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Wire Localization
I've been diagnosed (magnification mamogram) with some micro-calcifications and have decided to have an incision biopsy. But the whole notion of wire localization sounds horrifying. I once had a needle aspiration in a breast and would NEVER go through that again. I don't want to be put through torture. Just how painful is the wire localization --- really?
thanks for your reply Janet. unfortunately I can't post a question, as I tried and it says this topic is full at this time. maybe others will reply here. oh and I do not know how near the surface the lesion is, i'll ask the surgeon.
On the plus side, having smaller breasts means there is less tissue to "disturb" doing surgery -- on the minus side, removal of any tissue is more likely to be noticeable. I don't know much about VAB, on mine they gave me no option saying that the location of the lesion didn't lend itself to anything but open biopsy. Is your lump near the surface or deeper in the breast? (Mine was pretty much under the breast against the chest wall.) You might want to post a new question to get some feedback from "the experts" and it might also get more response from some others with experience that might be helpful to you. Good luck and keep us posted.
one other point, i dont know what difference this makes, but I have small breasts (A size bra)
thanks for the info Janet.
actually I am thinking about possibly doing a vacuum assisted (Mammatone) bioposy instead of taking the risks of surgery - they tend to think this is benign - but since my sister and mother had br. c. and, though the pathology report from the FNA saw nothing malignant, it did report "cellular crowding" that they wanted to know more about. the surgeon wants to be sure and he and others said the surgery is more accurate.
however in my research I don't know. I have read that Vacuum assisted biopsy is 99% accurate. My surgeon said something about not being able to see the lesion (why not?! if the tissue to get at a 4 mm lesion - to be sure he got it. but it seems like it is MORE accurate to do the VAB since then the radiologist IS seeing it with the sonogram and can direct the needle right on it. i also worry about the risks of him going in through the nipple to get to the lesion and damaging tissue that is perfectely fine. so the issue is does the level of accuracy of surgery and the fact that it gets 100% of the lesion really outweight the risks of it (shape of breast, etc.) vs. the vacuum assisted biopsy?
actually I am thinking about possibly doing a vacuum assisted (Mammatone) bioposy instead of taking the risks of surgery - they tend to think this is benign - but since my sister and mother had br. c. and, though the pathology report from the FNA saw nothing malignant, it did report "cellular crowding" that they wanted to know more about. the surgeon wants to be sure and he and others said the surgery is more accurate.
however in my research I don't know. I have read that Vacuum assisted biopsy is 99% accurate. My surgeon said something about not being able to see the lesion (why not?! if the tissue to get at a 4 mm lesion - to be sure he got it. but it seems like it is MORE accurate to do the VAB since then the radiologist IS seeing it with the sonogram and can direct the needle right on it. i also worry about the risks of him going in through the nipple to get to the lesion and damaging tissue that is perfectely fine. so the issue is does the level of accuracy of surgery and the fact that it gets 100% of the lesion really outweight the risks of it (shape of breast, etc.) vs. the vacuum assisted biopsy?
i am scheduled for a wire loc biopsy this friday. 1- i have two questions: can they use a sono instead of a mammo? i have had bad exp with mammos where they squeeze and hurt my breasts. 2- i am concerned about possible change in shape of my breast, dimpling, etc. after tissue is removed. the surgeon says he takes out about 2 cm of tissue (the lump is only 4mm, but he says he needs to make sure he has gotten it and since it it so small he may miss it if he takes out less.) what has been experience with how the breast heals? isa there anything I can tell surgeon and can do myself to maximze my chances of it healing well with no change in shape?
one more question: the surgeon does a cut along the nipple (1/2 circumfrence of nipple) so that there is no scar on the breast - but it seems to me then he has to go further to get the lump which is in the upper quadrant 2 o'clock position. has anyone had experience with this type of incision? does this work well? This doctor comes very highly recommended, and i liked him as well, but i wonder about that sort of cut. btw, his name is Dwight DeRisi: anyone heard about him or used him as a surgeon?
When I had my biopsy, the plan was to do the wire loc. by mammo but they were only able to see the lesion on one view and so couldn't get at it that way. They ended up doing it by ultrasound and then taking an additional mammo to see if they liked the look of the wire in that picture. I think it depends on what they're seeing -- have they done an ultrasound and seen the spot there? On mine there were a couple spots visible on the mammo and a couple on the U/S but they weren't saying for sure that they were the same things so this might also be a question. But, for me it didn't eliminate the mammo if that is your goal.
I had a mass 6 x 3 x 2 cm removed because they had to go fairly deep into my breast for the lump. This was on the outside of my left breast (about 2:00). Now, 3 mos. post-op, there is really no "indent" or noticeable dimpling in the area. A lot depends on the size and shape of your breasts and just where they remove the mass. 20+ years ago I had 2 surgeries on my right breast -- in the second they removed almost 1/4 of the breast (upper, outer quadrant). To me, I can tell that breast is smaller than the other and can feel a "void" in that area but visibly it's not noticeable.
As far as the scar location, when they did my right breast, they cut around the nipple and the scar is barely visible. I did have a lot of problems because of the extra "digging" they had to do to get to the lump but I think that was more due to the surgeon than the surgery. This time I told them I was not concerned about the scar and they went in from the side. The scar is almost 3" long and is still pretty red although it's not bad. I had a lot less bruising than before.
Talk to the surgeon about your options -- what are the pros and cons of each.
Hope that all goes well for you. -- Janet
I had a mass 6 x 3 x 2 cm removed because they had to go fairly deep into my breast for the lump. This was on the outside of my left breast (about 2:00). Now, 3 mos. post-op, there is really no "indent" or noticeable dimpling in the area. A lot depends on the size and shape of your breasts and just where they remove the mass. 20+ years ago I had 2 surgeries on my right breast -- in the second they removed almost 1/4 of the breast (upper, outer quadrant). To me, I can tell that breast is smaller than the other and can feel a "void" in that area but visibly it's not noticeable.
As far as the scar location, when they did my right breast, they cut around the nipple and the scar is barely visible. I did have a lot of problems because of the extra "digging" they had to do to get to the lump but I think that was more due to the surgeon than the surgery. This time I told them I was not concerned about the scar and they went in from the side. The scar is almost 3" long and is still pretty red although it's not bad. I had a lot less bruising than before.
Talk to the surgeon about your options -- what are the pros and cons of each.
Hope that all goes well for you. -- Janet
Had a wire/loc excisional biopsy last week. Wasn't too bad. Worst part was having to sit still for about 15 min. Hardly felt the wire placement.
I had a wire loc last Sept after a failed stereotactic- the wire loc/excisional biopsy was a breeze!- I too was worried, but it was much less stressful than I thought it would be, good luck!
Thank you all.
As you can see the surgeon's experience indicates that yours are not typical responses to the procedure. I hope mine will be in the "cakewalk" minority as well -- but I'm not sanguine.
As you can see the surgeon's experience indicates that yours are not typical responses to the procedure. I hope mine will be in the "cakewalk" minority as well -- but I'm not sanguine.
auntie mame: right on both counts!!!
One more encouragement for you. I was also concerned about the needle loc. Mine was a bit more complicated since they couldn't get a good view on it from the mammogram. They ended up doing it by ultrasound and then taking another mammogram to see if they liked the looks of things. It was a bit of a hassle and took almost 2 hours by the time we got done shuffling back and forth. The only "painful" part was when they did the local anesthetic (lidocaine) -- a lot of gals don't have this and it seems like the wire placement is no more painful than the lidocaine injection.
Don't be scared, like the other two responses said. But I too had this same procedure done. The only pain I had was, from the mamogram, I wasn't as lucky as some. It took about 30-45 min. for the radiologist to get the correct pitcure, to be able to place the wire. The wire placement was a breeze. This is the only problem that I could see that might casue some pain.Good Luck!
Dear Auntie_mame, I could not give you any better information/advise than what the person's having "been there" have posted to you.
One has to wonder if the surgeon is thinking "The patients have answered this question better even than I could" or "Best not to say that the experiences of these two patients were atypical."
Hmmm.......
Hmmm.......
Please don't worry too much about the wire incision biopsy (easier said than done, I know!). I had this done in hospital 2 weeks ago and dreaded it, as the needle aspiration done a few weeks before that had been so painful. But, in fact, the wire localisation was quite quick and much, much easier than the needle aspiration. My surgeon just did it from measurements, so I wasn't held in a mammogram for it. Afterards, there was a quick mammogram to check the wire was in the right position. It was! I soon recovered from the op, too and went home next morning. After all that, they said I'd had fibroadenoma, and not DCIS. I hope everything goes well for you and wil be thinking of you. Edith.
Oh please don't be scared. I had this done last week and a common toothache or tension headache is far worse... I was given a horse pill sized valium and a topical anesthetic for the mammogram and wire insertion and had demerol IV for the surgical biopsy. I was at the hospital by 7AM and on my way home without any need for pain medication at 11AM, more than I can say for any tooth extraction. The biggest difference for the mammogram part is I got to sit in a comfy chair. I was lucky in that the Radiologist got it on the first try too, at least that is what I ***remember***.
Good Luck, may your results be benign.
Thank you both for your kindness in posting. I do feel better already.
(But please pass the Valium this way)
(But please pass the Valium this way)
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