2nd opinion form used for breast biopsy

[crazybusymom]

I am 40 yrs old and had my 1st mamo. approx. 3 wks ago.  Went  for additonal mamo and ultrasound due to a spot approx. 1 mm spot in R breast w/ uneven edges. The radiologist recommended I have a mamotone biopsy done but surgeon wants to do incisional biopsy.  Said spot was too large and only does mamotones for calcifications.  Have scheduled the incisional biopsy in 1-1/2 wks. w/ a general surgeon.  Have a few questions:

1.  Should I get a 2nd opinion on type of biopsy performed?

2.  What do the eneven edges of the mass indicate?

3.  Since I live approx. 1 hr. away from 2 well know cancer ctrs., should I be seeing them prior to having the biopsy or have the biopsy for my peace of mind and go to the cancer centers after the biopsys?  An appt. will take almost 1 month and I'm not sure I want to live w/ the uncertainty that much longer.

Any opinion would be greatly appreciated.

[CCF-RN,MSN-JS]

Dear crazybusymom, There are many types of biopsy procedures.  The types range from a fine needle aspiration which is a non-surgical form of breast biopsy in which a small needle is used to withdraw a sample of cells from the breast lump, to an open excisional biopsy in which an entire mass is removed.  The type of biopsy recommended depends on how large the breast lump or abnormal area is; where in the breast it is located; how many lumps or abnormal areas, such as suspicious calcifications, are present.

A surgical biopsy often involves two steps.  The first step is a needle localization, in which prior to the surgical incision, the areas of calcification or abnormal area are located via mammogram, then a thread like needle is inserted (after cleansing and numbing the area) into the breast to mark the location.  The next step now that the location is tagged, is the surgical removal of area of calcified tissue.  The tissue is then studied under a microscope.  If a rim of normal breast tissue is taken all the way around a lump/or this area, biopsy can also serve as part of breast cancer treatment (if cancer is found).

An alternative to surgery for biopsy is minimally invasive breast biopsy.  Minimally invasive breast biopsy can be done using computer-generated images to locate breast abnormalities, and by accurately pinpointing and mapping the area to be biopsied, a tissue sample can be gathered without making a large incision.  The Mammotome is a handheld, ultrasound-guided, high technology devise, that is used under ultrasound or stereotactic guidance to obtain a tissue sample.

The unevenness of the area just makes it more suspicious and more likely that it should be investigated further.  It doesn’t mean that this is for sure cancer, but just makes having the area further evaluated more important, and this means having it biopsied.

Getting a second opinion is always an option for you, if you opt for this we would recommend seeking out a surgeon who specializes in breast disease.  The timing from a medical perspective is probably OK.

[rbmayer]

I had the mamatone (ABBI) procedure done on July 17. Not that I want to knock the procedure but it was not a good experience for me. First of all the numbing procedure did not take effect and I felt and was aware of the whole thing. I wished they would have put me completely out. Second of all the machine broke down while it was in me (as I mentioned the numbing was not there) I went in at 12:30 pm and did not get out until after 3:00 pm. Needless to say this was the second hopital I had to go to because at the first hopital, the machine was broke down as well. This procedure is suppose to be less invasive blah blah blah  in and out right? They had to call the manufacturer to see how to start it back up again (not a good thing). The surgeon really pumped the novocain in shot after shot after shot. Has this ever happened to anyone else? Nothing agaist the doctor, he could not believe that I still had feeling. I was just a little concerned that he went ahead with this procedure knowing the local did not take effect and did not choose another route. I have since then been put on Augmentin and pain killers for this less invasive procedure. I have talked to other people who have had the mamotone done and they had no problems at all. Just my experience was not a good one.