Questions on "wire insertion" prior to Lumpectomy

kcat2013

Mojim Glad you will be able to have some meds to make the procedure more tolerable for you! I didn't have a lumpectomy but I wanted to encourage you to speak up about your neck issues when you go in. I have rheumatoid arthritis and had to have an MRI guided biopsy which meant being in a contorted position for over an hour. Before the procedure I told the doctor about the arthritis and she immediately changed how she was going to position me and was very helpful in finding a position that was the least painful for me. I'm so glad I told her and didn't just try to grin and bear it.

Kendra

MoJim

Thanks, Kendra! I will definitely tell them about the neck issues as I've learned from past procedures if I don't, I pay the price. And, I will do the same when I start Radiation to make sure I'm as comfortable as possible on that table.  I had a massage yesterday in hopes it would help my neck, but sadly, it made things worse.

Sassa

MoJim,

I am not sure if you are talking about two different procedures: 1. the insertion of guidewires and dye to mark suspected areas; and 2. the injection of a radioactive tracer w/wo dye for sentinel node detection.

I have had both so I will share my experiences with you.

I had the guidewires and dye procedure done prior to my excisional biopsy (a lumpectomy when used for diagnosis). I was afraid of the procedure as my mammograms had always been extremely painful as my jumbo sized breasts were squeezed into a miniature sized space. I did not know how I would stand the pain for more then a few minutes.

The procedure for the guidewires were much more comfortable than for a mammogram. I was not expected to stand for the entire procedure. I was given a high chair (bar stool with a back) to sit on. My breasts were numbed and the pressure used for the mammogram was much less than used for the mammogram and did not cause me any pain.

I was nervous as the first needle was inserted. I did not feel the insertion of the needle used to send down the dye and insert the wire. Once the first wire was placed, I relaxed and became fascinated by the procedure. When the radiologist realized I was looking as the second needle, wire and dye was placed, he had a monitor screen placed so I could also see the tissue area he was seeing. I had a total of 4 wires covering three different questioned areas placed.

When the wires were placed, they were taped down and a dixie cup was placed over them to protect them until surgery. The cup under my gown was pretty funny looking and made me laugh (the pre surgery tranquiler probably had something to do with my giggles).

The sentinel dye and tracer injection: Unfortunately, I had this procedure before my mastectomy and it was at a different hospital then my biopsy. The second hospital,Spring Hill Hospital in Spring Hill , Florida, had a much more barbarous approach to pain control. No numbing of the breast was done before the 4 injections around my nipple area. The stinging and burning of the injections were unbearable I needed a 20 minute break before the 4th injection could be done.

I had requested that the breast be numbed after the first injection. I was told it was Spring Hill policy not to use pain numbing for this procedure (they didn't believe in it for post op mastectomy care either, but that is another story).

My procedure was done backed in November of 2006. At that time, a recommendation had already been made by whatever specialty group that included these procedures (I don't remember) that the standard of care should include numbing of the breast before the sentinel node injections. I wish I knew that at the time I had the procedure.

If you are having this procedure done, make sure the numbing of the breast is done.

Sassa

Whoops, I didn't catch there was a whole page one of answers and that you already had the procedure before I posted my answer.

I will leave my previous post for reference in case it helps someone.

MoJim

Thank you Sassa.  I will be having BOTH the procedures you mention above done on Wed.  The Nurse Navigator told me she will rub a really good numbing cream on my nipple & surrounding breast which usually takes care of any pain for most patients.  Just the same, I am glad I will be giving a tranquilizer beforehand to relax me.  I don't look at needles - EVER!  I prefer not to see what they are doing to me, so I'll pass on the "play by play" screen - LOL! Again, thank you for taking the time to type this all out for me.  I'm sorry your procedure at Spring Hill was so painful & awful!  There is no reason patients should be put thru undo pain when there are ways to allieviate it!!!

Moderators

Thank you ladies as the concept of a wire being inserted seems very painful, but as your responses show, it is no major issue. This can help enormously with the stress of waiting for tests and as you all know, that is a very unpleasant period.

The Mods

CeciliaAnn

Hi, I've arrived a little late to this, but hopefully can still give some reassurance...my wire insertion was completely painless, I didn't feel a thing. It also only took a few minutes, though I'd been waiting in my room for a couple of hours beforehand (I was more bothered by thirst than anything else by then, as I was Nil by Mouth.). I had a mammo taken immediately after which again caused me no discomfort at all. It doesn't look pretty, but they tape the wire up in a spiral to stop you catching it on anything.

Like you I had a cluster of calcifications rather than a tumour; non-invasive, oestrogen positive. The first excision surgery didn't get all of it so it was repeated. The second gave me clear margins. I'm opting for rads (with a few reservations) but have declined hormonal therapy. It can feel like a runaway train so take lots of time out when you can - and don't be afraid to ask lots of questions! Good luck with the next part of all this - I hope your acquaintance with DCIS will be brief.

mlb1202

I had the wires put in before my lumpectomy in August. I had a cluster of cancerous micro calcifications as well (2 different spots) so I had two wires inserted. I also was anxious about this before surgery especially since I didn't have the best experience with the needle biopsy! However, I have to say it wasn't that bad... And I didn't take anything. (But if could go back in time, i would have asked for it!!!) seriously though its just uncomfortable and just so "foreign" to what we are used to! They'll numb you... (I got 2nd dose as I felt her first attempt as my radiologist didn't wait long enough, so make sure they do! However after she started again.... It wasn't bad. A little pressure, but not painful! You do have to stay very still and I had a tech gently holding my back which helped relax me too! For me I think the anxiety was just more emotional like... "Is this really happening to me?" And being overwhelmed so for that i would say go for the Ativan!!! However, I have to say after that procedure the rest of the day was nothing!!!! You'll get your IV with happy meds and forget all about the wires and before you know it your in recovery and its all over!!!!! I'll be thinking of you Wednesday! Good luck it will be fine. xo

MoJim

Thank you "mlb" & Cecilia for your comments & reassurances -- it helps ALOT!  "mlb," I noticed that you have since had a Mastectomy!  Did they find the calcifications to be so malignant that it was "warranted" or was it your personal choice when considering the odds of it returning?  Gosh, I don't know what I'd do if I had to have my breast removed.  I guess you just deal with it when the time comes.

 Hugs,

M.

MoJim

OH NO!  My Nurse Navigator called this morning & my surgeon refuses to give tranquilizers for the wire insertions!!!  I asked her "WHY" & she said she didn't know, but some are "funny" about that.  Sheesh - I think THEY should have a wire inserted into their own nipple & maybe then they'd be more compassionate!  So, looks like I'm going into this "cold turkey" & my anxiety has now shot thru the roof even higher than before - Darn!  I have to go thru Pre-Op tomorrow at he hosp. since I have the K-T issues.  Financial office from the hosp. has already called saying I have to pay $886 (my copay portion) before they will even do surgery.  It is raining here today ... When it rains is POURS!!!

Janet456

My wire insertion was completely painless, didn't feel a thing even when the local anaesthetic wore off. Good luck xx

dsj

Maureen, you will OKAY. If you have unexpected pain during the wire insertion, tell the nurse (there was one sitting by me during the whole procedure). They will do what's needed. For me, as for others! the biopsy was worse than the surgery. You will be in good hands tomorrow, and you will be OKAY.

hugs

shuf

mojim, we will be praying for you as well as others-i am still waiting on the second biopsy on the other breast and the oncotype dx for her 2 - taking light xanax for nerves - my mother taught us that there is a silver lining in everything sometimes we have to look deep this one is a boil that appeared on my breast about a month before I was diagnosed. It could be worse.

slv58

MoJim, thinking of you, maybe try doing some meditative breathing. You could download some relaxing "positive imagery" on your phone and listen to it during your procedure. I like Bernie Segal but his is more verbal. Hugs

BrooksideVT

Also keep in mind that the radiologist performing the procedure has a lot of experience in determining whether a patient needs a little pharmaceutical help in order to tolerate the procedure.  I expect you'll be apprehensive, as were all of us, but that, like the rest of us, you'll do just fine.  Should that not be the case, you'll get the drug.

lovestorun

MoJim

Good luck tomorrow.  I had the wire procedure before lumpectomy, no tranquilizers other than the numbing medication they injected just before the procedure (the same as with biopsies).  I was really concerned about it beforehand - it just seemed so, well, bizzare.  And unpleasant.   As far as procedures go, it was not the most fun, but it was also not the most painful / awful (I had an MRI biopsy that was much worse).  Talk to your team and communicate throughout the procedure.  They want it to go well too!   Hope your surgery tomorrow goes well. 

MoJim

Thanks everyone!  I'm leaving soon for my Pre-Op appt. They are making me go thru pre-op due to the vascular malformation syndrome I have, but it has nothing that will affect the breast surgery at all. I've had MANY painful procedures in my lifetime & I'm not a "wimp."  But, come on -- why would it hurt to give a 63 yr old woman a tranquilizer to calm her nerves?? I don't understand these Dr.'s & Surgeons.  Anyway, I will let you all know how everything goes when I'm on the "other side" of it on Thurs.

Maureen

shuf

hi guys - right breast bio came back clear so I am on the road for surgery next Tuesday on the left side. Her2 positive I am still waiting on hearing on the oncotype. But I am ready to get this portion out of the way. Hope MoJim does well. My doctors have been nothing but kind and I have not been in any extreme pain or upset. Praying for all. Shuf

Mouche

@MoJim, I pray all is well, and to answer your question I'm in Greensboro, NC

MoJim

I apologize for not being on here for awhile. I'm glad my Lumpectomy is overwith - had that done on Nov. 19, so I'm about 2 weeks out from that. The part in Nuclear Medicine & Radiology, prior to surgery, w/ wire insertions was NOT "fun" but I did make it thru as you all promised me I would. My Surgeon would NOT prescribe a tranquilizer for me, so I really had to tough it out!!  The Radiologist didn't get the wire inserted in the correct place the first time, so he had to redo it - Ugh! He got nasty w/ ME for grumbling about the way they had me positioned & said "This is no fun for me either laying down here on the floor!"  I'm still really sore, swollen & badly bruised on my breast. He removed 6 sentinel nodes as they all "lit up" but they came back "clear." My pathology report came back - DCIS - High Nuclear Grade - Comedo Necrosis type.  Nuclear Grade was a 3 (high).  He got clear margins.  Now, the surgeon is telling me I have to go thru 6 weeks of Radiation or my chances of it coming back are high.  He is "adamant" about this. I know it's the "gold standard" to do RAD's after a Lumpectomy, but, SIX WEEKS?  A few years ago I would have just said "OK" & get it done.  But, now, w/ my husband having a recurrence of his bladder cancer & surgery for him this Thurs., I just want to take my "chances" & not put myself thru anymore added stress than I already have on my plate.  Jim & I both have major health conditions & I'm looking at "quality" of life over "quantity."  I don't mean to be "morbid" as so many of you have been thru so much w/ your breast cancers.  I'm not a "baby," I'm just tired of our whole lives revolving around surgeries, hospitals, & more cancer treatments.

I hope you all had a wonderful Thanksgiving!

Maureen

BrooksideVT

Sorry your wire insertion was miserable, MoJim, but, as you said, you toughed right through it.  Again, as I said, if you had really needed a drug (and some do!), you would have gotten it.  I'm glad you managed, but sorry your radiologist was a grump.  And your surgeon, clearly, a stick-in-the mud sorely lacking in communication skills.  I say this because it sure does not sound as though you understand his reasoning for being so clear about your need for rads.  At your follow-up, please ask him for the statistics he is quoting. 

Your cancer center will set up an appointment with a radiation oncologist in a few weeks.  Do plan to keep it, and maybe set up a similar visit in another (maybe bigger?) hospital,.  And use these sessions to grill, absolutely grill the RO's about four weeks of rads vs six, and also about the statistics of what rads or no rads will do for you.  Once you have all the information and options and whatall all stuffed into your understanding, you can either go ahead with treatment,or go away.  Either way, you will have made an educated and informed decision, rather than a reactive one.  Most of us had no significant problems with rads.

Oh, and they'll also probably set you up with a medical oncologist, who speaks about your body as a whole, rather than (as your RO will) your breast alone.  Your MO might also shed some illuminating light on the rads vs no rads question.

Working your way through the DCIS and radiation threads will give you lots of information about how others have handled post surgical decisions. 

MoJim

Thanks Brookside! I DID ask for a tranquilizer prior to the wire insertions, etc. but my D&*# Surgeon would NOT prescribe anything for me & neither would my PCP! I was so freakin' mad I wanted to spit in both of their faces that day!! I saw my Surgeon for my "post-op" last Friday & he spent maybe 3 mins.  w/ me & that was it!  When I asked for the pathology report & more information, he got "upset" & said I should have been given all of that after my needle biopsy!  This Surgeon obviously is sorely lacking in Communication skills & does not take the "time" w/ his patients.  I've been doing research on cancer since 2010 (for my husband's 4 cancers).  I KNOW the importance of having an Oncologist who will take the time to communicate & answer questions.  The problem is, we live in a town of 40,000 people.  We travel 3+ hours to Duke & UNC (1-way) for my husband's cancers AND for my K-T Syndrome. I can't imagine adding another "trip" to one of those on top of everything else we have going on.  I find this site & "threads" difficult to navigate when I'm looking for things/info.  If someone could shed some light on where I should be "looking" I would greatly appreciate it.  So far, I've had a "bad experience" w/ the way I've been treated by the medical professionals here in HICKory. 

Maureen

slv58

Maureen, I've been thinking of you and am so glad you updated us. Glad to hear it's over and sorry about your doctors bad bedside manner. It makes a difference when you find one who understands what you are going through- but they are hard to find (in my experience). I'm usually a quiet,easygoing type of person but I've learned to stand up for myself when it comes to medical "treatment". I wish they all understood the pressure we face and try and make it easier for us

QCA

Another NC gal here. I'm happy that so many of you had prior medication and also numbing cream or anesthetics, but I didn't. My surgeon had told me not to worry about it because she had taken special training and would do it after I was under anesthesia for the surgery. So, I relaxed. But someone from radiology came and got me, saying they needed "more pictures". When a radiologist appeared and said he was going to insert the wires and radioactive dye, I told him what my surgeon had said, and he said I couldn't be anesthesized for the procedure. I tried to protest, but he simply wouldn't listen, and since I was trapped by the mammo machine, that was it. I was in shock, then I was in terrible pain which I can only compare to labor.

When I arrived back in my room, my surgeon came in and said why didn't you tell him that I was going to do it? I said, I did and he wouldn't listen. The surgeon was absolutely livid. She later said the radiologist committed the cardinal sin in medicine in that he didn't listen to the patient.

Apparently my surgeon did make some heads roll, too. I was not charged at all for 6 weeks of radiation, and hospital policy has been changed accordingly too. The memory of the pain and fear has faded somewhat now, but I still have bad feeling toward that radiologist!

Kathy

MoJim

Kathy ~ That just makes me FURIOUS what the Radiologist did to you!! At least I knew beforehand that the darn Surgeon was refusing to give me anything beforehand, so I was "somewhat" prepared for the pain.  The very nice Nurse Navigator I had did rub a numbing cream on my nipple & surrounding area which helped "some," but it still was very uncomfortable & painful.  I still do not understand "why" they can't do this part when we are under anesthesia.  I guess because it takes about 2 hours for the nuclear dye to show up in the sentinel nodes.  I wish you well. I meet w/ an Oncologist on Dec. 16 to get my Radiation set up. I would have gone sooner, but my husband has 2 major surgeries coming up in the next few days.  He's a 4-cancer patient, so we can't get a "break" here in our household.

Where in NC do you live? We live in the western part of the state about an hour north of Charlotte. We travel to Chapel Hill at least every 3 mos. to see my husband's Oncologist.

Maureen

mripp

MoJim, I was looking around in the DCIS threads and read this one. Glad your surgery and wire procedure is all done and you endured it with good results. My experiences have all been positive so wanted you to know it does exist! I had Lx and SNB (0/3 negative), 33 rad tx and minor skin SE's from rad. My BS, MO and RO were all awesome! I opted for rad as my dx was recurrence goes from 20% range down to 0-2%, so opted for rad. I did left side whole breast with breath hold and it went well. I think the worst part was the daily trip and traffic to the rad clinic. The actual rad tx was only about 10-15 minutes including set up, tech checking and double checking position (very thorough, caring and professional). Had weekly xray for position check, and also weekly check in with RO. I have to say he is one of my best ever docs! I wish you well on your treatment and just say find a doc you like and trust and ask LOTS of questions. I did! I am on a followup plan every 6 months and hope it is smooth sailing from here on out!

water804

The whole wire insertion thing before the actual surgery, not to alarm anyone, but I found it exhausting and scary, and if I had known how scary I would have asked for a sedative. It seems to me that somehow humans have found a way to land a rocket on a comet, but in terms of technology related to treating this very sensitive area of so many of our bodies, we are in the medieval times. Has anyone else noticed- whatever man designed the mammogram apparatus, they did not include room for a human being with a head? There is a very large piece of machinery where one's head would normally go, if one were not contorted into unnatural positions and then told not to breathe. Its also designed as though all bodies were the same size. It also fails to do its job very often, so I would say that is a spectacular failure by I can't imagine how many industrial designers. More of a ruckus ought to be raised. In any event, the wire thing is like thumbscrews, except for your breast, and it did cause me to have flashbacks which I consider PTSD. The best part I guess is having lived to tell the tale. But seriously, everyone is different and so I don't want to make anyone anxious about this- they do numb you up pretty well.

Hopeful82014

MoJim, did you ever get your final pathology report? If not, I'm sure you know that you have the right to receive it from the hospital. If they give you grief, talk with higher ups and/or tell MO and RO that you will not take another step in treatment w/out having received a copy of the path. report.

You're fully entitled to that information and your BS should be reported for failure to provide it upon request.

Good luck with everything you and your husband are juggling and dealing with.

MoJim

Yes, Hopeful - I did get the pathology report from the Radiation Oncologist when I saw him a couple of weeks ago. I'm stage 0, but am high-grade aggressive, thus the push for the Radiation or it will recur.  I honestly did NOT want to do the RAD's -- not because I'm "afraid" but because I already have enough on my plate & frankly, am ready to die of "natural causes" since my life continues to spiral downward from bad to worse.  Well, my PCP told me she would no longer see me as a patient if I didn't follow-thru w/ Radiation & I live in a town w/ poor medical care & few "good" physicians. I don't particularly "like" my PCP, but she is brilliant & a good Dr.  Since my husband had a total knee replacement 2 weeks ago, I've been taking care of him (AGAIN!). No "me time."  I'm ready to "fly the coop" & I wish people would just let me make the decisions on how I want my body managed.  Thanks for caring enough to check back on me.  I've been absent on this site as of late due to my husband's health needs.

Hopeful82014

It sounds as though you're stuck between a couple of rocks and a hard place, Maureen. I feel for you. ((((Maureen))))