Monday, May 2, 2011

Stereotactic Core Biopsy: It's Not So Scary

When my doctor ordered a stereotactic core biopsy, the first thing I did was search online for details.  I wanted to know all about it:  how it worked, what to expect, and so on.  What I read was frightening enough that, if the possibility of breast cancer wasn't more frightening, I might have cancelled the biopsy appointment.

After I went through it, I decided to write about the experience ... not because I think you want to hear every detail of my day, but in the hope that I can help another woman in the same situation.  I don't remember finding a single reassuring article or personal account about the procedure, so I'm sharing mine.

"Stereotactic" refers to the way the area of interest is located.  Images from two different angles are used to calculate the location.  (When the radiologist called out a set of three coordinates, I felt as though she was playing a new version of the game Battleship.)  My understanding is that this image-guided technique is most useful for microcalcifications or in other cases where no lump can be felt.

"Core biopsy" uses a hollow needle to remove small cylinders (cores) of tissue for analysis.

If you're looking for an overview of what to expect, you can read about the stereotactic core needle biopsy procedure.  If you want to see the table and machinery, I found an image that resembles the system I saw.  (The image is copyrighted, so I can't include it here.)

After all that I read, I was more anxious about the biopsy procedure than about what the results might be!  I hope that, by sharing my experience, I might help someone avoid the same anguish.
This is my personal account.  Your experience may be different.  I am not a doctor:  instructions and information from your own medical team should always supersede anything I say.
  • I arrived at the women's imaging center for my appointment.  A receptionist got me registered, then gave me a gown (a bathrobe, really) and pointed me to the dressing room.
  • A nurse came to get me and took me to an exam room.  She asked a few questions, checked my blood pressure, explained the procedure, and gave me a consent form to sign.  The radiologist came in to introduce herself and answer any questions I had.
  • The technologist came in, introduced herself, and took me to the biopsy room.  She helped me climb up onto the table (the table was elevated, so I needed a stepstool) and get positioned.  Being flat on my stomach and not able to move was uncomfortable but tolerable.
  • She explained the procedure, then started to set up the imaging system.  This involves compression, but it was less than for the diagnostic mammograms I had.
  • Once I was in position and the technologist had located the area of concern, the radiologist confirmed the positioning.  Someone cleaned that patch of skin to prep for the procedure.  (The entire procedure is done underneath the table, so I couldn't see anything that was happening.)
  • The radiologist explained that she was going to inject a local anesthetic, much like the novocaine used by dentists.  (I think the injection also contained epinephrine.)  Unfortunately, I think she said, "Don't jump" at the same instant that the needle pierced my skin.  No harm done, but the nurse held my hand for the duration of the injection.  That injection was the most painful part of the whole process, and it only lasted for maybe 15 seconds.
  • After the local anesthetic was injected, all I felt was pressure.  Even the second injection of anesthetic (needed only because I had two areas of concern, just far enough apart to require a second "hit" of lidocaine) was nearly painless.
  • The machine collected the tissue samples and the radiologist transferred them to a tray.  Then the technologist took the samples to another room to be x-rayed.  This ensures that some of the calcifications had been removed.  (While the calcifications are harmless on their own, it was important to ensure that the pathologist had a sampling of the cells that had produced them.)
  • After the samples were taken, a miniature titanium marker was inserted at the site.  When both sites had been biopsied, the nurse applied pressure to stop the bleeding, then cleaned off the antiseptic.  She closed the puncture holes with Steri-Strips (looks like reinforced packing tape) and a gauze pad before she took me back to the exam room.  Meanwhile, the technologist prepared the tissue samples to send to the pathology lab.
  • The technologist took two more "regular" mammogram images, the radiologist stopped in to see if I had any questions, and I got my discharge instructions.  That's it!
The area remained numb for a few hours.  Even so, I used an ice pack on/off as directed.  By bedtime the area was very sore, and I took a dose of Tylenol.  In the morning it was slightly swollen and still sore, but not enough that I needed Tylenol.

This bears repeating:  This is my personal account.  Your experience may be different.  I am not a doctor:  instructions and information from your own medical team should always supersede anything I say.

As I write this, I'm still waiting for the pathology results.  I'm at peace with whatever those results are; I just want to know what we're dealing with and, if necessary, get on with the treatment.  This is far less nerve-wracking than waiting for the biopsy appointment!

Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid. (John 14:27, New International Version, ©2011)

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  1. Good for you for writing about your experience. I had to have a procedure done several years ago checking for cervical cancer. I remember looking up the info on line also and was not real encouraged! But all in all it was tolerable......I should have done a similar post. When women are looking for info I am sure they will appreciate your honesty and insight!
    And praying for that peace that passes all understanding for you!!!!!

  2. Thank you for sharing your experience so honestly. It seems as though people either try to scare you to death or else they sugar coat it. Please let us knw how you are. I'll be praying for you!


  3. i am glad the procedure went smoothly, sending well///good wishes your way

  4. Thank you for sharing this. I haven't been through it and hope I never have to, but its nice to know that you are willing to share this with others so they can rest assured its not as bad as it seems. Nonetheless, you are so brave! I hate needles. I am praying for you! God bless you.

  5. Thank you for sharing your experience. I am sure anybody reading your account will have a much better idea of what to expect. The unknown can be so frightening and nobody needs any added fear going into a biopsy.

  6. Personal experiences are the most helpful and it was wonderful of you to share it. I say this after having extensive personal experience researching to help diagnose my mothers condition many years ago.

    ** HUGS and Prayers to You & Yours **

  7. thank you so much for sharing this with us...
    i am thinking of you...
    let me know if you need anything..
    thoughts and prayers to you, my dear!

  8. I have the test scheduled Aug 10th and have been scared s...less. Everything I pull off the web makes me even more anxious so it was really deep breath comforting to know you went thru it and I thank you for explaining it so calmly. I have a history of breast cancer in my family (my mom, who survived it when women didn't speak about it). I try not to think about it, but as the date gets nearer I just want to cry- wish it was over. I had three amniocentesis when I had my kids and by the third one I just wanted it over so I could go to Zabars and get a chocolate croissant - I'm hoping the same holds true for this test. Deep breathing is keeping me going.


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