Intraductal papilloma

[Jaquta]

Hi,

A breast surgeon has recommended I have a microdochecomy.  I have strong reservations about GA.  Is it possible to have this operation done under a local?  (Is this operation even necessary?  I have bloody nipple discharge and multiple intraductal papillomas but biopsy results show no malignancy.)

Many thanks for your time,
J

[Jaquta]

Thanks japdip.

You made me smile for the first time in what seems like ages.

I think GA for any surgical procedure is roughly similar although I am definitely no expert on that.  (A GA is given before ect.)
I never was given ect (thankfully!) but the threat was there and it's left me feeling traumatized.

You make some good points.  

I have an appointment to see the breast surgeon this Friday.  I'll discuss my concerns with him then.
Do you think it's appropriate to do that?  It seems strange discussing emotional issues with a surgeon.

Thanks for your time and input,
J

[japdip]

I think you are wise in your decision to go ahead with the surgery. Be sure you discuss all your concerns with your anesthesiologist before surgery ... this would be very important in your particular case. You might get by without being intubated if the surgery weren't too lengthy. I had a procedure with general but without intubation ... it was about 45 min. in length. If you are clear about your concerns I'm sure they will all be addressed by the Anesthesiologist. I don't really see any similarity between general anes. for a surgical procedure and ECT. Kindest regards .....

[Jaquta]

Hi,

Thanks for your feedback.

I've reached a place where I believe perhaps I should have the operation.  The discharge has increased significantly since I had a ductogram several weeks ago.  (At the time, the radiologist said the needle had pierced one of the papilloma, so perhaps that explains that).

I spoke to my GP today and he recommended I have the procedure done.  He said if left they would likely continue to grow, much like warts on a persons hand.  He also mentioned that they could possibly cause infection (?become infected).

He was a little dubious about having it done under local.  In the radiologists report they were said to be 2 cm and 5+ cm along the duct.

I was concerned about the GA because of my psych history.  I was sectioned under the mental health act for severe depression and then threatened with ect.  I associate GA with ect.  Also, I was intubated once and was aware of that process.
Does the trauma of having it done under a general offset the trauma of it being done under local?

Have I missed the point?  It's not about trauma but about practicalities.

I don't want to waste people's time, but I also don't want to be left feeling suicidal after the procedure.

Do you have any advice or suggestions?

Many thanks,
J

[PaulMD]

Hi there.

Regarding the necessity of this operation:  Though the lesion is not cancerous, the symptoms can be debilitating or morbid for most people.  The bleeding episodes from the nipples can really affect a person's way of life. Sometimes, blood loss becomes significant that it produces anemia or low hemoglobin counts.  However, if you deem that you can live with these symptoms then this will be up to you.

It is very hard to do localized anesthetics in this situation since there are several nerves to be blocked.  You may end up having dozens of painful injections just to get all the nerves blocked.  General anesthesia is the best way to go, and if your anesthesiologist is good, then there should not be any problems.

Regards.