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Avatar universal

Stereotactic Bopsy

I'm scheduled for a stereotactic biopsy on thursday. My surgeon tells me this can be really painful. He said he wouldn't use deep local because that can move the cluster. I have a papable lump that I found myself and cluster microcalcifications on my mammogram. I have had 2 fibroadenomas removed in my left breast about 10 years ago. The problem is with my right breast. I'm 39 and I have a strong history of BC in my family. My mom was 41 and a cousin was 32. My Grandmother just had a mastectomy last year at age 83. I opted for stereotactic biopsy instead of excisional because the surgeon seems to think the palpable lump is "just breast tissue". I guess my question is how painful is this kind of biopsy and how accurate is it? My fear is that they miss the area of microcalcifications. Any info would be appreciated. I think this is a wonderful site for those of us who are scared and looking for info and support. Thank you.
20 Responses
Avatar universal
In stereotactic biopsy, computer-assisted X-rays allow the biopsy needle to be precisely positioned, especially for smaller lumps or lumps that cannot be felt.  Special mammogram films are taken of the site to be biopsied.  The radiologist uses these films and, with the assistance of a computer, calculates the exact location for needle placement to obtain the biopsy.

The procedure begins with cleansing the skin and applying a local anesthetic to numb the skin surface.  The radiologist then introduces a sterile biopsy needle.  Additional X-ray films are taken to confirm accurate needle placement.  Tissue samples are obtained through the needle.  It is standard procedure for the needles to be inserted three to five times in order to obtain an adequate tissue sample, this portion of the procedure takes ten minutes or less.  The biopsy site is so small, a Band-Aid is usually all that is applied, and a woman can resume her normal activities after the procedure is completed.  The entire procedure takes about one hour.

There are cases in which stereotactic core biopsies shouldn't be done, such as if the microcalcifications are more scattered and chances of missing the area are greater, or a radial scar that if not removed entirely it might be difficult to diagnose a small piece.  Other considerations if a person is over 300 pounds wouldn't fit on the machine, a person needs to be immobile lying flat face down for as long as 45 minutes, so if you are unable to do that this might not be the procedure for you.  Not being able to get adequate pain control should not be a problem, and I would ask your surgeon or the radiologist who is doing this procedure about this issue again, and what is meant by really painful, it should not be a "really painful" experience, uncomfortable, some soreness after the local anesthetic wears off but not "really painful".  

At our institution once the specimen is obtained they check it under x-ray immediately to make sure they have microcalcifications in the specimen.  This way they have more assurance that they were able to get the correct area in the specimen.  If no microcalcifications show up in the x-ray they can get another specimen right away.

Avatar universal
I had a stereotactic biopsy in August after microcalcifications were seen in my mammogram.  I had heard that it could be painful, but in my case, it wasn't really painful at all.  I took an ativan 1/2 hour before the procedure to relax and had no real problem.  I recall lying on the table for an extended period of time was the worst of it.  It may depend on what area of the breast they have to biopsy.  My calficifications were at the 12 o'clock region.  They took several samples and then looked on the xray to make sure they had gotten the califications.  It turned out I did have DCIS.  Good luck to you, I don't think it will be too bad.
Avatar universal
I too had a stereotactic biopsy three years ago. It was THE MOST PAINFUL experience I have ever had. I had a 10 pound baby naturally and this was more intense than that. Why does it have to be so painful? I would love to hear from people who have had this procedure with out this intense pain. I now am facing another stereotactic and I am not sure I can do it. Are there alternatives? What about an MRI instead? My diagnosis is microcalcifications. Doesn't that show up in MRI? Has anyone had a second stereotactic?
Avatar universal
When I had a stereotactic biopsy about six months ago, the procedure did not hurt at all.  Laying on the table (I call it the "torture rack", for the period of time that it took was what was painful, in that I have a lot of arthritis.  When it was over, I had a hard time sitting up and took a while to be able to get off the table and onto my feet.  There was a little soreness afterwards in the area where the procedure was done, but was nothing unbearable. That was my experience, anyway, though others' may be different.  Good luck and God bless!
Avatar universal
Thanks for the info. Sorry to hear that you have DCIS. The watiting is terrible. Do you know how your microcalcifiactions were clustered? I saw my mammo and they look pretty tightly clustered. I don't know if that makes a difference or not.
How soon did you learn your results from the biopsy? (please let me know if I'm being too personal here....I'm just looking for some insight from someone who has gone through what I'm going through) Anyway, thank you again for your comment. It is REALLY appreciated.
Avatar universal
Thank you so much for the info. The surgeon said some women tolerate the pain more than others, that he's had some that want to jump off the table and others have no problem. I'm hoping I have no problem. I don't have alot of fat in my breasts and therefore not much cushioning. Is the way the cluster is formed (tighyly or more scattered) give an indication or clue as to whether or not its cancer?
Thanks again for your help.
Avatar universal
My microcalcifications were clustered...though it turned out it was fairly extensive in the breast so had mastectomy.  I was actually relieved to find out it was DCIS as that is a pretty manageable thing.   I found out the results from my biopsy the following day.  As I said, I was happy that was the diagnosis.  Good luck and take care....Through this whole ordeal I've found the waiting for the biopsy and path results to be the hardest part emotionally....surgery was simple in comparison.   I would recommend taking a look at Susan Love's book....she has excellent, up-to-date information on every aspect of breast cancer from biopsy through treatment...It helped to ease my mind as well.
Avatar universal
Thanks again for the information. It seems like every shred of information I get is like a gift. You're right about waiting for the biopsy and results IS the hardest part of all this.
I wish you luck and you have my gratitude for answering my questions.
Take care :0)
Avatar universal

It was indeed satisfying and gratifying to read Binkie's post on the lack of
merit and danger
of x-ray mammograms.  It is well documented that ionizing radiation from
mammography can and does induce breast cancer.  There
has never been a credible study showing that
mammograms reduce the death rate through early detection.   All of the
recent studies on
this subject have been fatally flawed.  An x-ray mammogram is merely an evil
strategy by the profiteers to cause breast cancer to subject more women to
procedures and drug.   Even some of the breast cancer drugs are known to
cause cancers
in other organs.  Women are rarely, if ever, properly counseled on what is
when taking certain anti-cancer drugs.

Low-income women have the lowest incidence of breast cancer without
exception.  Yet,
many hospitals and the mainstream breast cancer organizations routinely
target them with
free mammograms.  This is simply a novel marketing strategy to induce breast
cancer in
them to create a larger pool of women for expensive treatment to be paid by
companies and the tax payers.  Further, many hospitals, cancer treatment
healthcare providers urge both healthy women and breast cancer survivors to
engage in
activities known to cause breast cancer.

Contrary to what is taunted by the American Cancer Society (ACS), breast
cancer is
essentially a preventable a preventable disease.   Through the years, women
have been led
to take what the ACS and the National Institute of Health (NIH) say as
gospel.  They
should be aware that both the ACS and NIH receive large sum of many of
money, directly
or indirectly, from the offending breast cancer industries, namely, alcohol,
petrochemical, drug, cosmetic industries -- to name some.   Also, many of
the editors of
mainstream medical journals have financial ties to the offending industries.
Consequently, information useful for breast health is rarely published if it
is deemed to
have an adverse impact on profits.

Therefore, it is unreasonable for women to place great reliance on advice
biased for
economic considerations.  Finally, most healthcare providers advocate breast
prevention.   What they are really talking about is secondary prevention,
i.e., preventing
the spreading of the disease not preventing a first occurrence.
Unfortunately, women
have chosen to support the illusive goal of finding a cure.   Finding a cure (aka 'racing for the cure)'
is well outside
the control of women singly and collectively.  Primary prevention in within
the control of
the individual woman.

Prepared and written by:

James Coleman, Ph.D.
Cancer Research Center of America, Inc.
Avatar universal
So what do you suggest women do?
Avatar universal
Sure, I was copying a post by a Ph.d; I wasn't trying to suggest to anyone what they should do. That is up to the individual and what they believe is best for them and what their symptoms are.
For myself I intend to never get a mammogram. It's just my personal preference. Best Wishes
Avatar universal
Well, in my case, my mammogram saved my life.  They discovered microcalcifications, and, after biopsy, DCIS.....after the mastectomy it was discovered that I had a tiny bit of invasive cancer .5mm, low grade...if left untreated, well, I don't think I need say more.  As it was the early detected allowed me to be treated with surgery alone, no chemo, no radiation.  I would urge every woman over forty to get a mammogram annually...but as you say, it's a personal choice.  I'm glad I made the one I did.  Take care all.
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