Stereotactic Core Needle Biopsy--Terrified and Second-guessing

Arielyn

Three weeks ago, I had a routine mammogram (my first in four years--because I'm lazy....no other excuse). Last Wednesday, I received a call that my old films from another facility had arrived for comparison and that I needed to come in for a diagnostic mammogram and US. As I am able to access my records via a patient portal, I was able to read the actual report. It identified "new punctate calcifications with clustered distribution seen in the posterior upper outer quadrant of the right breast."

I went in for the additional tests (tomo and US) on Thursday, after which the radiologist met with me to explain that, while she didn't believe it was anything "major", she would recommend a stereotactic core needle biopsy. I scheduled it for this Wednesday.

First, I've read absolute horror stories in the last twenty four hours re: the procedure. I'm normally anxious and a complete "baby" when it comes to any medical procedures. I'm totally rethinking my decision to have the biopsy after my clumsy "research", and I am wondering if this is a time for a second opinion (or if that is best utilized after the results of the biopsy?). I've called my PCP and requested something to relax me before the procedure, but with the report reading as it does, am I safe to simply "watch and wait"? I know you all aren't doctors, but I also know that most of you here have been either in my position or somewhere relatively close. I need a reality check and perhaps a kick in the ass.

Any support/guidance/suggestions would be greatly appreciated.

Grammy2be

Arielyn

I am grappling with the same fears and thoughts regarding my biopsy coming up on the 18th. My GP did tell me I could refuse the biopsy but he did not advise it. Really I don't think he could say otherwise. So, I am grudingly going to have the biospy done and am just trying to remember that if I wait another 6 months I will likely just be postponing the procedure. I hope you can find some peace I know it's hard!

mebmarj

All of us worry about new experiences and the internet can tell you things that don't happen to everyone(worst case scenario). I'm glad they called you after comparing your films, getting more images and ultrasound. Biopsy is the next logical step.

If you have questions about the procedure- call that facility. They can fully explain things likehow they will numb the area, how they get samples and how long it takes to get results. They can also tell you how often they do the procedure to let you know they are proficient in what they do. They may advise for or against something to relax you too- depending on if you drive yourself and their facility protocol because you do have to sign consents and anything that alters you is not to be taken until after that.

Best wishes to you. Let us know how it goes.

Teddy88

Hi Arielyn:

I am sorry that you are going through this fear and worry. Some thoughts:

I have had three stereos and 1 US-guided biopsy. Three of those were same day. I didn't feel anything as I asked for as much lidocaine as was legal The process itself took 90 minutes for the three procedures, and 30 minutes for the single stereo several years ago. I am no heroine, but I took the commuter train home after the threefer. A little sore but fine.

I think it's good to tell the doctor how you feel if you do the stereo. Tell her you are worried sick and how can she help make it less difficult? On this last round, I asked if she could tell me what she thought we were dealing with after the test. She warned me that it didn't look good. I had calcs too - same way my cancer presented initially in 2014 - so we had to check on these new ones. The next day she called to say the results were benign. So calcs can be something or they can be nothing

I suppose you could try and find a doctor who might suggest waiting - but would that relieve the worry? And if there is some small problem, would it benefit you to wait?

If you were my best friend or sister, I would very much ask you to follow-up with this test.

Good luck deciding and hope to hear back as to where this all goes for you.

Love,

Belle xx

Arielyn

I can't thank you all enough for taking the time to respond. In my head, and in my heart, I absolutely know that for peace of mind and my health, this biopsy is a must. I just also know that I am prone to knee-jerk reactions, like cancelling appointments at the last possible minute rather than face my demons. I will be reading and rereading your responses over and over again for the next few days and trying to "screw my courage to the sticking point" (sorry...I'm an English teacher and predisposed to drama...lol). Belle, it is so encouraging to hear that the biopsy was, for you, less than traumatic. After reading your response,I think I will make a note to remember to ask for as much of a local as possible (I can't have epinephrine, so maybe they can really load me up with something else!). Grammy2be, I will keep you in my thoughts as we travel this road together. Mebmarj, your suggestions are on point and productive--I will call Monday morning.

Thank you again....and, assuming I can be brave, I will post after the biopsy. The wait for results I think will be as anxiety-inducing for me as the wait for the biopsy.

bew66

Arielyn, I can totally relate to your fear of the actual biopsy.  I too, went 4 years without a mammogram (because I'm lazy, and don't consider myself high risk for breast cancer), and when I had to have a uterine biopsy 10 years ago, I absolutely refused to let the Dr. do it as an office procedure.  I insisted on IV sedation for that procedure because I'm a BIG BABY when it comes to pain.  One of my friends who has had several breast biopsies had told me years ago how painful a needle biopsy is, so when I got the news that I needed a stereotactic CNB done, I freaked out.  The only reason I went through with it was because the Drs. at the breast center had me even more scared that I had breast cancer.

Honestly, it was uncomfortable, but not painful at all.  It's awkward lying on your belly, with your boob protruding through a hold in the table, then being clinched in a mammogram-type apparatus.  The only "pain" I experienced was a little sting with the first lidocaine injection.  The subsequent lidocaine injections I didn't even feel, because the first injection worked that well.  When they were taking the samples (12!), it felt odd, like a little tug, but was not even really uncomfortable.  After the first few samples, I was able to get over my fear of possible pain, so I relaxed, which is always helpful.

I have another area that needs to be biopsied, this time under US guidance, and while I know that every experience is a new one and it might be different than it was last time, I can truly say I'm not worried about the pain of the actual procedure.

I hope your experience will be as easy as mine was with the stereotactic.....and of course, ultimately benign!

mebmarj

make sure you tell them NO EPI, as some lidocaine has epi mixed in with it but is always labeled as such. You might tell them what reaction you've had to it in the past also to underscore your concern about it. They can get lidocaine without epi also- so make sure they have NO EPI written on your chart, allergy/adverse reaction bracelet.

You can do this. It's the next step to get the information you need. You can always have a support person waiting with you beforehand and for when you are done with the procesure

AngelaJL

I completely understand your fears! I had the usual screening mammogram in August, and I was stunned when they told me that they were recommending biopsies on BOTH sides. Being the kind of person who loves research, I immediately went to the the internet to learn as much as I could about the procedure, and I started to freak out!

The morning of the biopsies, the nurse who took me into the room asked if I needed something to relax me, and of course I said yes. She gave me a Valium pill, which worked nicely. But honestly, as Bew66 mentioned, after the slight sting of the initial injection, I felt absolutely no pain during the procedure. There was some pressure and a little tugging, but no pain at all. They did the right side first, and by the time I had to switch positions to do the left, my anxiety was completely gone since I knew what to expect and knew how NOT painful it would be.

The only real problems were the discomfort of lying on my stomach for that long and my skin's allergic reaction to the tegaderm bandage they put over the biopsy sites. But the procedure itself was underwhelming compared to what I'd feared.

You can do this! And in my opinion, you *should* do this, as knowledge of what's going on in there will either put your mind at ease (benign results) or put you on a path toward healing (anything other than benign).

Arielyn

I want to again thank each of you for taking the time to help to allay my fears. My procedure is tomorrow morning, and I've had to struggle all day (called off work as I'm so wound up) to not cancel. The doctor prescribed me Ativan .5 to relax me before the biopsy, but from what I've read, that low of a dose isn't likely to do much for my overwhelming anxiety. I am also feeling so guilty for being such a baby about this. My dear friend is currently five weeks into a leukemia diagnosis and enduring more tests, treatmentsand therapies than I think I could ever have the strength to face. She has been an absolute rock, and I'm crying about a simple needle. SMDH. I am trying to be braver and failing miserably. I was able to read the report from the diagnostic US:

ULTRASOUND FINDINGS:

Real-time scanning of the right breast was performed. There is a cyst cluster

measuring 12 mm, at 9:00, 8 cm from the nipple, and 2 cysts, measuring 8 mm each

seen at 11:00, 5 cm from the nipple.

IMPRESSION:

Increased density does not persist. The cyst clusters are probably benign.

The calcifications in the upper outer quadrant are indeterminate.

EXAMINATIONS:

Stereotactically guided biopsy of upper outer quadrant indeterminate

calcifications.

Right breast ultrasound in 6 months for probably benign cystic structures.

BI-RADS Category 4:

Suspicious Abnormality

I keep telling myself that the odds are in my favor, but anyone who has found herself on the wrong side of the stats know that they are for the birds. I was once told my chances of conceiving a child with T21, at my then age, was hugely unlikely. Lucky me, right? He never made it to term, and I've since stopped believing that stats mean a damn thing.

I'm sorry to be so negative but I honestly have no one to confide in. My friends and family are being supportive, but I don't feel like I can fully express to them how scared I really am. If you've read this far, thank you. Writing is, for me, cathartic. I apologize if I've upset anyone and ask that you forgive my ramblings.

AngelaJL

Good luck tomorrow morning! While you're having your biopsies (don't cancel!), I'll be in surgery having lumpectomies on both sides. I'm nervous, too, but by this time tomorrow, the worst of it will all be over.

We can do this.

Arielyn

I am sending all the positive energy I can harness your way, Angela! We can do this!

Teddy88

Hi Arielyn:

I am so glad that you didn't cancel, and hope to hear how you make out tomorrow.

You didn't cancel - B*R*A*V*A!!!!!

Love,

Belle xx

KimYR

I had mine yesterday and it was nothing. The hardest part is I have architectural distortion and it was really difficult for them to find so they to keep readjusting my breast. Also it's uncomfortable because you have to sit very still and my neck started to hurt. Once they got everything where they wanted it though, the radiologist came in and the procedure itself took less than five minutes. There is a tiny prick from the numbing shot but it was way less than getting Novocain at the dentist in my opinion. After that I didn't feel anything. I know anxiety is hard but I promise it's not that bad.

Grammy2be

I hope it goes well Arielyn, sounds like you are going through so much. Hugs!

Pamrn78

hello everyone. I had my core biopsy yesterday for a suspected nodule in left breast with skin thickening. I have noticed under my left arm soreness prior to the biopsy. Worried that the biopsy will be positive. I am 39 years old with strong family history of breast cancer before the age of 40 years old. My nodule is in the upper outer portion with skin tickening. I have had multiple mammograms and nothing showed until this year

Grammy2be

Glad to hear your experience with the sitting stereotactic biospy went well, mine is anticipated to be done this way also, on Sept. 18th.

Arielyn

Well, I didn't exactly cancel, but circumstances did get the best of me this morning. My doctor prescribed, as I mentioned previously, an Ativan to help me relax. As a side note, I also take OxyContin, Gabapentin and Flexeril for a degenerative disc problem, as well as Zoloft for a bit of depression. Shortly after taking the Ativan, and before I had reached the surgical center, I broke out in silver-dollar-sized hives--head to toe. I was treated onsite with Benadryl and told to reschedule for next week. The assumption is that I had a reaction to the Ativan, or that the Ativan reacted withmy other medications. Whatever the case, I now must wait another week. Only me.

AngelaJL

Oh no! Sorry to hear about the reaction to the Ativan. How frustrating to have built up your courage and now have to wait another week.

Arielyn

Well, I finally had it done! It took two more visits, but a heavy dose of Valium, a good radiologist and a patient husband all came together to make sure I had the biopsy. It wasn't horrible, and to be honest, even the numbing wasn't that bad. What has proven painful, however, are the after-effects of the procedure. The next day, I was extremely uncomfortable, and even today (3 days later), I'm still sore. At any rate, the radiologist felt she got good samples and in fact said she felt that she removed most of the calcifications via the biopsy. I'm not sure if that's good news or not

I was hoping for the results yesterday, even though they said it could take up to a week. I'm on edge waiting, but I know nothing I can do is going to make this process any faster.

Thank you all again for the support. I will definitely post when I get my results.

Arielyn

I got my results today—at least a verbal report. My PCP called to say that it is DCIS. I have an appointment with a surgeon on Monday, and an appointment for an MRI on Tuesday, but I am just kind of numb. I have hundreds of random questions and can’t seem to shut down my brain for ten minutes to make sense of it all. I don’t think I’ve ever been this scared

MTwoman

Arielyn,

try to breathe. Just focus on the next step, and then the next. There are some really excellent threads here that can get you ready to meet with the surgeon. There is "A layperson's guide to DCIS" on the DCIS forum that is a great place to start. Beesie wrote it, and it's very comprehensive. Sending you warm wishes and gentle ((hugs)) Please ask any questions that you have. We're here with you!

Dark13

@Arielyn I understand exactly how you feel. I had my surgery on Thursday28thSep2017. I did not do chemo or radition as yet still waiting on sample analyses etc. Because of my history (mom had breast cancer) I decided to have a mastectomy and just be done with it. I am not doing any reconstruction. The thought of putting something foreign in my body does not appeal to me. I have not had any results in yet because of the hurricanes where I live the samples had to be sent to Miami so I guess they got delayed although my doctor told me not to worry they have measures in place. I am scared no terrified of chemo and I can't seem to tell those closest to me about this fear because they are trying to be strong for me. These groups have been the best. These ladies have managed to allay my fears and give me some good advice when my mind was racing all over the place. So far I don't have any pain and I am trying not to exert myself. The hardest thing for me is the drains trying not to get it hooked on anything. I did not prepare well in the clothing dept but anything with buttons down the front seems to work really well.

mebmarj

I'm glad somebody called with results. Sorry to know the results require further consult and treatment.

Now is the time to start writing down those questions to ask at your appointment. Take someone with you as an extra set of ears. When people offer to help or say call me if you need something- utilize that support.

You are capable of extraordinary things and stronger than you realize. Take things one day at a time and don't be afraid to ask questions to your providers. A well informed patient is able to make the best decision for themself.

Best wishes to you

Dark13

Good luck to all of you who have tests, biopsies, scans, surgery and reconstruction. GOD is in control the doctors are just the physical form to execute. Stay strong. Prayer changes things. You all are in my prayers.

tobie2

Dear All,

I'm new to this forum. My saga started about 7 weeks ago when I went in for my routine screening mammogram and the radiologist felt there was a slight enlargement of an architectural distortion that had been looked at several times in the past. The diagnostic mammo and ultrasound were inconclusive so I was sent in for an MRI. The MRI revealed abnormal enhancement on the left side and several masses, one possibly irregular in shape, on the right side.

Yesterday I had my MRI-guided core biopsy on both sides and I was completely unprepared for just how painful it would be. I told the technician from the outset that the compression plates were putting unbearable pressure on my underarms and ribs but she didn't reposition me. I have a high pain tolerance, having done both uterine biopsies and sigmoidoscopies without any numbing agent, and the lidocaine injection this time for the biopsy itself was nothing more than a brief sting. But the pressure on the ribs was AGONIZING. I'm now black and blue but above all I'm scared about what the results will be. People always say, "Hope for the best, prepare for the worst," but I have no idea how to do this.

Forlorn,

tobie

Moderators

Hi Tobie-

We're sorry you find yourself here with breast health concerns. We know how hard the not knowing can be! We hope for a benign result for you, you have this community supporting you no matter what. Please keep us posted!

The Mods

tobie2

Thanks for the support! I appreciate it. I will write back when I get the pathology results. You are a very informed community.

MTwoman

tobie, so very sorry that you're here waiting and worrying. I am hoping that you get good news soon! In the meantime, try your best to keep yourself occupied and distracted. We all know how hard it is to wait. Do you know what your BIRADS score was from your imaging?

tobie2

Thank you, MTWoman. I finished knitting a sweater and that was satisfying.

Today I got reasonably news. The biopsies didn't detect any malignancy but on one side they would like a larger sample. Evidently I have a radial scar with atypical ductal hyperplasia on the left side and atypical ductal hyperplasia on the right side. The radiologist recommended I have surgery to excise the affected areas, so next week I'm meeting with a recommended breast surgeon. I skipped screening mammograms at one point in my life and now I realize how important they are for early detection. Thank you for the support and thank you to this community for the countless examples of kindness and courage.

MTwoman

So glad you've gotten good news and that they'll be doing a bit more sampling to insure nothing is missed. That's great to hear!

Snosafred

Ariely...Sorry to hear....no one wants to hear cancer.

My mom was diagnosed with DCIS last year in September. By the way my mom was 79 at the time. We were scared didn't know what it entailed. It was small and stage one. She opted to have the mastectomy. She didn't want to go through radiation treatments for 5 weeks which she would have to do if she chose to have a lumpectomy.November 3rd of 2016 she had the mastectomy. She is doing better than expected. She sees her surgeon now once a year. And she sees her oncologist every 3 months. And she takes a pill once a day. I believe for 5 or 7 years. She's doing good.

Things will work out for you...