Surgical excision biopsy

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Mel1969
Mel1969 Member Posts: 116
edited May 2018 in Not Diagnosed But Worried

My appt with surgeon for surgical excision of a lesion of my left breast is on monday.

Any advice on questions to ask? I have a list, just want to make sure I'm covered and don't forget anything.

How much pain should I expect and how much work will I probably miss? Lifting more than 20 pounds is a requirement of my job. I don't have much of a support system at home.

The lesion is listed as Bi-rads 4 and the core needle biopsy stated papillary lesion with recommendation for surgical biopsy excision. The lesion is at 3 oclock, 1 cm from nipple, approx 15 mm.

Just dont know what to expect.

TIA

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    Hi Mel,

    I am in a very similar situation as you. Diagnosed with ADH, 11mm, and given birads 4. I met with my surgeon earlier this week and I am waiting on insurance stuff to go through so a surgery date can be scheduled.

    From what my surgeon said, the pain is not too severe after lumpectomy- some women get by with just tylenol. She also said to take a day off following surgery, and to be careful lifting for 5-7 days.

    I know there is a lot of variation from case to case.

    Hope all goes well!!

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    Thank you. Hope all goes with yours!

    Will they be doing yours under general anesthesia?

    Did they discuss what type of incision?

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  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited August 2017

    I have had lumpectomy and re-excision. I didn't think either was particularly painful. I had planned to only take a few days off, but I found that I really did need a full week to recover from the anesthesia.  Also, you will probably have lifting restrictions. This is to help your breast heal properly and not develop pockets of trapped fluid, called seromas. Very common with breast excisions--breasts don't like to be messed with. Activity and lifting too much weight will exacerbate seroma formation. I think I remember being restricted to 10-lbs. As way of example, a gallon of milk weighs 8-lbs. 

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    I will definitely be under general anesthesia as my tumor is pretty deep. I think the incision area mostly depends on the location of your mass- not sure exactly where mine will be.

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    Thank you mustlovepoodles. I've read about lifting restrictions but didn't know about seromas. Because my job does require lifting, I am hoping to get 2 weeks off.

    I am worried about anesthesia as I had severe post op myalgia after my last procedure.

    Was your lumpectomy with a periareolar incision?

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    mystic88, your surgeon didn't discuss with you beforehand what type of incision?

    I am concerned about what the insurance will cover.. I have so many questions.. and so tired of waiting..

    Had the mammogram, received a call back letter 5 days later, had to wait 5 weeks for the repeat mamogram/US. Then 2 and half weeks for the core needle biopsy.. then almost 4 weeks for the surgical consult.. waiting is hard.

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    Mel,

    I know how frustrating the waiting is. I'm on week 6, have gone through 2 ultrasounds, CNB, and two MRIs (one breast, one brain)-

    I honestly don't remember what my surgeon said regarding the type of incision- we covered SO much information - I'm guessing based on location it will likely be periareolar. Hope to get sx date by Friday!

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    Hopefully, it all goes well. I should have a date on monday!

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    Keep us updated!! :) Hope we both get dates soon!

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    mystic88..did you get a surgery date?

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    I did!!! I go in on the 8th. Did you??

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  • jjAriz
    jjAriz Member Posts: 28
    edited August 2017

    Hi ladies,

    I'm in about the same situation. My mammogram report stated BIRADS 4C. I had an ultrasound and then a core biopsy. It came back negative, but the radiologist recommended excision of the mass. The breast surgeon is trekking during August and I can't get in to see her until September 5th. The waiting is the worst part.

    Blessings,

    Jamie

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    Hi Jamie,

    Sorry you are riding in this boat with us. What did the biopsy report say?

    I'm glad you at least have an appointment - is that for a consult or sx?

    I agree the waiting is just the WORST! It's like time slow down to a standstill.

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    Mystic88, I go on monday..hoping to get it done quickly..we will see with insurance. I'll be thinking of you on the 8th. I made the mistake of watching some utube videos of surgical incision. ouch!!

    Jaime,waiting does suck...I am trying to keep occupied. Did they identify your mass?

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  • mommakat
    mommakat Member Posts: 147
    edited August 2017

    hi ladies! Sorry we're all in similar boats! My journey started in the middle of June and my exicisional biopsy isn't until 9/20! I had negative CNB results too, but with lots of cell changes etc noted, the radiologist deemed them discordant. Does periaereola mean next to the nipple? My surgeon wasn't sure where she could go In. The suspicious area is a bit far from the nipple. All she could assure me was that she would make the cut in a small least of a noticeable place as possible. I'm getting the radiological seed place do on the 19th. So until then, more waiting!


    Best of luck to all of you with your surgeries

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    Mammakat. oh My! Why the long wait?

    My report says nothing but Birads 4, dx after CNB is papillary lesion, recommendation for surgical excision for further diagnosis.

    Periareolar is around the nipple. I'm Hoping they are able to do it for me..I won't know until Monday! Cosmetically, it heals better..but it looks so brutal( I saw it in a video).

    What is radiological seed placement?


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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    Mel: I am so glad you are getting in on Monday! Hope everything goes well- I will be sending good vibes your direction :) I too watched a lot of videos but I'm kinda used to the gore factor so I found them entertaining. Nevertheless, I am very much appreciative we will be under for the cutting.

    Mommakat: I'm sorry you have to wait to long for this. For some reason the process is really dragged out. We shall all wait together!

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  • mommakat
    mommakat Member Posts: 147
    edited August 2017

    That's just how far out the surgeon was booked! I suppose I should see it as a good sign that she was comfortable waiting this long. Trying to keep it out of my mind as much as I can or I'd go nuts.

    The seed placement is done before the surgery, to place a small radiological seed in the tissue that needs to be removed. They do it using either a mammo or U/S. It's an alternate to using the wire localization. I had never heard of it until they told me about it. Then on the day of the surgery, they'll use a little wand device to locate the signal from the seed, so they'll know where the targeted area is.

    I guess they have to do it because you can't feel where my abnormality is. There isn't a lump. Maybe if you can feel it they don't have to do either? Not sure.

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    Never heard of it..sounds better than the wire localization. Just got out of the surgeons office, he will use the wire. My lump is not palpable either. Now waiting for authorization ..this all started in june.. so frustrated and tired of waiting. I asked them to see if they could get it fast. I just want this done and over. Going through a rough patch as my relationship ended 2 weeks ago..so I am just an emotional wreck, want this to be done so I can just move forward.. one less thing to worry about.. I am confident it's going to be benign..odds are in my favor. Just trying to stay positive.😁

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  • djmammo
    djmammo Member Posts: 2,939
    edited August 2017

    The advantage of the radioactive seed localization vs. the wire localization is that it can be placed a day or two before the surgery. This eliminates the need to come to radiology an hour or more before your surgery to have the wire placed. This is especially helpful if you have an early morning OR time. It still uses a needle for placement :-(

    Click Here for more Info (PDF Version Here)

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    I am getting the wire placed just before surgery. Have to check in at 8:30 with radiology and then go to the OR.

    Mel- isn't it ridiculous sometimes? Having to wait so long to get insurance approval for this is just nuts. I think we have been waiting for the same amount of time. My sx date cannot come soon enough! I keep ticking days off of the calendar. I'm doing my best to keep busy and hope time passes faster. I'm sorry to hear about your relationship :( I'm sure your results will be benign though!!!!!

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  • herewegoagain59
    herewegoagain59 Member Posts: 13
    edited August 2017

    Yes I must agree.Ins sometimes just takes too long

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    Mystic88, The surgeon was kind and said they would try to get authorization as fast as possible. He understands the anxiety it has caused. He said as soon as they have it I could be scheduled within the week.

    We talked about margins, I wasnt pleased about how much he wants to take..he kept reassuring me that it was probably benign but insist on taking as large margin, " just in case to avoid re-excision.

    Are you filing for short term disability for work? He said I'll be out a few weeks due to my heavy lifting requirements at my job.

    Herewegoagain59, it does take to long😣

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    Mel, trust me when I saw taking larger margins is always a good idea.. it is so frustrating (and expensive!) getting results back and having to go through the process again.

    I won't be filing for short term disability, I should be able to take it easy and let my nurses do the "heavy lifting" part. Sounds like you should do it though, if your job is more physically demanding.

    Hope you get authorized soon!! It took 5 days for me.

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    What type of job do you have?

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    I'm a veterinarian! I should be able to perform exams and do simple surgeries, but will not be able to do my normal things. I'm requesting they only schedule me small dogs, cats, and pocket pets while I recover.

    How about you?

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  • Mel1969
    Mel1969 Member Posts: 116
    edited August 2017

    I am a nurse in the ICU unit at a small community hospital. I am required to turn, lift, and push patients every 2 hours. I also float to the ER and that requires pushing gurneys. I can't imagine having to perform CPR a week after!

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  • mystic88
    mystic88 Member Posts: 155
    edited August 2017

    Oh my Mel! You will definitely need to take some time off. Thankfully I can ask my staff to help out here and can have some of the other vets take over the larger dog cases-

    I agree though, you should NOT be going around CPR-ing patients a week after! I know it makes sore on any other regular day!

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  • mystic88
    mystic88 Member Posts: 155
    edited September 2017

    Mel- How are things going? Any updates?

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  • Mel1969
    Mel1969 Member Posts: 116
    edited September 2017

    No! I wanted to make a follow up for the authorization. ..but it's been super busy at work. I will call tuesday.

    Your surgery date is coming up!!

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