stereotactic biopsy

[LMT3]

I am 57 y/o - postmenopausal - On 10/3 I had my yearly mammogram. I got a call back a week later for recheck on my left breast. I didn't know until I got in there that they found microcalcifications. I got nervous when they walked me back to talk to the radiologist and needless to say when he started pointing out the calcifications and showing me the three clusters, one in particular that had the most in it, talking about the shapes etc. He was quick to say most of these tend to be benign but again he started talking about the shapes and something to do about the edges. Needless to say I could think of no questions for him, he did telll me to contact a surgeon as soon as possible for a biopsy. There is no history of bc in my family, that I know of, but other types of cancer in my father's side of the family. In Sept I just had 4 pre-cancerous polyps removed from my colon. Now this. My surgeon has me scheduled for a stereotactic biopsy in 11 days, thru her I found out the cluster with the most microcalcs is at 10 o'clock but no one has mentioned anything about BIRADS ratings (or if they did I missed it). I am very nervous about this, my father died at age 57 of cancer, my brother thinks he has testicular cancer (at least he has a lump that has grown over the last 4 years that he has ignored no matter what signs he has. With what I am going thru he has decided he better get that checked out sooner than later. Thank God.) But I live alone with no family and I am not as cool and calm as I try to let on that I am. Could someone please help me understand this stuff?       lauraT

[marydenise]

Ditto what Laura said. Yay, benign! And also, more frequent mammos, but so what. That's doable. Because that just means if there ever is a problem, it's caught at a microscopic stage. Totally curable, with surgery.

And now, you don't have to worry!

Merry Christmas!

[LMT3]

I am so happy for you. If you have to go for the more frequent mammograms is no big deal. I will take that anyday to anything more serious.

Hope your Christmas and New Years are very happy.

Laura

[tennischick]

Had the stereotactic and it wasn't bad at all, worst part was a stiff neck.  I went shopping after and feel no pain today.  The doctor just called and said everything looked benign and to come back for mammogram next year.  However my surgeon called (they had notified him) and he wants me to have a mammogram in 6 months and come to see him.  At least I don't need to worry over Christmas - I hope everything is going well with you guys - have a great Christmas! - and thanks.

[tennischick]

Thank you so much for responding.  It has helped ease my anxiety.  It was so nice of you guys to let me know about your experiences.  Thanks for the tips too.  I am going to try to get everything done today so I can just take it easy tomorrow.  THANKS!

[LMT3]

I chose the surgical wire loc method. They do numb you with lido there too but I couldn't take the laying on my stomach. I know for a fact that if you feel anything they tell you to let them know. They won't let you hurt. All the people I have come into contact with during my procedures go out of their way to put you at ease and make things easier on you.

I agree with marydenise, don't count on playing tennis the next day. I had a very easy time of it and did go back to work the day after my biopsy but I only did light work and left a little earlier than normal. I also learned years ago to do self hypnosis and that helps too.

[marydenise]

If the radiologist numbs you up, sufficiently, the stereotactic biopsy should not hurt. And if they start and it does begin hurting, just speak up and tell them that it's hurting and they can apply some more lido.

But no, I don't think that you would be able to play tennis the next day. Ask your doctor, but if it were me, I'd wait 3-4 days, if not a week.

[tennischick]

I am getting really scared here.  I have a stereotactic scheduled for Wednesday.  I have heard it is suppossed to be painless, but on other sites I have read horror stories.  Litacaine is used, which doesn't numb me well at the dentist office - so that has me worried.  In the past I have had three benign lumps removed, a couple of cysts aspirated, it just seems like one of these times it has to turn up to be cancer.  I am 47 and have had a mammogram for 18 years, because my mom had breast cancer.  Any I am just worried about the pain, and will I be able to play tennis the next day?  

[marydenise]

Laura, benign, GREAT!

Doesn't it just give you a whole new lease, on life? After all that you've had to go through. All of this ****.

Well, it did for me.

And that Tamoxifen issue. That first came up with my right breast 2cm IDC diagnosis/successful lumpectomy/WIDE margins, in August, 2006. After I refused the radiation, I met with the oncologist and she basically said, "Well, if you refused the radiation, the Tamoxifen isn't going to help you, much."

And so, I didn't do it. And I feel great about it, to this day. It was the right choice, for me.

If my breast cancer comes back, I'll deal with it, again. Cut it out, again.

Although, it was interesting. My negative left breast October 2007 surgical biopsy results, (no cancer, no nothing) came after the August 2007 stereotacic diagnosis of ADH.

But then, after the surgical biopsy, again, negative, for anything, my surgeon outlines my options. Which were:

1) Continue 6 months monitoring. Mammos/MRIs
2) Take Tamoxifen
3) Have a bi-lateral mastectomy

The 3) caused great astonishment. To me! That had NEVER been discussed, even with with my 2cm IDC.

I guess she had to say it, to me, so that it would be in my medical record. So, I wouldn't come back and sue her, if the breast cancer, recurs.

Or whatever, I don't know. Again, I just find it sad that IMO, too many women do get bi-lateral mastectomies. For nothing. Because these doctors frighten them in, to it. A Mastectomy for some 2mm DCIS.

In the end, I'm choosing for myself. And everyone else is too.

Just choose, wisely.

Mary

[popcorn3]

When it comes to the breast I would not let it go even if you just go to the family doctor and let them check it and give you advice.  Hope you make out well and just keep researching.

Sincerely,

Popcorn3

[LMT3]

Got the results from the lumpectomy. The rest of the microcalcs they got out were benign so I'm clear. YaHoo ;-) ! She did say that on Monday they met with the onocologist [guess this is a routine Monday meeting when all surgeons who have treated anyone for BC talk about continuing treatments]. He agreed I didn't need the radiation but he suggested a treatment of Tamoxifen. Dr McFall and I discussed this in some detail before my surgery and I said that treatment was out and she told the onocologist that. So it's just a mammo for the left side only in 6 months.

Laura

[marydenise]

Laura, I'm so GLAD it all worked out so well!

And ha, even with my benign results, I'm on the "more frequent mammogram schedule," as well, for a while. Probably, for a long while.

Like you.

But that's totally fine. Maybe like you, after all of this, the more frequent mammos just result in getting anything caught, earlier. And by now, I'm totally up, for that.

If they can cut it out, do it.

And, IMO, that's very good that Dr . McFall didn't recommend, the radiation. Because you don't need it. Everyone told me that I needed the radiation, with my 2cm IDC, but I did not agree.  In my view, it comes back, again, cut it out, again. I have a high risk tolerance. After already getting cancer.

I'm comfortable, with the recurrence risk. I was NOT comfortable, with the radiation side effects. It wasn't worth it, to me.

But just, again, I'm so happy, for you! Now, it's done, now you can just live. You've been through the mill, and emerged, on the other side.

Have a great Holiday Season!

Mary

[LMT3]

Well the lumpectomy went even better than the biopsy did. The first day I had just a little discomfort, more like a pinching than a pain. No new bruising. Dr McFall said it went so well she didn't even recommend radiation, just more frequent mammograms for awhile. She surronded the area with small clips so they could see the area plainly on the mammograms.  

I can't tell you how much this board helped me. When I first heard the word "abnormalities and calcifications" I was so worried and scared. Now I am very confident that there will be no re-occurance and if there is I know the procedures.

Good thing I don't have to worry about the small size that had to be excized from my breast. When I was in my teens and 20's I barely filled out a 32B. As I got older, I got heavier and finally went up to a 44 but barely filling in the C cup. The incision was made along the areola so unless I do my regular and keloid it shouldn't be noticable.

Thanks Mary

Laura

[marydenise]

BUMMER!

Because now you have to have the additional surgery.

But from how you described your pathology report, from what you wrote it said, "Ductal carcinoma does not involve margins." That says, to me, there were clear margins, but Dr. McFall isn't comfortable, with the margins. Yet, there WAS a margin. I think they are just being safe, which is good.

And again, we're talking mm's being cut out, for you, not cm's. 1cm is less than 1/2 inch. I can't even quantify 1mm. But, this is So Small. They probably won't cut out, much more.

Of course, it does depend on your breast size. With my August, 2006 2cm IDC lumpectomy, she cut a LOT out. Because I got Wide margins. But then, I'm a 36DD. By now, my X-Cancer breast looks great. Even, naked, it's hardly noticeable.

And yeah, talk to the radiation therapist, but I just say, don't do it. It's not worth, the side effects. I didn't do radiation with my 2cm IDC lumpectomy. I got way clear margins, with my lumpectomy. I accept the risk of recurrence. If the cancer recurs, I'll deal with it, then. Last August, my Cancer Breast was BiRad 1. From both the MRI AND the digital Mammo.

Although, from reading these boards, apparently a lot of women, don't want ANY risk. And get bi-lateral mastectomies, for DCIS. Not to mention, IDC. Eek. I don't get that, but to each, her own.

But sorry, off the soap box.

At least, you know. By Now. And you've got the surgery scheduled and it will be fine!

The General anesthesia is more than the Local, but IMO, just slightly more. You just need more recovery time.

I'll be looking for your posts, as to how it goes. The lumpectomy and the subsequent pathology.

I'm sure it will be fine. Just sorry, you have to go through this.

Mary

[LMT3]

Well I wasn't as lucky as you. I came back positive for DCIS. But the good thing is we caught it at a really early stage.  This is what it said: 1) Ductal carcinoma in situ, cribriform type (I looked this up, it means the cells are arraned in a sieve-like pattern) with low nuclear grade and microcalcifications, 4.0 mm in greatest dimension. 2) Surgical margins: Ductal carcinoma does not involve margins but extends to 1.3 mm of superior margin, 2.6 mm of anterior margin, and 8.5 mm from posterior margin (closest margins).

I am going in on Wed to have my lumpectomy. This way the surgeon can reuse the same incision, but rather than a local I will have to be totally under because the biopsy leaves a pouch that the numbing medicine has a tendacy to fill up in.  I will talk to a radiation therapist but I think what I will end up doing is the lumpectomy and keeping a watch on it with more frequent mammograms. Dr McFall said there is only 7% chance of re-occurance with the lumpectomy and getting radiation only reduces it to 3.5 -7%.

[marydenise]

BUMMER, about the bruising. I had that, with my August, 2007 stereotactic, and it sucked. And five years, ago, with another stereotactic, I had a major hematoma. And my August, 2006, lumpectomy, man, MAJOR bruising/hematoma. My boob was like an entire, bruise, and with the SNB, it went down my back. Even my surgeon, she said, EEEK! When she saw me, a week later.

Three months, later, it was all fine.

And with my October surgical biopsy, NADA. NOTHING. NIL. I iced my breast the entire night, but nothing ever happened. By now, the incision is just this 1 inch line that will go away.

My lumpectomy incision, 14 months ago, it's hardly noticeable.

Although, for my part, I had the same surgeon doing my surgical biopsy that had done my lumpectomy. And she told me, in the pre-op appt, she was going to take Extra Care, to insure, no bleeding. And she did it.

I love her. She succeeded.

But ha,for my part, I did nothing, for the next five days. Told my job, in advance, I'm not going to be in.

Please do, post your results, when you get them. I'm so glad your Mother is there.

LMT3, you WILL get through this. By now, it's just a few more days ...

[LMT3]

My biopsy was Monday. Went really good. My breast is bruised but I guess that is to be expected. During the placement for the wire it was tedious because they had to keep taking new mammo shots to make sure they got the blue dye and the wire in just the right place. I didn't even feel the shot that put the numbing stuff in. The actual surgery the anesthisiolgist and take about the different methods of anesthia and decided on local (in otherwords they put you in a twilight sleep). My surgeon also said she was surprised that the very first sample they sent to be xrayed actually had the microcalcs in it because my breast tissue was very dense and the microcalcs were more or else dead center. But I felt so good I even went into work for 4 hours the next day. I did ice my breast for a couple of hours that night but as I said it wasn't bad. My surgeon suggested that I wear a bra for support for a few days and to wear loose clothing so that is what I have been doing.  

I get the results on Monday the 19th. So I really feel I am ready for whatever the results are. My mother is here and she will be with me. I think that helps take some of the scary away. I will let you know on Monday what my results are. I am soooo glad your results we good.

[marydenise]

So, how did your biopsy go? I hope it went well.

I'm almost thinking, in the future if this ever comes up, again (micro-calcs) I'm just going to go right to the surgical biopsy. You were actually lucky in not having to go through both. Although, probably in your case, it was because you multiple cluster sites.

Anyway, wishing you luck on your path results! When do you get them?

For my part, in my "waiting week" I just kept telling myself worse case scenario it's DCIS. And it's VERY treatable and you'll be fine. That worked until the week was coming to an end, and then, despite myself, I got nervous. But then, the All Clear!

Here's hoping you hear the same, RSN!

[LMT3]

Well actually my wire loc is kind of like that. I check into the hospital surgicenter at 8:30a, they take me to the Women's Breast Center (all connected within the hospital tho) at 10a, then my surgery is scheduled for 1p. When the doctor gets a sample they will send it back to the breast center for x-rays and the pathologist to see whether the sample she got has the microcalcs, then if it does it goes to pathology, if not she tries again until she does but all in one setting. I get the results a week later at my post-op.  

I didn't like Swedish either the couple of times I was there for tests on other things. I'm quite happy with Valley.

That's what my research has said, that if the path comes back positive and they do the lumpectomy, or whatever, thats it because DCIS is non-invasive. If they miss some it has the chance of coming back so I think you have to be really confident in your doctors. But you better belief I will be doing whatever my doctors tell me to. I don't think I will be happy if they tell me I have to take Tamoxifen tho. I have been thru a lot and I have beaten a lot already so I will this too, IF it turns out positive, but I'm praying for a negative.

[marydenise]

Hey, sounds like Valley is great! You certainly are in, good hands. And that's great that they now have the digital mammography.

I'm convinced, the only reason there was this "calcification's threat" on my left breast, August, 2007, was because that was the first digitial mammo, on that breast. Before that, I'd had film mammos, at Swedish.

I HATE Swedish. My June, 2006 2CM IDC diagnosis, on my right breast stemmed from a false-negative stereotactic biopsy result, from them, in November, 2002. They told me, it was nothing, 3.5 years later, IDC breast cancer. Jerks.

But even the Seattle Cancer Care Alliance/University of Washington Medical Center, for both my lumpectomy, last year, and my surgical biopsy, this year, the system is just ... not right. First, you have to go to the SCCA, for the wire loc, and THEN, get someone to cart you down to the UW Surgical Pavilion, for the surgery. 6 hours, later.

This is just like ... NOT right. I'm sure you don't have to do that, at Valley, or even at Evergreen Hospital, in my neck of the woods.

This "state of the art" facility should not operate, this way.

But anyway, yes, it is true. Your worst case is DCIS. And to repeat, again, Totally Curable!

We are NOT Elisabeth Edwards, with a Stage 4 breast cancer that has spread, when discovered, by a LUMP. She took hormone drugs and never had any mammos, at the age of 53..

Those are the people that die, from breast cancer.

NOT us. The ones that get mammos, and microcalcification diagnoses.

We're the ones, that survive.

[LMT3]

Funny you mention the UW, I'm having my biopsy done at Valley Medical in Renton WA. I have high confidience in their doctors there. The surgeon that is doing the biopsy has removed my gallbladder, placed the feeding tube I had during my pancreatitis episode, and removed a lipoma (fatty tumor noncancerous) from my arm. My mammogram was done in their Women's breast center. They just started using the new digital machine. So I feel very lucky on that.

Valley Medical Center is also a teaching hospital and some times I prefer the residents because they actually listen to you. Maybe being 57 that means a little more but they have never made me feel like I am a neurotic female. But I feel very fortunate for my doctors there. I

t was actually my surgeon that said told me that at most this could be DCIS, but that with the wire loc biopsy what ever the results it would be almost 100%. So if it comes out negative then there would be no second guessing. The cluster at 10 o'clock is the largest with the most microcalcs in it and the radiologist said that is the one they would likely use to do the biopsy. There were 2 other clusters but there weren't as many in them. So if they turn out to be positive would they have to remove all 3 clusters or leave 2 with more frequent mammograms? I haven't seen anything on that.

[marydenise]

Wow, a hysterectomy at the age of 29? Eek. You really HAVE been through the mill. AND pancreatitis? And you do have a lot of family cancer history, to consider. ALL, not good.

Yet, you're doing the right thing, now. Researching, and listening to all of our disparate opinions, on this board, and that's exactly what you should be doing. Reading and finding out, everything, and in the end?

Doing what's right, for you. Which you will do. Which we all do.

And just for my part, the wire loc is NOT painful. Ha, even though I had mine at the University of Washington Teaching Hospital/The Seattle Cancer Care Alliance/The Fred Hutchinson Cancer Care Center. In Seattle, Washington. And this Resident that did my wire loc was like a beginner. They had to try, like 3 times. But the Attending, was there, and again, it did not hurt, at all. I actually have a very low threshold, for pain. But it was fine.

It won't bother you, at all.

You're going to do great, LMT3. And most likely, it will be a negative result.

Ha, just don't worry about it. I had two months before they told me I needed this extensive biopsy, until I had it. Just don't think about it!

Once it happens, you'll then know, for sure

Just one other comment, Breast Cancer, at THIS stage, is almost NEVER fatal.


marydenise

[LMT3]

that message is for trixie567, usaangel and marydenise

[LMT3]

I have read some things that have said DCIS is cancer and others that say precancer but that it is in the ducts AT THAT TIME. It also said it could move outside the ducts and that is why further testing is necessary. Both of my friends that had the mastecomies had actual lumps not the microcalcs. The one that had the double mastectomy her mother had been diagnosed with breast cancer 15 years ago when she died she had been cancer free for over 6 years. But my friend never took care of herself, never had mammograms, never did self breast checks nor even annual visits to a gyn. She just felt the big bump one day when she was taking a shower. In her case she had no choice but the double mastecomy. The friend who had the single mastecomy had been on HRT for a long time and her doctor told her that's what caused her cancer. I had a hysterectomy when I was 29 (my uterus was literally falling out) but I retained my ovaries so I still had my cycles. But I was put on HRT (1.25 mg of Premerin) starting when I was 43 until I was 52. My Gyn says I am post-menopausal. I would not be receptive of going back on HRT because it caused my pancreatitis (it's why I went off them).  One of the reasons this is so scary for me is because my father died of cancer when he was only 57 (obviously not breast cancer colon cancer) and this all comes on top of finding precancerous polyps on my September colonoscopy (2 of the polyps were worse what the doctor says was borderline).  I take everything y'all are saying in, with comfort. I know everyone has a view and everyone's experience is different. Everything I'm hearing is actually helping me cope and the waiting easier. I also keep doing research. The more I know the more informed I can be it will help so that I won't blank out when I need to be paying attention.

Just want to say thanks to all of you that respond. After my biopsy I will let you know how that went. My sister is concerned because her sister-in-law had a wire loc and said it was exteremly painful. I have a high tolerance for pain so that doesn't scare me. I am researching right now what treatment will/would be if it turns out to be DCIS. If I'm prepared for what to expect with my luck (of when I'm ready it's not needed) I will get a negative reading. My fingers are crossed.

[marydenise]

Oops, sorry, meant to address my last message to trixie567, And NOT usaangel.

Sorry, usaangel!

marydenise