Poll on Sentinel Node Biopsy Pain

I am so grateful that I had absolutely zero pain or discomfort from this procedure. I had a very experienced physician who did the injections (I had nothing to do with this choice). She gave me substantial amounts of lidocaine. Perhaps it might have burned a bit but I really don't remember! I had it done in October 2008.

What standards are there for pain prevention??!! I had an extremely miserable needle biopsy so perhaps there are many differences in proximity of nerves to the path of our various procedures, e.g. lymph nodes? Was I just lucky or did it have to do with the experience of my physician?

I'm so sorry for everyone who had bad experiences.

Zerlina

Mine was done after I was sedated as part of the lumpectomy.  I couldn't imagine having it done while I was alert.  I am so sorry for all of you ladies that had to go through that pain. 

I had the injection about 4 hours before my bilateral mastectomy and it did not hurt at all. Guess I was lucky.

Mary 

Wow, ladies! I didn't realize how great I had it until I read your stories of the injections. My BS did everything after I was out (BM Jan. 19, 09). I guess because they were only doing SNB on left side, maybe they injected and took care of the right breast while the dye was working its way to the nodes.

I did have the wires placed back in November for lumpectomy and I agree with NVDiane......no man would go through all this without anesthesia!

Sorry you all had to endure such torture!!!

Hope everyone is recovering beautifully.

I experienced the same kind of painful injection for my Mamotone biopsy on Dec 23 as the SNB tracer injections. I had put lidocaine cream on my breast with plastic wrap, and used Lamaze breathing and my goddess warrior face. I'd rather go through those quick painful sensations than to have to live with the pain of after surgery seromas. It really is interesting to hear everyone's stories. They're all so different. There's no question about it though. Being prepared ahead of time helps.

It's hard to believe the range of different pain levels everyone had experienced with the sentinel node biopsy!

I had mine done one day prior to surgery as well (my surgery was Feb 9).  Of course, my primary question was "will this hurt?", and I was told that it's different for everyone.  My doctor told me that for the most part, I would feel something like a bee sting, and then the pain will go away very quickly.

Well, I got lucky.  It was exactly as my doc described - a very quick bee-sting at the nipple, and the burning only lasted few seconds and went away very fast as the doctor massaged the area and encouraged me to continue massaging for few minutes.  I think I felt the initial injection traveling in for about 3-5 seconds near the nipple, and then the pain just went away completely.  In fact, it was so easy, I was offering up my other breast with strange enthusiasm so that I can just get both sides over with quickly.

 If you've experienced a bee sting before in your life - it's quite accurately the  sensation I felt, except the bee sting's pain lasted hell of a lot longer.  If you've never experienced a bee sting, it feels like you got some burning chemical agent injected near the surface of the skin, but the pain goes away quickly, helped by the area getting massaged  right away and for few minutes afterward.

I'm so sorryy for people who had such horrible experiences with theirs.  I can't imagine how awful it must have been for you - already starting off scared and then having them confirm your fear like that.

Hopefully, some will be as lucky as myself and have a good experience with this procedure.   No matter how it goes, know that the needle procedure is very quick, so at least you have that going for you.  Thereafter,  I was asked to wait 30-45 min while continuing to massage my breasts in the waiting room (I went for coffee at the cafeteria instead), and then I had to get into an MRI machine - spending about 30 minutese in there for three different sets of films.  This made the entire process to be approximately 1:20 min including the waiting time in between the injection and the MRI. 

I was given a good explanation up front that there would be four injections all around the nipple and that the needle would only go just under the surface of the skin.  The clearly explained that it would only take a few seconds for each injection, and that I would then rest for a about 15 minutes prior to getting scanned.  I was then to wait 3 hours and get scanned again, and then my surgery was about an hour and a half after that.  Well, that was all fine, but "this will pinch a bit" was the only warning of pain that I was given.  So yeah, the needle going in pinched a bit - it felt like the sting of a small bee.  But then it was like YEEOW!! as the tracer was injected.  Uh, well, gee, thanks for the warning.  Having said that though, it immediately subsided (until the next one), and I forgot all about it afterward.  It was interesting to get up and pee for the first time after surgery and see the color of the Caribbean Sea, lol.  All in all, pain, yes, but only for a very short duration.

A "numbing" cream was applied to my breast about 30 mins prior to the SNB injections.  The first 3 injections were tolerable, but the last one sent me through the roof. 

I had this done about 2 hours before my BMX, so my mind was all over the place anyway.

I find myself intrigued by the number of varied procedures and responses  for SNB. I wonder if there is any difference between a biopsy using an injection  of just nuclear medicine vs. nuclear medicine and blue dye? I know I just had the nuclear medicine , no dye... and little pain........ any thoughts out there on this?

Just goes to show  what an individual experience this is for everyone.

sweetsunsets55 - I had the nuclear med tracer injection at least 4 hrs before surgery and it wasn't painful. The blue dye injection was during surgery after I was already asleep. They told me that the pictures after the injection was one check, the hand-held tracer counter during surgery was the second check, and the blue dye during surgery was the third check - all to positively identify the sentinal node.

Alyad:

I had the same thing happen to me.  I was told everything was negative at the sentinel node  surgery, then a week later they came back with a micrometastasis.  As it turned out, it's good that it happened that way, because I had signed a consent form for the axillary node surgery at the time of the sentinel node surgery so if they had found it then, they would have gone ahead and done it.  I was so terrified of lymphedema, that I decided not to do it, once I had time to think. 

I am now done with chemo, done with rads and mulling over the hormonal therapy options. 

Peeps

It was the most unbelieveable pain. I was only told it would be uncomfortable. It felt as if I hit the ceiling. No anesthesia - they said it would interfer with the test. I screamed like an animal and started to cry. I also think I'm pretty good at dealing with pain but this was on a totally different level. I'm glad you're putting this out there.

I find the range of responses to this procedure amazing.

I had wires inserted prior to my lumpectomy, had to get up off the table and go get a mammogram to make sure the wires were inserted properly. I can't remember if I had the radioactive dye injected before or after that, but it was just a pinch. I was expecting more pain and glad that I did not get it.

I have had an endometrial biopsy with no anesthesia. That was no picnic. I do think, however, that I do have a high pain tolerance(I'll probably regret saying that one day.....) because I can't think of a procedure that I have had that did not hurt less than I was led to believe it would hurt. I hope it stays that way!

Mary

I had my SNB (two nodes, because there were two tumors) done as part of my BMX (no recon) on Feb 1st. Both were done on the same side because my right MX was prophylactic.

I received only one injection and that was about an hour or so pre-op. No pre-numbing (in fact my pre-op instructions were adamant that NO creams or lotions be used within 12 hours prior to coming to the hospital) but it was just a little pinch/stick. Everything else for the SNB was done during my surgery so I was under general anesthesia the entire time. I had no post-op pain at all, anywhere (my surgeon is the best!) and my drains came out in 4 days. Some occasional random fleeting mild to moderate numbness/tingling feelings in the SNB area which disappeared entirely 5 weeks post op. Never had to take more than an occasional Tylenol (meaning maybe one or two every one or two days) during the first couple of weeks post-op. I had about 50% range of motion back in both arms at about 2 weeks out; 100% range of motion at 6 weeks.

Oh and despite everything I had read pre-op, I did NOT have any "blue pee" after the SNB at all. This might have been because they inserted a catheter during surgery which was removed before I left the recovery room, so if there was any blue pee it may have come out during the immediate post-op period; but as for anything after that, it was absolutely normal color.

Like lovetosail, I am the world's worst wimp when it comes to pain tolerance but I have to say, for being a major surgery (IMO) this was absolutely a walk in the park. 

I had so much pain from the sterotactic biopsy because the lidocain did not work on me at all. I was told nothing about the SNB before going in for surgery other than there was some procedure an hour before surgery. When I was taken back I was so terrified I couldn't even put the gown on and a nurse came in while I was changing and just stood there - I had to ask her twice to help me so that got me more anxious. Then they tell me they use lidocain. I told them it didn't work on me, was there something else they could do. They said no so I asked what exactly was going to happen and they said they didn't know. I said I needed some explaination. Then they came in telling me take take some pills and I freaked, I'm afraid as I was just so scared at this point and asked for my cousin to come back. They had told me 1 person could come back then told me no. I remember just sobbing in preop. sobbing like I never have before. They finally got my cousin. She was there when some woman not dressed like a nurse came in and said it would be inhumane not to give you lidocaine before this procedure and also I don't think we can not do it legally. Well, that didn't help at all! So it was so painful that not to use a medicine that didn't work on me was inhumane?!

Finally the man from Nuclear Medicine came in and he was really nice. I'm sure he isn't usually the one who wheels you down but he did and told me he would make sure it wasn't painful and talked to me the whole way and let my cousin come into Nuclear Medicine with me! I did take the pill which I'm sure was Valium and it did help. But what he did was he kept putting the lidocaine creme on every few seconds/minutes however long it was. He said when it doesn't work on people it means they metabolize it very quickly so it can wear off within a minute so he kept it freshly coated and there was little pain.

The sterotactic biopsy was as awful as others have described SNB. They used lidocain and it was so bad that even vice gripped in I was trying desperatly to jump off the table and they had 3 people holding me down while I was crying so hard - which of course moves your chest also. But I did think that was inhumane and to think about another procedure like that while being so terrified before a huge horrible surgery just isn't right. They need to figure something else better to do and certainly need to train the personal to be more compassionate.