Can they look at the tissue during the biopsy?

Frenchiegal83

Hello all,

Super weird question, but during ultrasound guided core needle biopsies are they able to visualize the tissue once it's pulled out and put in the petri dish? Do breast cancer cells cause tissue color changes? Do they look at it there in the room prior to sending off the samples to gauge what to expect from the biopsy results? I know, super weird question but I've got all this time to wait until my appointment (June 13th) and my mind just keeps spinning and turning over all the data from my ultrasound and MRI results (Irregularly shaped, angular margins, hypoechoic, posterior shadowing and peripheral vascularity) and while my Birads score was only 4a, I'm still researching all the possibilities b/c it makes me feel more prepared then to just sit and wonder. By keeping my mind busy, I help keep my anxiety in control, as I'm a control freak and need to have something to do. Thanks for listening to my weird question and random tangent about my anxiety lol

Sita26

same boat, my abnormal ultrasound was on Thursday 24th and I don’t get the biopsy until Tuesday the 5th. I’ve spent too many hours worried, googling, researching and lurking this forum. I would say to limit your time being worried because it really doesn’t help whatsoever. Why was an MRI done before the biopsy? Just curios.

Frenchiegal83

I've had unilateral clear nipple discharge from my right breast for the past year plus a history of very dense/fibroid breasts so they went straight to MRI vs mammo. I had an MRI back in November 2017 and this May had another MRI to follow up to make sure there were no changes but they found three different areas that had previously been stable/normal looking had changes in shape/density/margins in both breasts that were suspicious. They did a second look ultrasound to determine if they needed to biopsy the areas or just do another MRI in 6 months and decided they wanted to biopsy the areas through ultrasound. During the 2nd look ultrasound they kept saying things like "that's the thing/area we wanted to look at" and it was super weird to see people hovering over you and staring at a ultrasoun screen of weird shaped lumps and then all scrambling to the computer to compare MRI to where they were during the ultrasound. While I appreciate their enthusiasm I don't feel like they would of been that excited if it was just another fibroadenoma and when I started getting overwhelmed b/c of how they were acting (she read right through my smart ass comments and nervous laughter about their excitement) gave me some tissues and patted my arm. Just glad she didn't feed me some bs line like it's going to be ok. I'm sorry you're going through this too, keep me updated on your biopsy next week, I'll be thinking and hoping for negative results for you!

pingpong1953

The doctor who did my biopsy told me, "This looks bad - you're looking at surgery and radiation at least." She'd seen lots of BC in her career and she was right.

Frenchiegal83

What type of biopsy did you have @pingpong1953? I feel like I'd rather they tell me right then and there, the waiting in the worst! One minute I'm fine, the next minute I'm googling everything that I've already googled lol

Cindymb

Jski83, I am waiting for the biopsy phone call also. The radiologist said something about it looking suspicious and i will definitely need surgery. I swear all of this waiting and anxiety is going to give us PTSD or something. It is truly hell. I hope the best for you as I keep hearing that the majority of biopsies are benign. 🤗

Frenchiegal83

Cindymb, I haven't even had the biopsy yet lol, and you're right the waiting is hell! Keeping my fingers and toes crossed you get to hear good news soon!!!

pingpong1953

I just had core biopsies - my tumour was right at the surface, so there wasn't any imagery needed. I went from feeling the lump to having the mammogram in about a week. Once I'd had the mammogram and an ultrasound to confirm what was suspected, the doctor came in and did the biopsy the same day. Mammogram to ultrasound to biopsy was about 2 hours. Glad I didn't have to wait.

Frenchiegal83

Ping: How did they know that your lymph nodes were involved (I'm assuming that's what it means by having lymph nodes removed?) My lymph nodes in my right armpit are always swollen and tender, my right supraclavicular lymph node has always been larger but my primary MD hasn't been worried about it b/c there haven't been any other symptoms. Do they check for lymphatic fluid in the samples or ???

pingpong1953

Well, the first plan was to have a lumpectomy followed by chemo and radiation. When I met with the radiation oncologist he said that I'm not a great candidate for radiation because I have a history of lupus, although he didn't completely rule it out. During the lumpectomy the surgeon removed the sentinel node as well as a second node and cancer was found in the sentinel. After my chemo I met with the RO again and I agreed that I'd go with a mastectomy because of the lupus. The rest of the lymph nodes were removed during the mastectomy. All of the tissue was examined and no more cancer was found. And I hope that's that!

MelissaDallas

Generally, no. The description of almost every biopsy specimen is "yellow tan tissue". What counts is only seen under a microscope. That is why people have re-excisions to get clear margins. You can't see the abnormal cells with the naked eye

ChiSandy

In the old days, when they'd put patients under general anesthesia to biopsy breast lumps, a slice (section) of tumor was "frozen" with liquid nitrogen and immediately sent to pathology to be examined under a microscope. If malignant cells were found, a modified radical mastectomy (breast, all lymph nodes, part of chest muscle) would be performed and the patient would wake up without the breast; if the frozen section was benign, only the tumor would be removed and the patient would wake up with a breast intact except for the tumor; the tumor & margin would then be examined within the next couple of days and if malignancy was found, a mastectomy would be advised.

Core needle biopsies (performed by radiologists) need to be examined under powerful microscopes not available in the radiology suite; so no, they're not examined "on the fly." Besides, certain precautions (discontinuing meds for several days prior, not eating or drinking beginning at least 8-12 hrs pre-op, pre-registration for a possible hospital stay, arrangement for a ride home, post-op care) need to be made before surgery (even lumpectomy) is scheduled & performed. But core-needle biopsy results are often available w/in 24-36 hrs--my call came the evening of the day after the biopsy).

Frenchiegal83

Thank you MelissaDallas, Idk why I thought the tissue would be different color lol, probably just hopeful for some type of news during.

Thank you so much for the info ChiSandy! While I'm bummed they can't look at it while it's being done, I'm hopeful my results come that quickly!

Ingerp

I’ve never had anyone make a comment about the “look” of the tissue immediately after a biopsy, although I have while getting an US. FWIW, my BS described DCIS as “squirrely”— you can’t feel it; you can’t see it. I think that’s one reason so many lumpectomies require another surgery to clean up margins.

Frenchiegal83

Thanks everyone for all the input and feedback, makes me feel a little calmer (at least right now) heading into the biopsies. I know most get benign results, but you still have that "what if" haunting you in the back of your mind. I can't just sit and wait and not doing something. I've started back up with hobbies (reading, lampworking, biking) since all this mess started but I'm glad I did. Apparently taking lots of naps is not a healthy coping mechanism for anxiety and stress, it's not just this that's causing stress, but it was the icing on the cake that helped me realize I needed to do something constructive with my time instead of hiding in my blanket fort of pillows.

Recap

I remember a neighbor kid who tried to high jump a chain link fence with wires poking out the top-he sliced his calf open down to the bone and I saw it up close and personal-I usually remember that image of colors/textures when I am working with deboning raw chicken. 

I too have pathology-related curiousity. I wish the pathology order had asked for more, so the pathologist would have done more testing, or at least that he had fleshed out his very very brief not-so-grammatical report.

djmammo

Jski83

There are times when the big question can be answered at the time of the biopsy and its not from the gross appearance of the samples.

When I performed an FNA for cytology (fine needle aspiration, which was rarely) I would request a cyto-tech from pathology come down to the US suite with their portable microscope setup to evaluate the samples as I produced them to make sure I got adequate tissue. When they saw clearly malignant or clearly benign tissue, they would just say "stop". Many times an FNA report would simply come back as "inadequate tissue for evaluation'. This avoids that scenario. They do not do this for cores as they are too big and contain too many cells to do a quick slide prep at bedside for histology.

Frenchiegal83

I appreciate the feedback djmammo! I know my odds are probably good that it'll be benign, & since there's nothing I can do to speed up time, no way to change any outcome, I'm going to try to stay busy...while also researching on here what may come next. Hope for the best, prepare for the worst!

Frenchiegal83

Biopsies are done, 3 different areas with 15 different tissue samples, now more waiting. I had to wait for an hour past my appointment time before they even took me back to get started b/c they were so backed up, so that was probably the most stressful part. The radiologist was teaching residents while doing it so having an audience while getting your boobs poked is a little awkward & I don't think that he appreciated that I asked why the areas which had previously been noted as "probable intramammary lymph nodes" are now all of a sudden something that needs to be biopsied? He got a little flustered but explained that sometimes tissue changes can be caused by viral infections or our lymphatic system clearing out "debris" and causing changes. I didn't want to make him any more irritated b/c I had so many other questions so I held my tongue. He became really subdued and quiet during the biopsy on the right, and said that he feels that it was the most suspicious, and the little guy next to it that was also being biopsied would most likely be benign. It's a relief to get it over and I feel like whatever happens will happen. I also didn't realize they used epinephrine with the lidocaine so I was super shaky and hot flashy afterwards and so confused as to why, thinking I've had panic attacks before, this doesn't feel like it but I'm having symptoms like it, wth?! The tech then explained that they gave me epi to help with clotting I was like cool, now I can connect on a more personal level to my patients in the ICU, although the dosages I'm titrating for them are a hell of a lot more than the tiny amount they used on me. Overall it's done and now the hard part of waiting. Hope everyone's week is going well!

Shellshell69

Hu Jet ski I had my biopsy 2 days ago and it was a core biopsy.The lady let me look at the specimen it looked just kinda clear white... But I am so glad that it is over....I too was a birads 4

Frenchiegal83

Hi Shell. I got to see all the tissue floating in the formaldehyde, just cups of pink cloudy junk lol. I'm glad it's over too and I hope that you hear back soon and with benign results!

Shellshell69

frenchie I wish they would call ....on day 3 of waiting...I know I am inpatient but this is just terrible...how long did they tell you have to wait to get your results?

Frenchiegal83

They told me results will be available in 10 business days. I expect they often get results sooner than that but tell people 10 business days so that we aren't hounding them over the phone with our questions and wanting to know if results are back

Frenchiegal83

Shell have you gotten any word back yet? Hoping you have and they are benign results so you can enjoy and relax this weekend!

Shellshell69

yes I got my results I posted in another post did not realize I had not posted here....my results were b9 I have fibrocystic breast ...I was very relieved....I am not leaving this site as I have made so many friends and I honestly have never seen such a group of strong women this calmed me when I was so upset and worried....How are you Frenchie??

Frenchiegal83

Congrats on the benign results shell!!! So excited for you! No results yet, hoping Monday will be the day but my luck I'll have to wait all week

Frenchiegal83

Results are in, no malignancy!

More fibroadenomas with micro-calcifications and fIbroadenomatoid changes with micro-calcifications (although not sure what that last one is?) They're wanting to follow up in six months with an MRI and mammogram to make sure they're stable as well as referral to a general surgeon to clear out the ducts? I'll find out more about that next month. Such a relief to get that off my shoulders, I truly appreciate each and every one of you for supporting me through the stress of this, there are no words to express how grateful I am.

Jlarabee2286

Thank you for your post! I'm 32 and going through a scare and it's reassuring to see your results!