Propylactic Mastectomy

[Pediwonderful]

I had a previous core needle biopsy followed by excisional biopsy showing atypical ductal hyperplasia with radial scar one year ago.  My follow up mammo 6 months later showed an area that was new (since my previous preop mammos) but the recommendation was only to have another mammo in 6 months.  Now I have THREE!!! areas that the radiologist recommends should be biopsied by core needle biopsy.  Tomorrow I have an appointment with my surgeon since my previous experience with core needle biopsy was horrible.  I was told it would take 30 minutes and it ended up taking an hour and a half.  The only area of my breast that ever became numb from the local was the area of skin where the needle was inserted.  I felt every other poke and prod and it was very very painful.  The radiologist reinjected the local several times without any improvement.  The staff were ok and tried to comfort me but after my last experience I am going straight to my surgeon and am strongly considering prophylactic mastectomy.  I have a family history of breast cancer but only on my father's side of the family.  Mastectomy seems for me to be a way to put an end to the constant worry, mammos, and biopsies.  I am 46 and newly married (2 yrs) to a wonderful man after 21 years with an abusive man.  I don't want breast cancer to end the happiness for myself or my husband.


This discussion is related to Multiple site stereotactic biopsies in one breast..

[japdip]

Good for YOU or should I say Good for your Surgeon !! I'm glad you got someone to agree with you .... without having to be the "bad guy". Sometimes we have to fight to stay in charge of our own bodies but it's worth the fight. I'll be anxious to hear how your surgery goes and also wish you an uneventful and speedy recovery.    Best Wishes ...

[Pediwonderful]

I saw my surgeon yesterday and she is recommending bilateral mastectomy with immediate reconstruction.  She agreed that given my prior bad experience with core needle biopsy, I shouldn't go through it again especially of three areas.  I know that mastectomy seems drastic but I have endured 15 years of abnormal mammos and follow up.  My breasts will probably never pass a mammo without f/u due to recurrent calcifications, dense breast tissue and fibrocystic disease.  I am tired of the worry, every 6 month mammos, and f/u procedures.  I don't want to end up with breast cancer because I got tired of dealing with the whole thing and simply stopped having the mammos because I couldn't face the follow up.  I admit I have done this in the past.  I would like to get this monkey off of my back (or in this case my front) and live life like as normal a person as I can.

Thanks for all of the feedback!

[japdip]

Have you condsidered a second opinion (Surgical) and I would request a different Interventional Radiologist if you do indeed have to go with the Core Bx. I know they won't do the sedation though .. being a nurse you do know that you can absolutely refuse that type of biopsy. I'm sure they wouldn't think very kindly of you but it is your body after all and we always have the right of refusal. Have a "fit"; it always works for me ... LOL   Keep me posted and Good Luck.

[misawa47]

I also had a very painful stereotactic biopsy on my left breast for microcalcifications in August. They were unable to numb me and the pain was excruciating! I thought how barbaric. To make matters worse, they biopsied the wrong area which put me needing ANOTHER stereotactic biopsy. I vowed after the first one that I would never do it again; however, I was sent to have another stereotactic biopsy done in November. I pleaded with the surgeon to do an excisional and give me a general to knock me out. He assured me everything would be fine. I took a xantax to help relax me and they injected 10cc of Lidocaine. Honestly, I didn't feel a thing! My results turned out benign and I am so grateful I listened to the doctors and didn't proceed with an excisional. I think the first doctor doing the biopsy hit a nerve and for some reason, they were not able to numb me. The second time went very smooth and the pain afterwards did not even warrant a Tylenol.

I hope you reconsider. My prayers are with you,
Bernice

[Pediwonderful]

After my lumpectomy/excisional biopsy, I was informed that no further intervention was necessary. Mammos were advised every 6 months.  No one ever mentioned Tamoxifen or any other hormonal therapy, possibly because I was premenopausal?  In the following months I had two additional surgeries (not related to my breasts) so I didn't have the time or energy to question that no further intervention was necessary for the ADH and just considered myself lucky that I wasn't having to deal with the breast problem as well.  

I didn't receive a surgical referral after my mammo!  The radiologist recommended core needle biopsies of the 3 areas and I told her I was going to see my family practitioner to get a referral back to the breast surgeon.  After my previous core needle biopsy that required excisional biopsy I had discussed with my surgeon that if it happened again I would just have the excisional biopsy instead.  

The issue I am facing, however, is my breast is already somewhat deformed from one biopsy and three more will leave me with only a tiny amount of breast tissue in that breast since I am small breasted.  Why leave a small amount of breast tissue when I will need reconstruction anyway?  What is the gain for me considering the increased risk?

I see my breast surgeon today and if she advises that I should go ahead with the core needle biopsies so we can better decide what type of surgery I need, I guess I will have to find a way to get through it.  When I tried to tell the radiologist what a horrible experience I had with the previous core needle biopsy, she said they would not use sedation for the procedure no matter how bad my experience had been before.  As an RN I can't believe this type of attitude still exists in medicine!

I really feel sorry for my husband.  He is so supportive and I know it is difficult for him to keep watching me go through this.  He joked with my family practitioner that maybe he should check and see if there is a lemon law for spouses in our state!

[japdip]

As a rule when ADH is found on biopsy a lumpectomy is done followed by radiation and then hormonal therapy (Tamoxifen). Bilateral mastectomy is often done and does put an end to the constant worrying but I would certainly get a couple of opinions from Surgeons before I made that decision. Then there is the option of having reconstructive surgery ... this can be a rather involved procedure and time consuming. I'm a bit suprised that you keep getting the 6 month re-check recommendations rather than a surgical referral like you have now. Good luck with the Surg. appnt. ... keep us posted as to what you decide.  Regards ....