Premedication for Core Needle Biopsy

PamO

Hi everyone,

I am having a core needle biopsy in a week. Most of the time I'm not too worried diagnostically speaking. My lump (found on routine screening mammo and well defined on US) has all the characteristics of a fibroadenoma. Apparently, the lump has very defined edges, very oval shaped, hyper echoic I think, growing parallel to the other tissues, and a bit sore on and off. All of which suggest fibroadenoma I'm told. And I have dense breasts. I had a fibroadenoma before, 25+ years ago. It is kind of weird to have another at age 49, so thats a little disconcerting. Lots of breast cancer in my great aunts, but none in mom, sis, grandma. My cousin has a lump that was very aggressive and had a lumpectomy. Eventually diagnosed as benign phyllodes tumor.

So I have a tiny bit of concern about the diagnosis, but a growing concern about the core needle biopsy. I have post herpetic neuralgia, a chronic pain condition, and have a significant amount of trauma about being under treated for pain and physicians not responding to real and significant pain (part of that being my fault for not speaking up, and partly theirs for minimizing). I'm scared of getting in there and asking them to give me a generous amount of lidocaine to protect myself from any pain, and having them say yes yes and just do the regular thing, and leaving me in a painful spot. I have a VERY hard time speaking up for myself in these situations because I dont want to lose it and cry all over the place. I have a hard time getting to the state of mind of being angry and self protective versus sad and scared.

I know this can go both ways. I've have very careful doc's and very dismissive doc's and it doesn't actually seem that what I say changes the situation much. I suspect people are going to be who they are going to be.

So my plan is to time some of my regular pain medication to help with the biopsy. I'm sure my doc is fine with that as I have to take them anyways. My question for you all is: Have any of you premeditated? (Officially or unofficially, i don't care.) What have you used? Did it work or not? Did you get anything other than lidocaine (numbing injection) for the procedure.

And did you say anything before the procedure about your wishes regarding pain control?

Ive been lurking on this board and its been very helpful. Thanks for all you do.

wrenn

I found the core biopsy to hurt less than when I have blood taken from my arm at a lab. The needle to freeze is tiny. I didn't even really feel discomfort and when it was done there wasn't much bruising. A non event as far as medical testing goes in my opinion but I am sure there will be horror stories as well since these things are different for everyone. If you are anxious you could take anti anxiety meds but I don't really think you will need pain medication.

Hoping your fears regarding breast cancer history are laid to rest with the results of the biopsy.

LisaAlissa

Unofficial pre-medicating (unofficially) can turn out to be a very, very bad idea. The effect on bleeding. The combination with the anaesthetic used by the biopsy team. All things you don't/can't know.

Does the biopsy team know about your pain meds? Have you specifically mentioned the meds to them? If not, you should. If they do biopsies regularly, they are likely to be accustomed to doing biopsies on patients on pain meds. You just need them to understand that you are in that population, even though you don't have a current cancer diagnosis.

Do you have a pain doc? He/she may well have ideas (or even want to interface with whoever is doing the biopsy).

What I would suggest is call the biopsy center and ask to speak to the pain management doc. Give them all the information you can about your pain meds,, tell them about your concerns and ask about anxiety pre-meds or if there are other things they'd suggest.

Separately (and this may sound silly), but the breast center that did my core needle biopsy put a warm blanket over me and had a volunteer who (with my consent) rubbed my back/patted my shoulder and held my (other) hand during the procedure. Very comforting. And I had someone's hand that I could squeeze if I needed to.

Best wishes with your biopsy (for best pain control & results!)

LisaAlissa

Smurfette26

I agree with LisaAlissa. Tell them beforehand about any pain meds or anxiety meds you take.

I did read a post on here where a lady took anxiety meds prior to presenting for her biopsy. She told them when she got there and they rescheduled her. They wouldn't do it at the original appointment as she had taken anxiety meds before she had signed the consent forms. Overkill I know, but it can affect things.

My biopsy immediately followed my diagnostic mammo and ultrasound so I had no time to anticipate and worry.

I did find it to be a very easy and relatively pain free procedure. Just a small "pinch" when the needle went in. It goes numb very quickly. I did say in a jovial way, "make sure you give me plenty of pain relief" and they did. I also had a nurse holding my hand and I did look the other way. I didn't even have a bruise.

Hope your biopsy goes smoothly and your results are all good news. Donna.

jewels9

The center where my biopsy was done actually informs their patients prior to scheduling the biopsy that if you wish, to call your primary doc for anti-anxiety meds. However, like another member said, it's crucial you inform them if you are going to take anything AND you can't take it until after you sign the concent forms. I too have a chronic illness that I'm on regular pain medication for and informed them of this prior but had no issues with bleeding or post biopsy complications. It's important though that you communicate this to them so they are aware.

Does the center where you're having the biopsy have an online system where you could write a message about these concerns? Just an idea that if you aren't comfortable stating your concerns, perhaps it would be easier for you to write them so they are aware? I fund that's been helpful for me, PLUS, it provides documented proof that they were made aware of your concerns and can be prepared in the biopsy that if you request more numbing meds, that they ensure to do so.

Last, the biopsy itself is not all that bad, at least not for me, but I did have to ask for more lidocaine during it. Don't be hesitant to do so - it's your body, your experience, and you deserve to be as comfortable and pain free as possible.

My best to you for benign results and a comfortable biopsy.

fizzdon52

I have had two biopsys and there was no pain with either of them. I find it much more painful plucking my eyebrows haha! Good luck.

PamO

Thanks Wrenn, that is def. one of the better reports I have heard. Good to know. Thanks.

PamO

Thanks everyone, these are the best core biopsy stories I have heard. Glad to know it can be a non-event. I thought about calling and talking with someone in advance. I would feel like a bother and a wimp, but maybe its better to be up front about it, since I likely AM gonna be a bother and a wimp

The warm blanket is a nice touch. There is a form to fill out with preexisting meds so they will know everything I am on and the most recent dose, but I definitely would not have thought of needing to take the anti anxiety med after signing the consent form. Thats kinda overkill, but lawsuits are everywhere I guess.

You all put my mind at ease. Thanks so much. And thanks for the best wishes. My heart goes out for so many that have such a long hard road with this disease.