Vacuum Assisted Biopsy

Deb_B · July 2016

I got a letter from the insurance company telling me the following tests have been approved :

(I haven't heard from my new GYN at all nor have I been given any results from my magnified / compression images done on the 7/8/16)

77031C+ - SCNB - VACUUM ASSISTED LT X 1

19081 (CPT®) - BIOPSY, BREAST, W PLCMT OF BREAST LOCAL DEVICE(S) & IMAGING OF THE BIOPSY SPEC, PERCU; FIRST LESION

77031H+ - SCNB - VACUUM ASSISTED RT X 2

19081 (CPT®) - BIOPSY, BREAST, W PLCMT OF BREAST LOCAL DEVICE(S) & IMAGING OF THE BIOPSY SPEC, PERCU; FIRST LESION

19082 (CPT®) - BIOPSY, BREAST EA ADDL LESION, INCL STEREOTACTIC GUIDE

I am calling the breast center myself tomorrow since no one in my GYN's office has bothered to call me at all since my mammo on the 15th of June. Since the tests are approved I will just make the appointment myself. This is really aggravating me.

Has anyone had one of these vacuum assisted biopsies done? How do they feel in comparison to a normal FNA or Core Needle biopsy?

Thanks for sharing

Deb

marie5890 · July 2016

Hi Deb,

If I am understanding that right, you have been approved for stereotactic core needle biopsy, which is vacuum assisted. At least mine was. This is where you are laying on your stomach on a special kind of table with your breast hanging down thru holes. They use x-ray technology to get the right area(s). It can be kind of uncomfortable, physically, because you have to stay in a certain position as the core needle is guided by the machine. Core needle takes bigger and multiple samples (my took 8 samples) vs FNA, so less chance of missing the area, and a great sample size.

My experience wasn't awful, just somewhat uncomfortable for having to stay in that one position for 20 mins or so (which was probably made complicated by my being a chair mobile paraplegic. Laying on my stomach in a comfortable manner is impossible int he first place due to my deformed legs, hips and back) . Most women do ok.

marie5890 · July 2016

Oh forgot to explain that

"SCNB - VACUUM ASSISTED"= SCNB means Stereotactic Core Needle Biopsy- vacuum assisted.

Hope that helps

Deb_B · July 2016

Thanks. I am rather large breasted and have never had an easy time laying on my stomach. I wonder if the table has 2 holes for both breasts. lol

I had biopsies done on my thyroid (8 nodules)12 days ago that came back benign (notified today) and I still have constant pain from that. I'm supposed to have a Thyroidectomy soon. I don't know if all this breast stuff will interfere with the thyroid surgery.

Did you have any pain afterwards? Did it last very long?

marie5890 · July 2016

CONGRATS on the B9 results for your thyroid. Hope the the surgery goes smoothly and uncomplicated.

They advise you to take tylenol for pain if need be, and they do send you home with small ices packs to tuck in your bra(use them to keep the swelling down). I also recommend something like a sports bra , or one that is more comfortable. It looks like you have 3 areas to be biopsied, so you may be in more discomfort in comparison to someone like me, who only had one area. But again, keep up with the ice packs. They will help because it's the swelling that will be the greater cause for discomfort, post-biopsy.

For me, no, there was no pain afterwards, and I didn't need any tylenol, but I did use the ices packs for about 12 hours. Again, I only had one area to be biopsied, BUT it was near the chest wall, which can be harder to get at. Every woman can have a different experience, though. With the SCNB, the vast majority do ok, however.

Deb_B · July 2016

Thank you so much for sharing your experience with me. My 17 year old daughter had a Core Needle Biopsy last month and she had a lot of pain afterwards so I was just wondering. I personally have a high tolerance to pain so I am sure I will handle it. I'm just one of those people that like to be prepared for whats coming.

muska · July 2016

Hi Dev, I was diagnosed by SCNB. I was large breasted too and they had to take two samples from different quadrants. They weren't sure I would be able to handle two biopsies one after another but I did. It wasn't the most pleasant experience to say the least but it is a very efficient procedure in terms of finding the lesions. They put tiny markers into the breast where the tissue was taken and do a quick mammo after the procedure to see that the markers are where they are supposed to be and everything is fine.

I had no pain or issues after the biopsies whatsoever. Everything healed very quickly and there were almost no marks left on the breast, so it was quite a disappointment to have the breast removed altogether soon thereafter.

Deb_B · July 2016

it's seems the radiologist recommend 3 in my right breast and 1 in my left but they are only doing 2 in my right breast and the one in my left.

I called and asked about the difference between the orders and the radiologist report. Apparently the radiologist and a breast specialist got together and made this change.

Shouldn't they have included me in this discussion? Or is this a normal accurance?

muska · July 2016

Hi Deb, you somehow learned about the change of plan, right? So some communication is happening. I would recommend not getting too upset about some gap in communication and your being left out of doctors discussions - happens quite often - but rather focus on the positives and be glad they are talking to each other. That being said if you have any questions about the procedure you should call and ask. Three biopsies on the same day is not easy. Good luck!

Deb_B · July 2016

I was never talked to at all. I only noticed the difference because I got a hard copy of the report and a disk with the images. Not once has my Gyn called or sent me a letter through the back office at MyKelsey. My old GYN who is not on my insurance anymore always communicated with me. I guess I was spoiled by a doc that was right there with me.

They haven't diagnosed me or even done the biopsies, yet they assigned me a Breast Cancer Team today. So I do NOW have someone to talk to but it does make me worry more knowing I have a "BC Team" assigned.

I know my report stated BRAIDS 4 so there is a good chance that this is not BC and that is what I tell myself when I start worrying to much.

marie5890 · July 2016

Deb, if you feel like sharing, exactly what does the radiologist report say?

cuddyclothes · July 2016

Hi -

Last year I had several core biopsies. They were very unpleasant - the comparison that comes to mind is a staple gun. There wasn't much pain because of local anesthesia. I can't remember whether or not it hurt afterwards.

In June I had a follow-up MRI, which revealed a new lesion in my right breast. So first I had diagnostic mammos, then an MRI-guided stereotactic vacuum biopsy.

I was first put on the MRI table face down, with my arms arranged above my head, and one breast hanging through one side of the table. A large plate was placed on my back to keep me from moving, and my face rested on one of those padded circles you see on massage tables. First they slid me in to get an exact picture, slid me out, I was told not to move. After a while they came back, and I'm a bit fuzzy about this next bit because they gave me a lot of anti-anxiety meds. I didn't feel much of anything, mostly twinges. They did two biopsies. Afterwards Tylenol took care of the minor pain. My breast looked like a Picasso for DAYS. Here's a photo several weeks out:

Most of the tissue looked fine, but there are some abnormal cells. Yesterday I had an excisional biopsy, which I gather is the same as a lumpectomy. I had that on my left breast last year. There's been little or no pain since.

Make sure your medical oncologist tells you everything. You should be kept well-informed at every step of the way. Also, ask a friend to come with you, because you won't hear half of what you're being told.

The MRI biopsy was extremely unpleasant but hardly the worse thing in the world. Good luck!

marie5890 · July 2016

Cuddy, Im not sure if you are aware of this, but it's a rule violation to post pictures like this. Im guessing it has to do with legal concerns

Deb_B · July 2016

marie5890 I don't mind sharing the report at all. Ya'll know a lot more than I do and Dr. Google doesn't help much. So much conflicting information.

First mammogram was done on 6/15/16. This is the results from the spot compression magnification one on 7/8/16. They found a third area on my right breast during this mammo.

Radiologist Report

Bilateral diagnostic mammogram: 7/8/16.

Clinical: Abnormal mammogram.

Comment: Diagnostic digital mammography was performed and interpreted with the assistance of computer-aided detection (R2).

The patient returned for additional imaging of both breasts. Spot compression magnification views were performed at the site of microcalcifications.

Within the right breast, three groups of indeterminate microcalcifications were seen.

The first group is upper outer quadrant anterior third.

Second group is lower outer quadrant anterior third.

Third group is upper-outer quadrant posterior third.

Recommendation is for stereotactic biopsy of all three groups.

Within the upper outer quadrant anterior third of the left breast, there is one group of indeterminate microcalcifications.

Recommendation is for stereotactic biopsy.

Impression: Three right and one left groups of indeterminate microcalcifications.

Recommendation is for stereotactic biopsy. BI-RADS 4, bilaterally.

Note: The report was called to the Breast Diagnostic Clinic on 7/8/16 at 2:00p.m.

Diana Robinson was notified of the BI-RADS classification.

cuddyclothes thank you for sharing your experience with me. I believe they are using the mammogram machine to guide my biopsies. My advocate stated that they did not think that I could handle having 1 on the left breast and 3 done on the right breast in one day. I am on meds for my blood disorder and diabetes that I have to be off of for a week before they do the biopsies. So I have to wait until the 21st to get this done.

I have an hour appt with a breast specialist followed by the left breast (1 hour) and then the right (1.5 - 2 hours). It is going to be a long long day. At this point I am driving myself so no anti anxiety meds for me until I get home.

Mixed with all this I am dealing with 8 nodules on my thyroid which thankfully came back benign (biopsies on 6/30/16) and Hashimoto's disease. I am pretty much hyperthyroid right now. I have an appt on 8/10/16 to discuss having my thyroid removed. It is so large and swollen that I have a hard time breathing when I lay down which throws me into a panic attack. I just don't know how this will all work out. I pray the breast docs don't want to put me in a MRI machine. The only good thing that has happened is that I have lost 46 pounds in the last 6 months with no effort on my part.

marie5890 · July 2016

MMmm, they didn't really write in any great detail, did they? Just "indeterminate microcals".......Are these new in comparison to previous mammos, or showing a change? (forgive me if you have mentioned this in previous posts)...

I can understand why they are asking for biopsies, but try to take comfort in that they didn't describe them as "clustered" or "linear". Words like that are more concerning. Im not saying that there is nothing for you to be concerned about at this point, just that the report is in a grey area of concern.

I know you are very familiar with medical issues and the anxiety and fretting that can come with all of that. Try your best to stay busy (but not researching anything to do with this) for now. Deal with one thing at a time. Take heart that the Dr's want to get an definitive answer for you.

Deb_B · July 2016

These are all new areas. I've never had calcifications before. But no... they are not sharing much in the reports. I have heterogeneously dense breasts so I don't know if that makes it harder for them to see. I picked up the disk so I could look at the images. Most are the the shape of a Y and some, as my hubby says, looks like broccoli. lol I hate broccoli. Not being a radiologist I don't know if it means anything at all. That is just what shape some looked like to me.

My mom had DCIS and chose a bilateral mastectomy with no recurrence. Her older sister also had DCIS (I don't know what treatments she chose) and her baby sister died from invasive breast cancer at 52. Her and my father had cancer (lung) at the same time. When my dad passed away I think she just gave up. They were cancer buddies and gave each other hope and strength. I'm trying to keep a good attitude because statistics for BRAID 4 being benign are pretty good.

Deb_B · July 2016

These are all new areas. I've never had calcifications before. But no... they are not sharing much in the reports. I have heterogeneously dense breasts so I don't know if that makes it harder for them to see. I picked up the disk so I could look at the images. Most are the the shape of a Y and some, as my hubby says, looks like broccoli. lol I hate broccoli. Not being a radiologist I don't know if it means anything at all. That is just what shape some looked like to me.

My mom had DCIS and chose a bilateral mastectomy with no recurrence. Her older sister also had DCIS (I don't know what treatments she chose) and her baby sister died from invasive breast cancer at 52. Her and my father had cancer (lung) at the same time. When my dad passed away I think she just gave up. They were cancer buddies and gave each other hope and strength. I'm trying to keep a good attitude because statistics for BRAID 4 being benign are pretty good.

Vacuum Assisted Biopsy

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