missing clips?

abster

I was diagnosed with DCIS and did a stereotactic biop. where they put in not one but two clips--they couldn't find the first one, so they inserted a second one. No problem. I asked if they were visible on the mam, and the nurse said, "Yep! Side by side!" Fine. Last week I did the pre-op with the wire locator, and they coud not find the clips. After intense scrutinizing magnification (both the mam lense and with a literal magnifyingn glass), they found a small calcification and thought THAT must be the area. Fine. Surgery went well.

However, I went to the surgeon yesterday, and pathology is concerned for two reasons: 1. one of the margins is too close to comfort to the cancer they thought they wire-located and 2. there is NO tissue evidence that a core-needle biopsy was done on the part that was taken out. I'm stunned and quite frankly, devistated.

My sister thinks I should transfer treatment to Minneapolis after talking to my primary physician. Others think I should demand to have answers in person with the radiologist, surgeon etc. My main two questions for those involved are: I want to know how I was able to leave readiology post biopsy without them being able to find the clips (clearly the nurse was mistaken) and why the surgery was allowed to proceed if the location was in question.

What are your thoughts? What would you do? I live in a small town in MN, and up until this, thoughts this was going to be a routine, simple proceedure. Now, becaue of healing, it will be quite some time before I can get an accurate mam done to discover if the clips even existed and if the cancer was all taken. Thanks--

mgdsmc

I'm so sorry you are dealing with this. I'm sure you are frustrated.



First I need to clarify. From what I'm reading they took tissue that came back positive for cancer and that's why you had surgery correct?



As far as not having clear margins that's happens often. They are trying to work on how to prevent multiple surgeries people have to have to get clear margins.



As far as the clips being missing it could have been seen at first than was somehow dislodged from the tumor. It's very tiny and used only as a locator. The tissue not showing it was biopsied could be that it's an entirely different tumor.



Was the tissue that was taken and sent to pathology cancer?



I don't think there is a need to get a entire new team. Nothing has happened that couldn't have happened at another hospital. Now if they removed non cancer tissue by mistake that's a different story.

MelissaDallas

No, the way I understand it her wire localization was incorrect so her surgery was performed in the wrong location and she will probably have to have another. Abster, was your surgery an excisional biopsy or lumpectomy?

mgdsmc

That's the part I'm wasn't clear on because of not having clear margins. If the wrong area was removed and no cancer present the margins would be clear.

abster

The wire was near where the cancer had been for this lumpectomy, but the pathologist thinks that they may have only removed part of the cancer. Their concern is that the lump that was taken, although positive for cancer, it didn't show that it was the area that was biopsied. There as no evidence that a biopsy had happened in the chunk. I'm much too swollen and bruised for any screening at the moment. Pretty colors, though. in essence, it is as if they operated in the wrong area because the markers that would have provided guidance were gone.

mgdsmc

Ok now I got it. As a nursing professional I can give you this advice. It appears that there were many things that went wrong. You are absolutely correct in saying surgery should not have happened without knowing the exact area, not the general area which it appears they did. Now you didn't say how large the tumor was nor the size tissue that was removed. Most are tiny which is why the clip is so important in finding it.

You can look at it this way too. Just because the side that the biopsy was done wasn't removed doesn't mean they didn't remove the correct area, just remove the opposite side. So technically they did operate in the right area. example my lumpectomy removed the area but didn't have clear margins but my pathology report didn't say anything about the biopsy area being part of my sample or not. They wanted to go in to clear the margins I think the next week and I said no do chemo first. I know how you feel after the lumpectomy.

So you have a hard decision to make. You can change surgeons at the same hospital which would be easier in going for treatment if the other choice is far. You have to have trust in your team and right now you don't.

You can give the surgeon another chance to make things right which they will do given the fact that the reputation of the entire hospital and doctor will be tarnished which I'm sure you could careless about and I agree with you. It's your life and you have to fight for it. One thing I have learned after being diagnosed don't assume everyone does their jobs like they should. You are armed with the knowledge of what should be done and I'm sure you will make sure it's done correct the next time.



I'm so sorry this happened to you as if you didn't have enough to think about. Remember it's your life do what makes you comfortable. All the medical professionals on your case it's a job not their life.

CTMOM1234

This is really upsetting, and I would likely transfer treatment. I do not understand moving forward with your surgery without visible clips, and wishing you the very best with future care.

Kassylou

I am sorry you are going through this. I work at a hospital in a small town and understand your feelings.



If if was me, I would schedule a meeting with the doctors so they can explain what happened. You should have someone with you to listen and ask questions. Give them a chance to show you the images and explain. If they dismiss you or are condescending then you will know they view you as a number and can move on with a clear mind. If the opposite is true then your faith might be restored.



Doctors are people and do make mistakes. How they live up to those mistakes and errors will show you their character.



I wish you the best and if you want an ear, please feel free to private message me. I also new to this process and my second biopsy done today.