BIOPSY MISTAKE
Comments
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I been diagnosed with ILC stage 2 and they did ultrasound and biopsy and been told that the lymph is not involved than I went to MD anderson, taking all my reports, they still did memmogram,and during
the ultrasound they did biopsy in one lymph that they suspected might have cancer.after I waited 20 minuted for the primary results I been told by the doctor that its negative. and today after 7 days they call me and inform me that the lymph is positive and they have have to remove the lymph nodes during my scheduled surgery next week...Did anyone happened with them the same
Iam so mad, I been told twice that the lymph is negative and now is positive
any answer
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Frances,
I am not an expert on this, but it was my understanding that once they biopsied the suspected area in the breast (which in my case was ILC on one side and DCIS with a micro invasion on the other) that they only way to determine lymph node involvement was to do first a sentinel node dissection (removal), and the results of that did indeed take several days. I am basically surprised that anyone could tell you anything before the lymph node was sent to the lab for the pathology work. It was the same once they found that the sentinel node was positive; I had axillary node dissection (removal), and it was some days before the path report came back with any results. So it sounds normal to me that it could be days later, but odd that they would have indicated it to be negative before that. Do ask to clarify what happened; it is very important in this process and your upcoming decisions that you feel very trusting and comfortable with your doctors and other providers. Thinking good thoughts. Leigh
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Frances, JPS is right. I have friends that were told the same - MRI/ultrasound nodes looked good, and initial path nodes were clear - BUT a few days later, one node had cancer cells. I know when I had my surgery my surgeon really stressed that in surgery the nodes were clear, but they won't know for sure for a few days. One of my friends had posted on her caring bridge blog that her nodes were clear, then posted a few days later that the final report was 1 or 2 nodes had cancer cells.
I can imagine how frustrated and disappointed you are - this is such a roller coaster ride. I also agree with JPS that you should claify what happened, and also how frustrating this is to you (and all patients). However, I do think it is fairly common.
Sending you positive thoughts for surgery and an easy recovery.
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Frances: I know this is frustrating, but I agree with Leigh that I do not think it is uncommon, and they really don't know until they remove the sentinal node and do a biopsy. I had a needle biopsy done and was told that it was negative. However, when I woke up from surgery (bi-lateral), they told me I had 6/7 positive nodes. This was hard to hear, but I was glad in the end that I opted for the bi-lateral mastectomy.
I think that the patholgists just want to let you know right away if it comes back negative, though in your case, they should have waited until they knew for sure.
Have a blessed day!
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Hi Frances1,
Not exactly the same situation, but my initial dx changed from ductal to lobular once the final path report on my breast biopsy was completed. And, get this- the Dr didn't even bother to tell me the dx had changed! The only reason I found out (2 days before my mastectomy) was that the copy of the path report stated it was not final so I went in to get the final report, which stated it was "amended."
There was also a lot of necrotic (dead) tissue in my biopsy sample, which I think resulted in an invalid mitotic count- my ki67 level was sky high (indicating it was very aggressive) but the mitotic count was 1 on a scale of 1-3.... of course if you're looking at mostly dead tissue, you aren't going to see a lot of cell division going on!
I wish your Dr had made clear to you that the preliminary path report may well change... I don't think they really understand the psychological impact of being told one thing and then having that change- especially for something so important! I guess it just becomes routine for so many Dr's... and I do know they always prefer to tell good news to their patients rather than bad news.
After a lot of problems with the first place I went, I changed oncologists... I would suggest you carefully consider how happy you are with the people treating you. I regret not giving enough weight to my initial concerns regarding the first place I went.
Also keep in mind, lobular cancer is considered "sneaky," and you may be re-staged after surgery. Mine grew considerably between the time I first found it and the mastectomy a month later. Have they discussed neo-adjuvant (before surgery) treatment with you? It can be useful in terms of both shrinking the tumor, and also gauging how well your tumor responds to a given treatment as they can measure any change in size while the tumor is still there (which they can't do after surgery, unless you unfortunately have mets, as I do.)
I hope this all goes well for you... this is probably the hardest part that you are going through right now.
Good luck and best wishes,
Lynne
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Yes, I was told that there was a 10% chance that the lymph node status could change from initial pathology testing to final. They should have told you that! I'm so sorry you had to hear that news after believing you were in the clear.
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I experienced something similar. My nodes looked good on the MRI and PET. My tumor shrank to the point to being unpalpable by neochemo and three different docs thought the nodes would definitely be clear because the response.
During surgery, SNB was done on two nodes with a total of four taken. The initial diagnosis was negative. With clear margins around the 2cm tumor left, I was given a clean slate. Two days later, my very dispirited surgeon stopped by my room to say that pathology had found individual cancer cells in the two sentinal nodes, but the others were clean.
The difference is that the sentinal nodes are quick frozen, slices are shaved off and examined under a microscope. It is impossible to examine all of it that way in a reasonable amount of time so only a small sample is examined. When pathology gets a chance, they perform an immunoassay on the entire node where antibodies literally light up any cancer cells by attaching to them. This takes too long to perform during a surgery while a patient is under.
I am so sorry for your disappointment Frances and totally understand. If there is any good news, it is that there was so little cancer in the node that it did not show up immediately.
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Thanks to everyone that answered my question
I feel much better today after going to church last night and prayed for healing.
Amazing what prayers does..yesterday after hearing the bad news I couldnt function ..but after
praying and leaving the church last night I felt peace and comfort..and I am still praying for a miracle and I believe god listen.
Peace to everyone..and may god be with all of you.
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I was told that the nodes would be checked while I was still in the OR. They said it takes an hour for the lab to get results. My husband was told that the nodes were negative. Only when I went for my follow-up appt with the surgeon, was I told that they were further checked and were negative. So I could have had the same surprise after telling my entire family that the nodes were negative. What's with that! I was lucky that the results did not change but I think we should be better informed by our surgeons.
Roseann
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All through ultra-sound, exam and MRI I was told my nodes were probably clear. I went in for a Mx and SNB and was told immediately after that the nodes were clear. Imagine my surprise when I get the path results a month later and there were 9 nodes with cancer! They had done an axillary disection after all (without telling me afterwards) because the surgeon suspected during the operation that the nodes were not clear. I wish they had explained more clearly that no matter what they think in the beginning, it is only the final path report that has the final answer. I had the feeling that every time I went to the onc I would keep getting worse news. The fact is that my "stage" never got worse, it is only that I found out about what stage I was in bits and pieces.
I know that I had to learn ALOT about BC before I could understand the half of what was happening to me. In all fairness to the doctors, it could be that I couldn't really process all the information of what they told me so I possibly assumed that things were more definitive than they were. But I also think that doctors will rush to tell you the good news while they will wait until they are absolutely certain to tell you the bad news.
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krcll
How was post surgery and after axillary disection..what did you go through..
I been told that I need axillary disection and lumpectomy for the tumor that is 2.5 cm ILC
The doctor telling me doing lumpectomy with radiation later will give me the same results as doing mastectomy....
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Yes, I was told too that Mx vs. lumpectomy + rads has the same result. I had to have a Mx on the left side because I had 2 tumors in different quadrants. I ended up having to have radiation anyway because of the lymph nodes. I'm doing rads now- only 5 left and no burning or uncomfort yet. I'm just a little tired.
I had Mx with ALND on the left and lumpectomy with SNB on the right (biopsy said cancer, final path report no cancer....). The surgery really wasn't too bad. The most painful part was having the drains. Once they came out (after 3 days) I was able to move around more easily and didn't need any more painkillers. Both the Mx and lumpectomy were a total piece of cake. What was sensitive and uncomfortable for a long time afterward was the SNB and ALND. I had some swelling on the Mx side and my arm was uncomfortable for awhile but already 2 days after the surgery I had full range of motion in both arms.
As scary as the operation seems in advance it actually is not such a big one (assuming you aren't doing reconstruction). It is on the outside of your body so they aren't fussing around with internal organs. I had a hysterectomy three years ago and it definitely took me more time to get over that. I am a musician in an orchestra and could have gone back to work 2 1/2 weeks post-op if it hadn't been for my left pectoral muscle that was cramping (probably got nicked during the op). I ended up going back 3 1/2 weeks post-op.
After having ALND you should be careful about lymphedema. Have a look at the LE threads here and see what you can do to help prevent getting it.
Just know that you are going through the very worst part of the whole journey right now. Waiting to get going with treatment and lots of decisions to be made. When you finally get the path report and the docs tell you the plan forward things will fall in place. The next months won't be alot of fun, but it isn't nearly as scarey as what you are going through now.
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This is my post from a few weeks after the operation. I posted on September 11.
http://community.breastcancer.org/forum/64/topic/739814?page=1#idx_20
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I know when I had my mastectomy 2 years ago- my daughter was in the waiting room- and she had the list of questions that I wanted her to ask the breast surgeon- she very honestly said- she doesn't like to give prelimary results until she gets the final report- as things do change- some of the tests that are done with the biopsies-takes several days- and they are not 100% proof. She had someone due a double check on the sentinel node- because of the type of dcis I had- was very high risk and appeared to have some cells that could become invasive. -it came back negative but she and my oncologist is keeping a very close eye on me.
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