Stereotactic Biopsy- Help

I'm sorry you're going through this. I would ask the radiologist what options are available - they may suggest some sort of anti-anxiety medication if they don't offer a more general sedation. Honestly, I was a little surprised only a local was offered, but I did not feel my first biopsy, so it must have worked. One of the nurses kept me talking and made sure my head was turned so I could not see any part of the procedure, which was helpful.

Hi SallyPWells,

We definitely get it - it's not an easy procedure, particularly for someone with a fear of needles. Other members have mentioned being given anti-anxiety medication, and some offices do offer more sedation options for patients. We definitely second what AC1965 suggested, and talk to your doctor about what your options are, either a pre-biopsy med or something a bit stronger when it comes to sedation. Please let us know how it goes when you talk to your doctor!

The Mods

A quick word about anesthesia and sedation.

In medicine, a rule of thumb is not to employ a method of anesthesia that carries a greater health risk than the procedure for which it is being used. This is why conscious sedation (requiring IV administration) is not routinely used for breast biopsies.

Many breast biopsies are performed in outpatient facilities and they will shy away from any form of anesthesia or sedation that requires IV access and might require CPR should there be an adverse reaction. Likewise things like propofol cannot be administered by anyone but an anesthesiologist and finding one in an outpatient facility would be rare indeed and add tremendous cost to the procedure.

I have very rarely had anyone that could not be sufficiently numbed with lidocaine but many that had a degree of anxiety that accentuated the discomfort of the procedure to the point of requiring sedation. In these cases we would recommend the ordering physician prescribe oral anti-anxiety meds to be taken at home prior to the biopsy as long as someone comes with them to drive and receive discharge info for the patient. Signing the permit for the procedure may have to be done prior to sedation depending upon regulations at the facility.

I am not afraid of needles at all, and I had 3 biopsies. I was numbed with lidocaine for each and two didn't hurt at all, but one hurt a lot. It was my large, vascular looking cancer tumor. I'm pretty stoic, but it really hurt.

So my point is that if you think you'll freak out, you'll probably want at least a sedative on board in case you are unlucky enough that the biopsy hurts.

My breast center offers no sedation whatsoever.

SallyPWells

To date I haven't run across a patient with your particular concerns.

If you require being unconscious for this biopsy have it done in the breast imaging of a hospital or have a surgeon do an excisional biopsy in the OR as a short-stay patient.

Good luck.

Sara536

We can and we do. It is the rare patient that does not respond to lidocaine alone for adequate pain relief during a breast biopsy and we encountered them on average once a year.

The medical definition of "conscious sedation", the term used in the original post above, is an IV or IM sedative given along with the local anesthetic. Some patients take an oral anxiolytic (like Xanax) on the way to a breast biopsy to approximate this when performed in a typical outpatient imaging setting.

Although attached physically to the hospital, our breast imaging section was classified as an outpatient facility and therefore was not allowed to give IV sedation as it requires trained personnel and dedicated monitoring and resuscitative equipment none of which we had nor had ever needed. X-ray tech training does not include these nursing skills. I once suggested we all be trained to use nitrous oxide for IR procedures but the hospital administrators declined my request.

Although they are outpatient procedures, oral surgeons commonly use conscious sedation as their procedures require it for a majority of their patients and they have trained staff and the requisite monitoring equipment.

See: https://medlineplus.gov/ency/article/007409.htm