Thursday, August 28, 2008

My Stereotactic Breast Biopsy

Though I have a pretty low level of disclosure, I'm hesitant to post really personal information, but my desire to possibly help someone else who might go through this far outweighs my concern about posting my own story.
When I learned that I would need a breast biopsy, I did some research online about the procedure, the stereotactic breast biopsy, and found mostly questions from women who were nearly in panic about the procedure or the possibility they have cancer. While I can't do much to quell fears that someone has cancer, I can describe this procedure which will at the very least set your expectations about what you may go through. As backstory I'll just say I went for my first mammogram, the baseline, and they found "something". That "something" could be malignant or benign, it could a regular part of my anatomy or it could be the beginning of something not great.
I arrived for the biopsy, and after waiting a short while for the doctor, was brought into a changing room and given a robe. My mom was made to wait in the waiting room. After only disrobing from the waist up, I was brought into the biopsy room, nervous, and had to sign some consent forms- pretty standard stuff about the possibility of infection, the risks, etc. There was nothing unusual about the risks, that seemed pretty routine.
I was then shown my new hardware. I had no idea that I'd be implanted with a titanium marker. This is a small thing that is inserted into the biopsy site to allow future doctors to know the exact location of your previous issue. I was a little surprised by it- I asked if it could cause scar tissue to form. The answer was "not really". The doctor then told me that many doctors insert the chip without even telling patients, it's standard. Well, after a little hesitation, I agreed. Really now if I ever own a titanium bike, I'll be made of the same material- think of the synergy!
Next I was lead to the table- it has a small hole in it where your breast comes through. I started to cry on the way to the table because I was nervous, and I asked that they not really describe needles and incisions to me (I have a needle phobia). I laid down and just like a mammogram, the breast is compressed in what can really only be described as a vice grip. It was mildly uncomfortable, but moreso in a general sense, nothing unbearable. The nurse positions your breast from underneath the table and an x-ray picture is taken to ensure that the area of concern is reachable. They positioned me right the first time. Now it was time for me to hurry up and just lay there. I had tissues in hand for my tears, and was told to lay still. I could still wipe my tears though, being clamped to the table really doesn't allow you to move anyway.
The area of the incision was cleaned, swabed with betadine. The nurses kept checking in with me, asking if I was ok. For the most part, I was. I had planned initially when I was so nervous about the procedure, to be "calmed" with some anti-anxiety medication. But the day of the procedure I decided against it. I wanted to summon my strength and get through it on my own. The nurses said most people take something before they get in- actually they said that they require you're coherent enough to sign the papers, but that's all.
After the swabbing, I was given lidocaine. I had expected that this would be a topical application, however it was a needle. The surprise of that upset me and this I have to say was the worst part of the day- the unexpected needle that felt like it went very deep. I was warned that it might burn a little, and it did. I was scared, a few more tears came, and I avoided the banter of the nurse who was trying to get me to talk about what I did, how old my son is, etc. After the numbing, the nurse kept assuring me that I should really not feel any pain and that if I did, the doctor would stop and make it more comfortable. Fortunately, the initial application appeared adequate. I could feel mild discomfort, but nothing earth-shattering. My fear was really far outreaching the actual pain.
After the numbing came time to take the samples. I heard a sound that was pretty much like a dentist's drill (a terrible sound because it usually hurts at the dentist's office when you hear it), but there was no pain. There were I think 5 or 6 drill sounds, the nurse was telling me I was doing great. Then they told me they were taking the samples to be x-rayed to make sure they got what they needed.
After a few minutes, they came back and said everything was good. I didn't feel the marker being placed in me at all. The doctor said she thinks she removed all of the suspect tissue- not really the intention of the procedure, but when the problem area is so small, an added bonus.
I was released from the grip of the clamp, pressure was applied to the incision, and I was told to lay on my back while the nurse continued to apply pressure.
Steristrips were used to close the incision and I was bandaged up, given an ice pack and told to alternate ice therapy every 30 minutes for the rest of the day. The nurse also told me I didn't bleed at all during the procedure. That totally surprised me but she said that's just the way some people are.
I was then taken to the mammography room and given two mammography pictures in order to ensure the marker was in the right place. Being squished into a mammography moments after the procedure was mentally upsetting, but I was thankfully still numb, so the physical pain was almost nil.
I got dressed and went home, a little sore, mentally absolutely exhausted, and told to rest.
A short while after getting home I looked down at my shirt and noticed that I had bled through my bandage and through my shirt, but not an alarming amount. I changed my shirt, supplemented the gauze, and was fine the rest of the night. I was even able to sleep on my stomach, though I did sleep in a sports bra to keep the pressure on and the bandages firmly attached.
Today I'll return for a check up and have the bandages changed. No heavy lifting for two days, no shower for a day or so, I can expect soreness and bruising for a while.
If this is something you have to go through, don't panic. The procedure took less time than I was initially told, and a lot of concern was given to me feeling as little pain as possible. Mentally, it's a tough thing to get through, especially if you're so concerned that you're about to face a cancer diagnosis. All I can say about that is to not worry in advance. Easy to say, hard to do.

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