Scared about upcoming Surgery don't know what to Expect
Hi Everyone. I just joined the site today and I have so many unanswered questions. I have been reading different posts, but most, that I have seen, are older or for different things.
A little backstory. I am 31 and I have had a full hysterectomy about 4 years ago and am currently taking hormones daily. A few months ago, I found a lump in my right breast. I waited a few weeks to see if it would go away, but it didn't and it started to feel a little bigger. So, I went to my doctor and he ordered a mammogram and an ultrasound for the next day. They had a hard time seeing anything in the mammogram due to me having very dense breast tissue and they had trouble finding the lump in the ultrasound. They said it was too deep. So they referred me to a surgeon. I went to my appointment, with the surgeon, about 2 weeks ago and the only option he gave me was to have surgery to have it removed. My surgery is scheduled for next Thursday, 08/10/2017, and I am freaking out. I was in such shock, at my appointment, that I didn't ask many questions. My mind went blank. I wasn't expecting to have to have surgery and so soon.
I have no idea what to expect and why I'm having to have it removed. I only took the day of surgery off of work. Will I need more than that? How bad is the pain after? Any tips on preparing for the surgery and following the surgery?
Any advise would be greatly appreciated. I do not know anyone who has ever had this done and I'm terrified.
Comments
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did he give a reason as to why he wouldn't/couldn't do a needle or core needle biopsy? i'm new, so i don't know if there's an explanation for this circumstance that i haven't learned yet, but someone with much more knowledge than i will be able to answer you.
one thing i do know, is that it's ok to get a 2nd opinion. and i think you've got time to do that.
i hear you on the fear, especially when you don't know what to expect. you've landed in the right place to get answers tho.
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Lilt, I think they need to give you more information before you let them do surgery on you. Typically a lump would be biopsied to determine what it is before any surgery would occur. Maybe yours is too deep to be biopsied, if that's even possible. I'd write down all of the questions you want to ask ahead of time, and make an appointment to talk to the surgeon/your doctor before surgery. You may want to bring someone who is close to you and detail-oriented to take notes/advocate for you, because it can be very surreal to receive a bunch of medical information while in your mind you are imagining the effect the information will have on your life. Of course you were in shock at your appointment and didn't ask many questions! As professionals, they should have realized that and slowed things down.
As far as questions about time off and pain-I personally would plan to take more than a day off, and I did not have pain with my mastectomy, but many do. Maybe they are planning to do a lumpectomy, which I do not have experience with. It is different for everyone.
Good luck, and don't let them steamroll you!
L.
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Agreed!
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Hi lilt,
I'm guessing they're planning a surgical biopsy (which is often just like a lumpectomy), but since you haven't been diagnosed with cancer, the purpose of the procedure is to find out what your lump is, not to remove it with an appropriate margin. Call your surgeon's office and speak with their scheduler, assistant, nurse, or whomever. Tell the person who answers the phone that you have questions about your scheduled surgery and need to speak with someone about your questions.
Talk to your primary care doc (who sent you for imaging) and ask if the surgeon the imaging people sent you to is a specialist in breast surgery. And if that is who he/she would recommend. It's possible that the surgeon is an excellent surgeon who focuses on breast cancer surgery (what you want) but is a lousy communicator. Docs who have that problem frequently have someone in their office to help with those things.
But in any case, you're entitled to understand what they recommend and why they recommend it. And your primary care doc should be in your corner in figuring this out!
Also ask your primary care doc for a referral for a second opinion to a large university-affiliated breast cancer program, or an NCIC designated breast cancer center. It's possible that a breast specialist in a specialist facility will be able to do a less invasive biopsy procedure. And if so, it would be nice to avoid an open surgical biopsy intended to just figure out "what's what."
Finally, have you signed any consent docs yet? If so, take a look at it and see exactly what it says you've agreed they can do. If not, ask the surgeon's office for a copy of the consent doc, so that you can review it at your leisure.
Take a deep breath and make some phone calls.
HTH,
LisaAlissa
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Thank you all for your advise. I have not signed anything yet. My understanding of the surgery is due to location and size, but I'm not 100% on that. My husband is set on wanting me to have the surgery to ensure it is tested properly and nothing is missed. Breast Cancer runs on my mom's side of the family.
Any advice on clothing or anything I may need for after?
I have talked to more than one doctor about it and the other doctor advised that a needle biopsy wasn't an option, but did not explain why.
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Hi Lilt, I was in the same boat and had a lumpectomy - biopsy. My lump was in a position that they couldn't biopsy it. I agree with the others to get more details on what the surgery is, what exactly are they doing so you can prepare for the post surgery. There are many options they can do... you need to know which one. - "Surgery" isn't enough answer.
Things like - are they going to just biopsy - or lumpectomy - or check lymph nodes - Just because cancer runs on your side of the family, doesn't mean you have it. Believe me, it is the luck of the draw - so to speak.
Hugs to you and remember to breathe.... You will get through it and it will be ok. As far as clothing - button in the front shirts - you won't want to pull things over your head for a bit. Just cotton front close bras no underwires - but be aware, depending on what they are doing you will be a bit swollen so don't overstock on stuff - use what you have until you know how thing go. Hope this helps.
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lilt1841: Did you have a breast MRI?
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No. They only did the mammogram and the ultrasound.
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lilt1841: You really should have a breast MRI before breast surgery.
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What will the MRI show?
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A breast MRI will (should) show the tumor and any other areas of concern. Will also show the lymph nodes.
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bellasMom is right. MRI can "see" areas that mammo and us can't. It isn't a biopsy, but it could give lots more information about the finding. Going in "blind" doesn't feel very comforting in this situation.
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Thank you for the feedback. I will ask about it and see if it is an option.
If I do have to continue with the surgery... what kind of anesthesia would be best (general or local)? The dr said I could do either.
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I always opt for general if given the chance, but I've never had a problem with general anaesthetics. If you tend to vomit or have other bad reactions to a general, you need to weigh the pros and cons. If you have no experience with it an don't know how you'd react, it seems that in the past 10 year or so that the drugs they use now tend to have fewer side effects. Hope this helps.
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lilt, there are very different risk profiles to general vs local anesthetic. The recommendation for which you should use, IMO, should come from someone with knowledge of those risks considered along with your specific medical history (comorbid conditions, age etc). Is it just me that finds it odd your surgeon is putting that choice in your hands without the proper risk information? If they are doing a surgical biopsy, I would want to know how often do they do this on breasts (back to LisaAlissa's point about the surgeon having expertise in breast surgery) and what they typically use in those situations for anesthetic. For a core needle or fna, it is typical for a local to be used as the risk of general does not outweigh any benefit, but I guess I'm still not clear on exactly what kind of procedure he's talking about. How long would it take? How much tissue does he expect to remove?
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I have had general before with no complications. I have had 4 previous surgeries all with general.
He said I will have the option. Said both will work fine. I have read that the pain after is better if done with general. Not sure how much of that is true or not.
He said the surgery will take about 45 mins. He is unsure about the amount of tissue that will be removed because it was hard to measure the size of the lump. He also stated that there would be a possibility of him having to remove lump nodes, but that would depend on how the lump and things inside look.
I have done a lot of research on the surgeon and he has amazing reviews. A lot of this is my fault. I didn't know what to ask. He did over risks from surgery and anesthesia. But I was in too much shock to keep asking questions.
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I just want to put it out there that sometimes an MRI won't see a cancer, it completely missed the one I have now
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Thank you Bella
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It is NOT your fault that you didn't know the right questions to ask! It is the responsibility of the caregivers to explain what they are going to do and why, and to answer any questions. Good caregivers get that you don't always know the right questions to ask and will explain (or ask someone on their staff to do so).
I agree that you should call the office and ask the questions; say you are confused and you need more information! I also would NOT sign a consent form without more info, especially where the doc said he or she wouldn't know what they are taking out till they 'get in there', especially since you do not have a cancer diagnosis. Keep in mind that they won't be able to definitely tell by looking at the lump tissue whether or not the lump is cancerous, they will need the pathology (biopsy) results for that information. Regardless of how your well regarded your surgeon is, if he or she does not specialize in breast cancer, it is my opinion he or she is NOT the right surgeon for you. (I'd say that is almost always true but especially in your case where there is not yet a diagnosis).
Hugs to you!
p.s. Your hubby is of course anxious, but regardless you shouldn't have surgery without understanding what it is and why it is needed. Ask him if he can help by taking notes when you talk to the doc.
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With very dense breasts an MRI should be approved by insurance. I had mine done and had surgery two days later so they can get results back fast. I did not have a biopsy but my mammo and ultrasound said even if a biopsy came back negative they would still want to do a lumpectomy, so there wasn't any reason to go through the biopsy process, for me. Not sure what the wording was on your mammo and ultrasound. Did they give it a bi-rads rating?
I had my lumpectomy on a Friday and went back to work on Monday, but everybody is different. You may need to take Thursday and Friday off.
The best thing the doctor gave me was an ace bandage with a Velcro closure that I could use to bind around my breasts, that thing was great.
Hugs, hoping for the best.
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I know someone who was in your same situation , had the mass removed and it was B9 here's the kicker her insurance denied it and is paying nothing because they deemed it unnecessary. I do agree with what the other ladies it's not your fault and call and ask more questions. Can they do an MRI guided biopsy ? An MRI will give you more information but it is not perfect it missed the tumors in my lymph nodes and one in my breast butt it will give you more information than you have currretly.
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Her insurance denied it???
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Just wanted to post my update ::
I couldn't have the needle biopsy due to not being able to see the lump on ultrasound or mammogram. The dr said that most insurance companies will deny the MRI and if approved, it would take weeks, so we went ahead with the surgery last Thursday.
He removed 2 large lumps and found several more small ones that he left alone. He didn't want to remove too much tissue without knowing what it was. My incision is about 3 inches and I still have a lot of swelling, but healing nicely.
I had my follow-up appointment this morning and got my B9 results!!!!
Thank you all for your advice and kind words.
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Congrats, lilt! It's great to hear that they were benign, especially since you are so young.
Thank you for updating us.
Trish
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Re: anesthesia. I had four excisional biopsies done over a period of 40 years - three under local anesthetic, one under general because the lump was so deep. Since your lump is deep, you might be more comfortable afterwards with general. I had zero pain after the general biopsy, I think because I was relaxed under anesthesia as opposed to tense while listening to what they were doing. But I agree with what the others have said - call the surgeon's office, talk with the scheduler and find out just what they are planning to do.
MJ
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