Multiple site stereotactic biopsies in one breast.

[vermontgirlII]

Hi,  I was just told that instead of a single stereotactic biopsy site, they are going to sample two different areas.  My BIRADs is 4, with heterogeneous micro calcifications.  My question is this.  Does the multiple site sampling change the odds that I have breast cancer?

Thank you

[CCF-RN,MSN-JS]

Dear vermontgirlII:  From what you have written, it looks as though the mammogram has identified two areas that appear suspicious,  requiring biopsy.  A BIRAD category four means suspicious lesion, biopsy recommended as 25-50% of these may be malignant.  These would be the same statistics for each area being biopsied.  Multiple sampling does not mean that you are more likely to have breast cancer.  It means that there is more than one area that requires biopsy.

[Under Forty Pam]

That will not change your chance of it being BC.  They probably just want to test multiple areas because they see calcification in several areas.  The chance of BC is low even though it doesn't look that way on this website.  We are all here to help because we ended up in the low percentage.

[vermontgirlII]

Thank you.  I was getting scared all over again.  Now I have to wait 10 days for the biopsies, then probably another week, because the biop is on Thursday, for the results.

[laure113]

I'm going through exactly the same thing. Except, they couldn't do both of mine at the same time, so I have to wait until Dec.6th for my second. The waiting is very nerve racking. I feel for you! Hang in there.

[vermontgirlII]

Thanks, I feel for you too.  Hang in there!  Diane

[blondieny]

I'm also having to areas of microcalcifications biopsied, also with a fibroednoma removed,how long do results take?

[boninclyde]

It is normal for them to test several areas (sometimes 3/4/5). Results usually take 3/4 days. Hope you all have nothing to tell us later but good news.

[cally44]

I was supposed to go for a breast core needle biopsy today but was late for the appointment and then rescheduled.  I wanted to know do they dye the needle, or do they just numb the surrounding area.  Also, if it is a benign tumor like fibroadenoma...do they have to remove it or is it better to leave as it is?  What if there are 2 lumps on the same breast...do they take a sample of each lump or just one.

What are the after effects of the core needle biopsy?  pain, soreness, etc??

Thanks and I hope it is nothing.

[boninclyde]

I haven't heard of dying the needle but they do give of shots for pain that don't really hurt. My biopsy hurt because I have heart problems and could only have very little pain meds. I 'm not sure what they do with fibroadenomas but I think they leave them. If there are two lumps they will sample both. They will get numerous samples. Or at least you hope they do. My first was inconclusive. They did not get enough tissue so after waiting 3/4 days for results I had to have another biopsy and wait another 3/4 days. Hope this helps.

[cyn17]

If it's a fibroadenoma, it will be removed. They take multiple samples with the core needle, which actually removes the fibroadenoma. Also they will biopsy both areas. The biopsies are not so bad to go through...they will numb you up. I think the worst part is the tension of going through the experience. Try to stay calm. If you've had a baby, use your labor relaxation techniques or ask your doctor for something to calm you. You'll do fine!!

I also have not heard of the dye needle, so I can't comment on that. Just know...they will make you comfortable with whatever technique is used. Stay strong!

[Twocapes]

It is my understanding that the lump is not completely removed via needle biopsy, only with surgical removal.  Multiple needle core biopsies are taken but it does not eliminate the nodule.

[blondieny]

This forum is UNBELIEVABLE, I have understood alot more through everyones comments, Iam a nurse and still have millions of questions. Understanding and being able to discuss has really made me more acceptable of what is going on, I turned 39 11/12  getting out of the shower that a.m. i felt a lump, seen my Md the following day, was set up for mammo and us 2 days following, seeing surgeon today to consult. I hve a mass and two areas of calfications, possibly one in duct. Being able to read other womens experiences have made me feel stronger. THANKYOU

[Bunny711]

This is an amazing forum isn't it.  I too was diaganosed with cluster microclaifications, and had excusion open biopsy, due to where it was located they could not do a needle or sterotactic.  Which is the way I wanted it.  I wanted these dead/bad cells removed completely whether benign or maglinant.  Turns out benign for now.

I hope all comes out well with you, I'm sure it will.

Take care.

[Bunny711]

Hi there, hopey you are smiling.  You know I was never really sure, so I will ask now.  I believe you had the sterotactic?  Correct?  Does this procedure remove the whole cluster?

Just wondering, and hope you are having a good day.

[cyn17]

Thank you twocapes for correcting me on this...I did not mean to give inaccurate information. My first biopsy was on a lump that turned out to be a fibroadenoma. The core needle could not penetrate it, so they biopsied the tissue around it and left the fibroadenoma alone. They also inserted a clip so they can track the growth on future mammos.

I thought my other two biopsies were also fibronomas, which were removed completely by core needle. However, they were complex cysts, not fibroadenomas.

Thank you again for the correction!

[laure113]

Yes, I did have the sterotactic and my first cluster was removed completely. I'm not sure if this is always the case. I hope so!

[cally44]

Hi

So when I get my core needle biopsy can they remove the entire lump???  I would like that so would it be possible?
Also, can they be sure not to hit a milk duct area b/c I am nursing and I would hate to have that leak or an infection happen.

Thanks

[cyn17]

Whether they can get the whole lump will be determined as they are doing the biopsy. There's no way to tell right now. Also, not all lumps have to removed. As for your concern about hitting the milk duct, I think you'll have to ask the radiologist that question.

[boninclyde]

I hope you get good news. This is hard just before the holidays or at any time. Please keep us posted. All our stories help each other.
bunny711 - great news.
Happy Thanksgiving All!

[blondieny]

HAPPY THANGSGIVING! Once i again i have to say what an amazing forum this is. I work for a family MD and i feel as though i have acquired more info through everyones experiences. I seen the surgeon yesterday good news is they feel as though the one area of calcifications which i was extremly concerned about because it was in the duct, was more like  a ribbon of calcifacations, and that we need to keep eye on, when i go in for the biopsies of the other calcifacation, and  the fibroadenoma i will requestion my concern reguarding it being in the duct. I just want to tell all of you that getting the most knowledge of what is going on before you talk with a surgeon ( or md ) is extremly important. My us showed the mass diagnosed as fibroadenoma, which now has become smaller, I asked if this was possible answer being NO, it probally is a cyst, they will find out during biopsies. I didnt think us could confuse fibroadenoma and a cyst, SO just ask lots of questions and be knowledgable.  HAVE A GREAT THANKSGIVING

[Ladymusical]

Hi All:
I had a stereotactic biopsy yesterday.  I had two sites also. Quite frankly the whole experience was not good.  I thought the initial meeting with the surgeon was pretty good.  My opinion from yesterday was entirely different.  I, unlike other women found the procedure to be invasive. I felt nauseaus during the entire procedure.  Start to finish was 45 minutes-not 15 as I was originally told. I was given sufficient novacaine.Thank God.  Then it changed it was like I wasn't there. After it was done they told me to sit up. The surgeon went to filling out forms and dictating to his office on the phone about the procedure and she (the tech) was reviewing the screen and going on and on about the samples. How great they were. And that I should be excited about this. They left me sitting for over 10 minutes holding my breast where the incisions had been made. As they chatted on and on.  Yes I understand the importance of getting good samples and noting the information  BUT note to doctors and techs make sure the patient is taken care of. Everyone else was lovely and empathetic. These two were much too clinical. If it turns out that they had to take care of these matters immediately, then have a nurse come in or someone to make sure the patient is ok. Afterwards I went to have another mamogram (mammogram) so they could record the markers. For the most part I have found the medical world a different place than the doctors I grew up with.  If it turns out to be malignant I will have to find a different surgeon.  Someone that recognizes that this is a difficult and scarey time for the patient. I am to call my doctor's office tomorrow for the results after 10. This past month has seemed surreal. You ladies and my husband have been so helpful, thank you.Good luck to all and my prayers are with you.

[ziggy123]

I am sorry that you had such an unpleasant experience with your biopsy. It it amazing how all of us have had such a wide range of experiences with procedures and the medical profession in general. You are right to plan to seek out a new more understanding physician if need be. I will say a prayer that this is not necessary and that everything will be fine for you.

[laure113]

That sounded awful. I was told not to eat several hours befor the surgery because some woman get sick. I was lucky! Mine also took an hour. I was not left alone in the room. I hope my next one is as okay as the other. Not fun by any means. Medicine has become so cold. Most of the time, I feel like a number. You have to feel comfortable with your doctor and I'm glad you wouldn't settle. Hope everything turns out okay. Please let us know.

[Montana girl 06]

There is a huge difference in medical centers. I'm so sorry you had a bad experience. I had a nurse rubbing my shoulder during the stereotactic. Then she compressed my breast after the stereotactic to keep bleeding to a minimum. Then I was walked down the hall for a mammogram. After that they sat me in a recliner with a warmed blanket and offered me juice. Of my 3 biopsies, this medical center was definatley the warmest/most patient centered. I would definately look for another place. I hope your results turn out ok.

[blondieny]

oh. had biopsies done yest, surgeon called 1 hour ago , biopsies positive, what next i dont know

[ziggy123]

I am sorry to hear your news. Did your surgeon give you any idea of what your next steps will be? The ladies at this site can be a great source of comfort and information. Please remember that you are not alone.

[Montana girl 06]

I'm very sorry to hear your diagnosis. I'm sure you'll find a lot of support, encouragement, and advice from the ladies at this site.

Also, if you're comfortable sharing more info I feel it could be very helpful to me in making future decisions since I have similar problems. I'm especially interested in the fibroadenoma that was possibly a cyst in reality.

[blondieny]

the fiboadenoma was negative, the surgeon completely removed it by biopsies, the calcification was positive, The surgeon will be out of town for 1 wk, then I go for more answers,  I had myself convinced it was negative. I receive the results over the phone at work yest and was unable to to question the surgeon because i became very upset. What id id understand was lumpectomy possible masectomy and if needed chemo or radiation.

[BarbaraRN]

Hi,         1:40am Friday morning.
New here.  Thank you all for your experiences. I am so moved by the anguish felt by all of you.
My mammo showed a class 4 birad last week, scheduled for sterotatic 3 wks out. Too long to wait! Requested to see surgeon yesterday & got appointment today (12/1). I have a long history of fibrocystic & calcified tissue never biopsied. I have been on Premarin for 26yrs, am over 50 & started menstruating very early. My family has an extensive history of lung cancer (x6) and testicular/ uterine cancer (x2).

Please bear with me as my frustration comes from 35 yrs as an RN. I spent those years as a patient advocate & liason. Feeling their pain & anxiety. Demanding the patient needs with Md's, Insurance companies & overworked clinic & hospital staff.

I feel so helpless reading that you all have had to wait, wait, wait & wait again. Wondering, suffering, having self doubt, doing the right thing, asking the right questions, am I going to go through years of biopsies and mammograms? Am I informed enough to stand up for myself and and be proactive? Should I wait until the fibrous tissue or calcifications come back malignant even though the biopsy 6 months ago was negative? Should I get a 2nd opinion? Is the Surgeon sensitive to MY needs? Is he/she expediting my case in my best interest? Can my case be handled better? Is enough being done? Will this only be taken seriously when the report is positive & I am then handed off to the Oncology team with all of this to start again? I can't talk to my family...they just don't understand.

I need support to be the squeaky wheel, the pain in the butt! Ask questions and present senarios that effect my case. I have to be proactive.

I can't have my life evolve around mammogram to mammogram, biopsy to biopsy; constantly wondering/worrying what the next exam will bring, are they exediting my case as they should, did they forget to call?

Over the years I have seen too many MD's, RN's and others unmeaningly go totally clinical with the diagnosis & testing processes. You know: "Oh, I have you scheduled 3 wks out for your biopsy, no big deal or "I didn't tell you you are a class 4, guess I over looked it" or "I missed in your history 5 years of calcific mammo findings". I don't mean to sound jaded but the medical profession is as human as all of us. Being a case manage the last yrs of my career I saw too many times where patients just got lost in the shuffle with "Oh, a few wks won't make a difference, no big deal", only to hear after the biopsy that findings are positive & Oh tests are only 80% correct most of the time...these things just happen...you are one of a few that don't show up and the ever so popular "I have not had this happen before".                                           Please forgive my frustrations.
I hope to give an update later today. Thank you for being here tonight.

[vermontgirlII]

I'm so sorry to hear your test results were positive.  It sounds like you have to wait a week now before you get you sit down with your surgeon?  Can you get a copy of the path report so you can start learning about what they might recommend?

[blondieny]

yes, i can get the path, which i will do today, i am a nurse through my primarys md office. I Have lots of resources, just still scared. I just turned 39 11/12. newlywed 6 months, just didnt think this was possible. Thankyou for being concerned.

[boninclyde]

Yes please get a copy of your path report. The nurse should be willing to sit down with you and explain it even though the surgeon is away. Some radiologist will speak with you. At my center there was a patient advocate that would talk to anyone, anytime and answer anything. I am so sorry. Rememer maybe this was caught very early. Some questions:

How many clusters, lumps or mases were there? The size? The grade? The stage? Is it possible to be in the lymphs yet? Is this DCIS and does it look invasive?  Ductal or lobular? What types of test were used to make the determination on the samples?

I had mine sent for a second opinion at a large hospital in another city. The office (your radiologist) will do this for you. Choose the facility for your 2nd opinion, get their address, call your  doctor tell them to send samples (slides) and pathology report.
This can be done pretty quickly. This is Friday. Get answers for your research. You don't want to go the weekend wondering.

This site and breastcancer.org (great discussion board there) will help guide your way.

As the RN above said you have to be your on advocate.

[boninclyde]

Sorry you are having to go through this. Please keep us posted.

[Ladymusical]

I am so sorry to hear what you have gone through.  I just got the news on Wednesday from my stereotactic.  I was luckier my results are benign.  It is surreal when you answer the phone. I was so nervous.  My prayers are with you.  Thank you to everyone for your support.

[laure113]

Glad to hear your good news. Thanks for sharing. Gives me hope.

[laure113]

Very sorry to hear about your results. You're in my prayers.

[BarbaraRN]

Hi,
Remember me! I am the tired of the medical bull s..t retired RN with Class 4 Birad.
Thank you for the note of encouragement. Women should not have to wait til it's oncology time. It seems like waiting in line as cattle waiting for your turn..when will it be me!!
I have neglected to follow my own advise to every patient I ever worked with...Get Copies Of ALL Your Written Reports, Office Visits and Lab Results. It is every patients Right to receive these.  
I have neo & micro calcifications, severe breast density in that area (I an small breasted) with breast asymetry. The ultrasound revealed the same. I had also an R2 Image checker?   (anyone heard of that?) I have a total of 3 calcific clusters and 1 mass. This is just in 1 breast. The areas are not even where I have the highly palpable 3-4 cm (1/2+ inch)extremely painful nodules.
I went to the general surgeon and my jaded impression of what happens happened. The general surgeon I was sent to wound up being a Bariatric (gastric bypass) & Vascular surgeon with no clue of breast physiology other than women have breasts & cut it out, bill you and make his next house payment. (Please forgive my morbid humor but that is how it made 30+yrs as an RN.) Needless to say I walked out..receptionists were putting on their makup and taking personal cell phone calls.
I am very rurally isolated in south eastern Oregon. I am an hour from any city. It has 3 surgeons, all general. Stone age medicine!! Also it is Friday & everyone take off Friday.
It's too bad that breast abnormalities happen 24hrs a day. We also have no breast center, even the next city 3hrs away only has an answering service for oncologists. They consider this their Womens Breast health Center.

Does any one know of plastic surgeons that work on premalignant or malignant cases either within their practice or with a breast surgeon?? Thank you for listening, please drop me a line.

[boninclyde]

You absolutely crack me up. Your are to funny. I am sure you are serious but sorry it's funny. My surgeon was actually a general surgeon. But in a large cancer center. Which means he removes cancers from many areas of the body. I am sorry you are so far away from help. I do know if you contact the airport the have special flying for people with cancer and they will fly your on corporate jets to anywhere for treatment free. Do you know about this? I have the article somewhere and can give you exact info on it if you need it. The program is called Flying Angles and again, it is free.

[Montana girl 06]

blondieny - I understand you being upset after the phone call. No one can really be prepared for the "c" diagnosis even if we already think we have it. You have a lot to deal with, being newly married. I think any truly good man stands by his woman through these tough times. Many women at this site have mentioned how wonderful their husbands have been through all of this.

Ladymusical - So glad to hear of your benign results.

BarbaraRN - Your breasts sound like mine - so filled with calcifications, lumps, and "gunk" (to quote the us tech) they don't know where to start. Guess what? At my last biopsy the radiologist told me I had too many clusters of calcs to know which one to biopsy. He said we could just "pick one" LOL, wait and watch 6 months or have most of my breast (and the area of calcifications) removed surgically (which is not recommended by my surgeon, but has been recommended by 2 different radiologists over the years.) Since I've had 3 benign biopsies, I chose to wait 6 months. We have no true breast specialists in the state of Montana, so I'm left out on a limb, also.

[blondieny]

please do not just wait, ihad myself convinced my areas were neg. Ive read story after story about how the calcifications came back neg, dont chance it. My mamo results came back as more than likely benign but suggest biopsiy to be sure I had even questioned should I have  biopsies done due to my age and family history. Nobody knows until that path report comes back. and as ive told you mine was positve.

[cyn17]

Interesting that you mentioned a plastic surgeon...that may be worth checking into. I don't know if they just do reconstructive surgery on the breast or if they can also do the cancer excision too. Like many of the doctor's you describe, many plastic surgeons do cosmetic procedures to pay for the big house. I was very fortunate to find a wonderful plastic surgeon (that didn't have her name up in big gold letters) to remove skin cancer on my face. Good luck in your search!!

[Pediwonderful]

A related discussion, Propylactic Mastectomy was started.