think this thread has answered that question.  Thank you to all who have described their experiences, both good and bad.

To anyone reading this because they are about to undergo snb, please do not assume your experience will be like anyone else's, good or bad.  But do question your surgeon (and radiologist if possible) as to how they administer the radioactive/dye and INSIST that you want some form of numbing agent prior to the shot if it cannot be done under anesthesia.  Finding out you have bc and facing surgery and treatment is frightening and overwhelming, but it helps to get as much information as possible.    And do not let your doctor intimidate you or blow off your concerns.  Remember, YOU are paying THEM. 

smilinkar

My experience was also not that bad. It was done about an hour before my mastectomy.  They had to wheel me from the hospital to the breast center across the street. I remember sobbing as they pushed me through the waiting room. I think I scared the pants off the women waiting there for their mammograms! I cried even harder when they said my husband couldn't come in the room. But the nurse held my hand and stroked my head and it was barely a little sting then I was done. I think it also helped that I had my IV at that point with something in it that calmed me. I felt kind of foolish for carrying on that like but the idea of it was much much worse than the actual procedure. 

lisa137

I'm another one who went into it much more terrified of that injection than I was of the surgery itself. When the time came, I asked if they used anything for numbing and the guy who was doing it said it really wasn't necessary, which made me even more terrified.

I didn't even feel it. Not even a pinch. After that I was so relieved that I kept falling asleep on my gurney every time they'd park me someplace. (The ativan I'd taken that morning probably contributed to that, lol.)

Some sort of study really needs to be done to figure out who it's going to be painful for, and why, so that women can stop being terrified ahead of time and instead be recognized as someone who will likely feel a lot of pain, and steps take to mitigate or remove that pain. Both the pain that some feel, and the terror that others feel, need to end.

skbrown

I had 4 shots, North, South, East, West.  Only one hurt and that one was directly into the tumor area.  I am terrified of needles and hyperventilate when one comes near me.

angelia50

jobur, I agree with what you said. I don't want to scare anybody, not at all but I was given some cream to put on prior to coming to the hospital that day and twice more when I arrived and it still hurt.  When I returned to the holding area, I told the surgeon that was terrible and she was surprised and asked if I had used the cream and said most people didn't have problems.  So, not sure what difference mine was.  When I woke up from the surgery, I was not in any pain and didn't have any pain for any of my fills or anything after and none for the 5 biopsies prior to my surgery, but that injection hurt and I don't think it had to do with pain threshold. Even the people that did it said they understood and knew it hurt.  Now, I will grant you, it only hurt for a few seconds, but I still say, that was more uncomfortable than the entire mastectomy was, but only for a few seconds, which seemed like minutes, at the time.

clarrn

I have to say I don't agree with the pain threshold theory on this.   I had back labor as my child was facing the wrong way so I know what real pain is.  I had 21core needle biopsies before this and did not find them painful.  I was not worried about the injection.  I had emla cream an hour before, and I can honestly tell you that the blue dye/radioactive combination I received was more painful than my back labor.  The excruciating pain lasted for 10 minutes and then slowly subsided over 3 hours.  This is not an 'over the top description' and I refuse to water down my experience.  I resent the implication that those who experienced pain are somehow being dramatic. I am so glad that many of you will not experience this level of pain.  But if it does hurt please do not feel like you have to pretend it wasn't just to please someone else.