Wire Guided Lumpectomy
Comments
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Hello my friends,
The BS just called with the results of last week's wire-loc lumpectomy, which, by the way wasn't so bad. The diagnosis is tubular cancer. They found some very tiny spots. The good news is that we caught this at the very beginning. The bad news is that I have to have more surgery and radiation. The BS needs to take more tissue and remove 2 lymph nodes to make sure the nodes are clear. My post op appointment with the BS is next Wednesday. She's trying to schedule an appointment with a radiation oncologist the same day. I had radiation therapy in a different area 20 years ago. I'm sure it's much better now, but I don't know if I want to go through it again.
All of your e-mails and words of wisdom have helped more than I can say.
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I had this same procedure done in March. They told me they would give me something prior to surgery to make things easier. I assumed they meant prior to wire insertion. When I got to radiology they gave me nothing and did not deaden the area before inserting the wires. It was not fun! When I got to day surgery, I asked why they didn't give me something prior to inserting the wires (I had two). They said they didn't want me to be loopy and fall down or something. They wanted the wires to be in the right place. They did give me something (valium?) once I got back to day surgery prior to getting prepped for the surgical biopsy. I always felt they should have at least deadened the area before they inserted the wires as this was a very painful experience for me.
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Hi there texasmom,
Before they put the wire in, they injected a full syringe of lidocaine. I told the doctor in radiology that I had a low tolerance for pain and didn't want to feel it. I was looking the other way and only felt a little pinch when they gave me the lidocaine. The whole procedure was over in about 20 minutes. After that, I was wheeled over to the pre surgery area.
I can't believe you've had this done twice with no local. If they had told me no local, I would have said - are you nuts?
That must have been awful for you.
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I have had the wire guided lumpectomy 3 times and every time they inject me with lidocaine and made sure that I could not feel anything before they started inserting the wire. The first time I took a wheelchair to same-day surgery to prep me for the procedure, the other two times I walked to same-day surgery. That is when I got the good stuff to make me loopy.
Sheila
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I am going to have a surgical biopsy and have 2 wires inserted. I have had past reactions to lidocaine so the radiologist says he won't use any local anesthetic. I can't imagine going through such a procedure. Even if they give me valium or xanax, won't it still be painful?
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RitaRose----my wire localization was a lot of intense pressure, but no actual pain but that was directly due to the fact that I was numbed up very well. I can imagine it would be like having a cavity drilled at the dentist without any novacaine--I've had that done and it wasn't pleasant!!!! There's got to be something they can substitute for the lidocaine for you--I would question the radiologist about it in detail beforehand and make sure they have something else they can give you.
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I just had this done a month ago and seriously, it is weirder mentally than physically. I even had to take a medi-van from one location to another (don't ask) with the wire inside - felt a bit strange and you certainly won't want to wiggle around too much but it is truly not a big deal at all.
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Ritarose,
What kind of reaction did you have to the lidocaine? I had a reaction to it recently. As it was being injected the lidocaine burned like fire.
I also had a wire-guided biopsy. It was quite a few years ago but I remember it just like it was yesterday. I was put in a mammogram machine so they could see where the lump was and as they were inserting the wire (ok I am still in the mammogram machine!) I broke out in a sweat and almost passed out and they had to stop for a few minutes. They said my breast was dense and it was like trying to put the wire through a cement block. Worst experience I have ever had. No mention of numbing the area. I am sure things are alot better now with this procedure since so many ladies have responded with positive notes. So do not worry about it. I won't have to ever again because I just had a bi-lateral.
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I had two wire-guided biopsies in June 2007. For the first surgery, it was a little uncomfortable (more so the anticipation than anything) and then two weeks later I had another surgery with wire-guided biopsy. Both times injected with lidocaine....had no adverse reaction at all. Marynh is right, it is definitely more mental than physical. Initially, I found it hard to stay still since your normal reaction is to move.
Don't worry, you will come through it with flying colors.
Joyce
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Hello,
Thx for your comments. I've had reactions to lidocaine and novocaine, so the radiologist does not want use any caine. He says he doesn't know of an alternative. I'm going to talk to the surgeon on July 9th and hope she has some ideas.
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Thank you to all of you! I've never joined an on-line group before. It's great. I don't feel so alone.
I've had reactions to novocaine and lidocaine so the radiologist won't try any caine. He doesn't know of an alternative. I hope the surgeon can suggest something or order some oral pain medication, valium and whatever else she thinks will work. I'll keep you posted!
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I'm glad I read all the way down, because I thought I was the only one who had problems with the needle localization! I think it takes a lot of emotional strength to go through most of the tests/procedures, like the loc and stereotactic biopsy. First, you have to use a step ladder to climb up on a table that has a hole for your breast to hang through. And, then you have to keep yourself still, as there is not harness or anything for your arms and legs. Second, after the stereotactic biopsy I'd said I would never do anything like that again...sedation for me all the way! Never say never, as that is exactly what I had to do for the neddle loc. Finally, as my luck would have it, the clip they'd placed in during the biopsy had slipped down the track, so the wire was not at the lump. The radialogist said it was a 1 in 500 odds of that happening. I played the lottery that night hoping for good odds:-)
So, I'm saying that while they do give you lidocaine, it is a challenging procedure, laying face down on a table with an exposed part.
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The word is in --
Last Wednesday, met with the BS first. She reviewed the path results of the wire loc lumpectomy I had done on 6/12. She removed a very tiny <.1cm spot which was tubular, invasive ductal carcinoma. The next step is to go back in, clear the margins and do SLN. She then went on to explain the procedure for SLN. Didn't sound too bad. Her recommendation after that was either rads or mastectomy. Again, pease keep in mind, that this was caught at the very beginning, so the tumor was very very small. Asked her why rads? Response was to kill any cells that just might be floating around. Because of my experience with rads 20 years ago, I told her I am pretty much against it. She told me to talk to the rad oncologist (who I had an appt with right after meeting with her) before making any final decisions. The rad oncologist that I was seeing is one of the top ones at the hosital I go to in Boston. Before telling about that appt, I'll give you my history for those of you that are new or catching up.
When I was 29, I was diganosed with an undifferetiated carcinoma, right side, neck area. Grew a tumor the size of a grapefruit literally overnight. Went right into Boston to meet with specialists. They could find no reason this had happened. So, I did about 39 radiation treatments and six month of chemo. For chemo, I had to have a 24/7 five day infusion, so off for a hospital stay in Boston once a month. The ages of my kids at the time were 2 and 3 1/2. Those treatments were the worst thing in my life. After treatments ended, took about 3 more months to start feeling somewhat human again. After that, it was follow up visits and cat scans for about five years. All was good.
Then, in 2004, developed a malignant tumor, right shoulder, soft tissue in the muscle. Had it removed and back to Boston. The doctor is the chief of staff of orthopedic oncology at Beth Israel. He is one of the finest doctors I've ever met on my life. During that time, my case was constantly being reviewed by the tumor board at Beth Israel and Mass General. It was decided to monitor me with MRIs and PetScans. In early 2005, I grew 2 more tumors side by side, rt shoulder area again, each was the size of an egg. Had another operation to remove the tumors and have muscle replacement (took some from the left side). I am very small, so there wasn't any muscle left on the right side for the doctor to close me up. It was major surgery and I was out of work for one month. Several doctors felt that the reason why I was growing these tumors COULD have been a post radiation effect, BUT no one lived more than 5 to 10 years after having what I did when I was 29 so they could not be 100% positive. Late 2005, grew another tumor, same area. And, just to add to the fun, I had a hole in my shoulder the size of a dime. My scapula bone had broken through the skin. So -- January 2006 had surgery again. They removed the tumor and trimmed the scapula and sewed me up again. I jokingly say that my back looks like a road map. Since then, all my MRIs have been clear with no sign of activity in the shoulder area. Last visit with the ortho doctor was December 07 and he gave me the good news that I didn't have to have another MRI for a year.
I had my first mammo in years February '08. It showed some suspicious calcifications in the Left breast. Since I certainly wasn't going to mess around with the local area doctors, back to Boston I go.Called the ortho doc and had him recommend me to the best breast surgeon at Beth Israel. Also made sure that they pulled all my records from 20 years ago for reference.
Had stereotactic in April which was inconclusive (they didn't get enough samples to get a tru diagnosis). Wire loc lumpectomy on 6/12.
So --- Met with rad oncologist last Wednesday. Funny thing was he remembered me from an appt I had in January '05. I guess I made an impression..
.We discussed my history and especially my experience with rads 20 years ago. I can still remember not being able to swallow anything more than jello or ice cream. My throat was so sore at the time and red, it resembled raw meat. We then discussed the chances of recurrence with mastectomy - 1%, radiation - 5%, no mast or rads - 35%. Also talked about possible harm to heart, lung, chest wall. He said they angle the beam from the side, so the possible harm to those areas was small. Told him how I had read that some women that were exposed to large amounts of radiation at a younger age could develop breast cancer. He said that since I had received rads to right side and was shielded, the chance was slim. He said I possibly could have received a little due to my age at the time, happens more with younger people. I made it very clear that I didn't want the rads and needed to be convinced otherwise. The doc said that in MOST women he would say get the mastectomy. Here's where it gets good. Told him that I didn't think I needed to do that either. Let's face it, I've been living for the most part on borrowed time for quite a few years. I'm not ready to lose my breast at the age of 49. So, what did he think about me taking my chances and being one of the 65% with no recurrence after no treatment? With my lousy luck, I'd probably end up being one of the few that developed complications with the heart or lung. Told him that if I was lucky enough to turn 65 and something happened, I'd do a mastectomy then. At this stage in my life, I'm not ready to lose the breast. I know that rad therapy has come a long way in 20 years, but I just don't want to take a chance with possible complications for obvious reasons.
Sooooo, he greed and felt good about the decision. We talked about hormone therapy too. He said that if a 65 year old woman with my history had what I do, he would not recommend rads, but would have her do Tamoxifen. Since I have somewhat of a special history, he will be recommending I do the Tamoxifen and will refer to the specialist for that at Beth Israel.I also told him that after having the SLN, if it comes back positive, I may reconsider. After reviewing the path reports, he feels that the result will very likely be negative - but definitely have the node tested and clear the margins.
After all of this - he said he feels comfortable recommending hormone therapy and no rads. He'll let the breast surgeon know about all of this. I honestly think she was waiting to hear what he had to say.
So, I have an appt with the BS this coming Wednesday to discuss the next surgery and get that scheduled. I'd liked to get it done ASAP, so it will probably be early July.
I know this post has been extremely long, but I wanted to share the story. I know there are women out there that have had rads before and may have similar feelings about getting zapped again. I'd love to hear back from anyone else that has had rads before.
All my prayers and best wishes to everyone during the journey.
Rafaela
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Sounds like you have the same luck as me. I had my first lumpectomy in Sept. 07. After the surgery, pathology couldn't find the marker/clip . Two days later went for a mammo and they could see the marker so they weren't sure if it move or not during surgery. My BS being very conservative decided to go back in in two weeks, clear more margin and find the marker. Both times margins came back clear and marker found in second surgery. The pathologist/radiologist/surgeon said it has never happened to them before. Finished rads in November 07, been on tamoxifen for 5 months and just went for f/u tests.....waiting for results.
Joyce
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I recently had 3 stereotactic biopsies done. Now on the 4th lump I have I need to had a needle Loc done 6/4/2009. Very nervous about the anestesia. does anyone know how long the procedure takes? Thanks
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Hi there just had needle loc and lumpectomy done 5 days ago and for me the wire loc was less painful and uncomfortable then the core biopsy. They numbed me up and then stuck a small needle in the spot where the marker was, then did mammogram to check position, then threaded very thin wire through the needle, felt odd but not painful at all, then back for another mammo. The mammo's where the worst part, I got a bit dizzy probably because I hadnt eaten or drank anything for 10 hours! Dont worry about the wire loc sounds way worse than it is. And my lumpecctomy site was less swollen than biopsy but I did bleed quite a bit during biopsy. Anyway I too was nervous but it was over before I knew what they were doing. If you are very anxious you might ask if you can get a xanax or somthing for before procedure. I got one but didnt take or need it and Im a chicken!
Good Luck.
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My wire localization procedure took almost an hour, but that was because the area of concern was in a difficult spot, way up into my armpit almost. The hardest part was sitting so still for so long with my head turned to the side. But they numbed me up really well,so it didn't hurt, just a lot of pressure.
Anne
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I'm the world's biggest chicken and I survived a wire localization. While the surgeon was doing his thing, one of the techicians stood behind and held me. Took maybe 10 - 15 minutes (seemed like eternity). After they covered it so I would not have to see it. Taken by wheelchair upstairs to wait for my surgery.
Not a pleasant experience but if you have had a biopsy this is not really different.
Good luck
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I am scheduled for my wireguided Lumpectomy on !2/29/09 I have just read all the blogs and I feel pretty good about it. The stereotactic bx was a breeze the worst was the days following, but the procedure was no problem. Thanks for posting you experences for me to read. Happy Holidays to All
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It was really not a big deal at all. I felt a pinch but that was it. I even looked at pictures of the nurse's grandkids right beforehand. The hardest part is the wait between the wire placement and the actual surgery. There were two of us women waiting to be taken back down to the OR prep area, with our styrofoam cups placed over our breasts and under our gowns - we had never met before, but we were placed next to each other in our wheelchairs and spontaneously reached for each other and held hands. It was clear that we are of different religions, but I surely appreciated her prayer for me, it meant a lot - I still get tears in my eyes thinking about it. I often wonder what her surgery revealed and how she is doing. All the best to you, Rafaela.
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I have read comments on here about the pain endured while having the wire inserted but thought i would share my experience of when i had this procedure yesterday.First of all i was told that i would have to have my wire inserted in one breast clinic and travel to another hospital to have the lumpectomy operation!!!Nice eh? I was very worried and felt sick and shakey of the thought of a WIRE being pierced into my breast but the radiologist was very nice and gave me 2 injections to numb the area whilst a nurse was kindly speaking to me to take my mind off of it. Then the wire was inserted and i can honestly say that there was no pain, it was just a pulling sensation and very bearable.I must admit though i didnt want to look! Then i had a mammogram to make sure the wire was in the correct position.All being well i then travelled to another hospital ( i was told to get a bus if didnt have transport which i can honestly say there was no way i was in a fit state of mind to get on a bus with a wire sticking out of my breast).
Once i arrived at hospital the staff were very nice and prepared me for my operation,which was all plain sailing.I must admit i was a LITTLE uncomfortable after but nothing like id imagined id be like!!I had the op at 11am and came back to the ward about 1.30pm after recovery etc..
Once id shown them i could drink and wee i could go home with pain killers,which was about 6.30pm. At home i was totally pain free and can HONESTLY say from my experience that it is nothing to worry about,i know its easier said than done, and if i can do it anyone can!!!lol.
If anyone needs any quwstions to answer or help, then if i can, i would be only too happy to,
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i had this procedure done and was very little discomfort............
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I had that done 2 years ago and in between that and my surgery they put blue die in . I didn't have surgery until later that afternoon so me and my family went out to lunch. I couldn't eat but was feeding my 9 month old granddaughter. I don't remember it being so bad.
Nancy
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A year ago I had the wire inserted in 4 places in my breasts for surgery...two in each breast. All were fine except one on my left breast and it wasn't the wire but the mammogram afterward that hurt because a hematoma had formed since the needle biopsy of that breast.
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I have just had a wire guided lumpectomy yesterday and I think I can give some really useful advice. Firstly let me tell you I did not feel a single thing and I was absolutely terrified when I first heard about the procedure.
This was my strategy.
1. I put copious amounts of EMLA cream over the breast two hours before the procedure. This numbs the skin.
2. I took 2 Panadol extra strength and 5mg of diazapam an hour before. My GP told me I could have also added some codeine but I didn't want to.
3. I INSISTED that the doctor gave me some local even though he said they don't normally. I did not feel that becasue the EMLA cream numbs the area.
4. I took my I tunes and stuck the ear phones in and thought about something else.
5. The procedure only took about 5 mins to put the wire in and the x rays a bit longer.
6. I had to be driven to another location for the OP but felt nothing of the wire in place.
7. I also put EMLA on the site the anesthetist was going to use to put me to sleep so I didn't feel that either.
8. I asked for plenty of stuff to stop me being sick and I didnt even feel sick.
I also asked the surgeon to inject local into the site while I was asleep so I did not wake in any pain at all.
9. Today I have had practically no discomfort, have taken a couple of Panadol and gone about my normal daily activites.
Obvioulsy it is a very anxious wait for the results but there is not much I can do about that...afraid EMLA doesnt work for that! I hope someone reading this will benefit from my experiences.
As an aside I had to pay in advance and on the receipt it said "Insertion of hook wire" Now I ask you....how is that to make you terrified!!?? Let's rename the thing a "guide thread" That doesn't sound so bad does it?!
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Hi, I'm scheduled for a wire-guided lumpectomy tomorrow at 12:30. They've scheduled me to stay overnight and I wondered if that's the usual protocol or not.
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Mine was out-patient. Why do they want to keep you?
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I've had four wire-guided lumpectomies on the same breast, and two additional lumpectomies on that same breast. I've never stayed overnight, but I was always given conscious sedation by IV (propofol cocktail), not general anesthesia, although some women on these threads have had general anesthesia. The difference is that you are intubated (tube put in) for breathing and the muscles are temporarily paralyzed for general anesthesia. Conscious sedation just knocks you out (you have an oxygen canula, but not a breathing tube). The only reason I'd see for an overnight stay would be either recovery from general anesthesia or some high risk health condition (risk of bleeding, etc.)
None of the surgeries was ever a big deal. Recovered quickly and returned to exercise in a few days. I actually had more discomfort from a stereotactic biopsy.
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I had a two-wire LX because my lumps had disappeared during chemo and the only things visible under the mammo were the two small biopsy markers.
I had general anesthesia, but with a mask. I was given my choice of tube or mask, and because I have a few loose teeth (and wouldn't appreciate a scratchy throat or missing teeth the next day), I went with the mask. The anesthesiologist said "okay, here's the mask" -- and swung it over to me-- and said "put it on." That was the last thing I remember, pushing it down on my face.
They did not keep me overnight. I think they had been forewarned that I was a pain in the butt.
Carol
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I will be getting this type of surgery done, hopefully, in February 2019, after I finish up my TCHP. I had an ultrasound about 2 weeks ago and my tumors have shrunk enough they will use this wire. If anyone would like to update their status, I would appreciate any advice on lumpectomies, node removal, lymphedema, radiation, or whatever you might be willing to share with me. I believe I will have a year of Herceptin following chemo and perhaps Perjeta as well. That is as much as I know at this date. Thank you for all you strong warriors that are here to help those of us going down this path, you are appreciated. Lisa
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