Dis Breast Cancer Survivors Part IV - GAGWTA

[snappy]

Comparison of the two types of needle biopsies from the Mayo center website. Notice that is suggests at the end of the first paragraph to ask your doctor to explain why one is being recommended over the other.

There are several breast biopsy procedures used to obtain a tissue sample from the breast. Your doctor may recommend a particular procedure based on the size, location and other characteristics of the breast abnormality. If it's not clear why you're having one type of biopsy instead of another, ask your doctor to explain the reasons in more detail.

Types of breast biopsy include:

Fine-needle aspiration biopsy. This is the simplest type of breast biopsy and may be used to evaluate a lump that can be felt during a clinical breast exam. For the procedure, you lie on a table. While steadying the lump with one hand, your doctor uses the other hand to direct a very fine needle — one more slender than that used to obtain a blood sample — into the lump. The needle is attached to a syringe that can collect a sample of cells or fluid from the lump. Fine-needle aspiration is a quick method to distinguish between a fluid-filled cyst and a solid mass and, possibly, to avoid a more invasive biopsy procedure. If, however, no fluid can be withdrawn and the mass doesn't resolve on its own, you may need further evaluation with a diagnostic mammogram or ultrasound or surgery to remove it.
Core needle biopsy. This type of breast biopsy may be used to assess a breast lump that's visible on a mammogram or ultrasound or that your doctor feels (palpates) during a clinical breast exam. A radiologist or surgeon uses a thin, hollow needle — but not quite as thin as the needle used in fine-needle aspiration — to remove tissue samples from the breast mass. Several samples, each about the size of a grain of rice, are collected and analyzed to identify features indicating the presence of disease. Imaging techniques, such as mammography, ultrasound or MRI, are often used to guide the positioning of the needle used in a core needle biopsy.
Stereotactic biopsy. This type of biopsy uses mammograms to pinpoint the location of suspicious areas within the breast. For this procedure, you generally lie facedown on a padded biopsy table with one of your breasts positioned in a hole in the table. You may need to remain in this position for 30 minutes to one hour. The table is raised several feet. The equipment used by the radiologist is positioned beneath the table. Your breast is firmly compressed between two plates while mammograms are taken to show the radiologist the exact location of the area for biopsy. A small incision — about 1/4-inch long (about 6 millimeters) — is made into your breast. The radiologist inserts either a needle or a vacuum-powered probe and removes several samples of tissue. The samples are sent to a laboratory for analysis.
Ultrasound-guided core needle biopsy. This type of core needle biopsy involves ultrasound — an imaging method that uses high-frequency sound waves to produce precise images of structures within your body. During this procedure, you lie on your back on an ultrasound table. Using ultrasound, the radiologist locates the mass within your breast, makes a small incision to insert the needle and takes several core samples of tissue to be sent to a laboratory for analysis.
MRI-guided core needle biopsy. This type of core needle biopsy is done under guidance of MRI — an imaging technique that captures multiple cross-sectional images of your breast and combines them, using a computer, to generate detailed, 3-D pictures. During this procedure you lie facedown on a padded scanning table. Your breasts fit into a hollow depression in the table. The MRI machine provides images that help determine the exact location for the biopsy. A small incision of about 1/4-inch long (about 6 millimeters) is made to allow the core needle to be inserted. Several samples of tissue are taken and sent to a laboratory for analysis.

 

[Pea-n-Me]

I found a couple of articles for you, paintnolish, that I think you'll find helpful.

http://www.mothering.com/community/t/529388/core-needle-biopsy-while-breastfeeding

http://www.lalecheleague.org/llleaderweb/lv/lvdecjan03p136.html

I never heard of a lactating adenoma before. Hey, you learn something every day.

http://breast-cancer.ca/type/lactating-adenoma.htm

 

[snappy]

I also learned new stuff today, thanks Linda for posting those links.

 

[paintnolish]

excuse the lowercase. holding the baby.
i called the place where i had the tests. at first the recptionist was not helpful. she said they could not discuss results when i asked what it was about the mammo that warranted biopsy. she also said there were no sooner openings for the test. i was crying and told her i did not know how i would make it until the 13th, which btw us fri. the 13th. she said the tech from yesterday would call.
the tech said the mammo couldn't definitively rule out anything and the only sure way would be to do a biopsy. in fancy terminology she said the mammo showed that part of the nodule appeared cyst-like and part appeared solid. it was also oval in shape. she also said they could get me in for the biopsy on tues. and didn't want me worrying any longer than necessary. results will take 1-2 days and the numbing stuff will be out of my body in 4-6 hours so not to nurse then. she didn't know if i had to pump and dump. i think i'll call the lactation consultant at the hospital.
thanks for the advice and ifo, ladies. it is good to see that 80% are ok and also to see what it could be besides cancer. without you i probably would not have called and would be waiting for the 13th.

 

[Pea-n-Me]

excuse the lowercase. holding the baby.
i called the place where i had the tests. at first the recptionist was not helpful. she said they could not discuss results when i asked what it was about the mammo that warranted biopsy. she also said there were no sooner openings for the test. i was crying and told her i did not know how i would make it until the 13th, which btw us fri. the 13th. she said the tech from yesterday would call.
the tech said the mammo couldn't definitively rule out anything and the only sure way would be to do a biopsy. in fancy terminology she said the mammo showed that part of the nodule appeared cyst-like and part appeared solid. it was also oval in shape. she also said they could get me in for the biopsy on tues. and didn't want me worrying any longer than necessary. results will take 1-2 days and the numbing stuff will be out of my body in 4-6 hours so not to nurse then. she didn't know if i had to pump and dump. i think i'll call the lactation consultant at the hospital.
thanks for the advice and ifo, ladies. it is good to see that 80% are ok and also to see what it could be besides cancer. without you i probably would not have called and would be waiting for the 13th.

Yay for Tuesday! And oval is great. Cancers are not nicely oval shaped, they're irregular and ugly. I had a nice jelly bean shaped spot early on that I wanted biopsied (rather than waiting and worrying for 6 months which was the recommendation). It came back as a benign fibroadenoma. (And later I developed cancer in a different spot.) I would hold on to those good thoughts!

 

[Pea-n-Me]

Benign Fibroadenoma - oval

Cancer - irregular

Microcalcifications/DCIS - speckled

 

[snappy]

Glad you got moved to Tuesday! It pays to insist, and tears don't hurt either. Really that was way too long to wait.

Kiss that babino for us!

 

[paintnolish]

Thanks again, ladies. You've helped me become a little more informed and that has mad me feel better. I haven't cried in the last few hours and spent time watching tv with older ds while holding the baby. I also busted out the pump and pumped a few ounces. The baby hasn't had a bottle yet, so I need to ready him for Tuesday.
Dh is going with to the biopsy on Tuesday and I have a friend watching the kids. Dh is really bad around needles and blood, but if he passes out or vomits it will at least provide comic relief!

 

[MerMom60_94]

Boy, that MRI was helpful in your decision making, huh? That's good!

If you look back to page 5 here, someone else asked about mastectomies and got answers there. Ask if you have more specific questions. Also www.breastcancer.org and www.susanlove.org are good informational websites.

Are you by any chance on Fantasy in April? I might say postpone but I know how much prices have jumped up. Is it just your immediate family or are you going with a group? That's a tough one. We still don't know if you'll be doing chemo yet, do we? If you are, that will be in the midst of that, and in that case I might wait until I was feeling better. If no chemo, then maybe. There can often be little annoying problems that crop up after any surgery that might make it difficult to be out of the country and such, though. Tough choice.

I will take a look at page 5, thank you. I started reading up on breastcancer.org last night and was getting a little wigged out so I stopped. My cruise is on one of the Norwegian Cruiseline ships to the Western Carribean. I have been told I won't need radiation but nobody has mentioned either way about chemo. This leads to my other question. Do they wait to analyze the tissue that is removed before making that decision? My hunch tells me that is the case in which case I could find out after the surgery that there is more work to be done.

Mer mom, thanks for the update. I am glad you will be able to just worry about one side, not two.

As for the mastectomy, it takes several months for the wound to heal, especially with reconstruction. The main area of pain as far as the breast goes, is the underarm area if nodes are removed, which dissipates over time. You will have exercises to do to make sure you regain mobility in the arm.

What kind of reconstruction are you thinking about, tissue transfer of implants? That would change how I would look at this, IF you are not facing chemo.

Tissue transfer is big surgery, actually much more involved than the mastectomy, as you have multiple incisions, could have three if you have the unaffected breast lifted or reduced.

I went nowhere for a month after the free tram flap done two years post mastectomy. And I healed real well. Biggest problem was the stomach incision, hurt a good bit even with the binder to give it support. Three months is longer but I think a six month interval would be preferable.

That is a big decision and one I would address to both of your doctors. My reconstruction was five years ago, and I am sure there have been improvements in flap surgery if that is the way you are going. The Diep method is especially said to be easier to recoup from since the muscle in the abdomen is not cut in that procedure. There was no one in my location who was doing DiEPs in 2006.

I would definitely discuss as I am sure you intend to your planned trip with both surgeons and get their input.

You may not have the pathology from the mastectomy back before your final payment on the cruise. Do you think you could request more time from the cruise line, due to the circumstances, or are there deadlines set in stone?

Worth an inquiry.

I did not have chemo so can't add much to discussion on whether you would be ready for a cruise three months after embarking on chemo. Heck, I do no know how long chemo treatment takes, but I know that varies greatly, and can be drawn out if you have a reaction.

Breastcancer.org is an excellent resource.

Glad your daughter took things so well. It is wonderful that she will have someone to talk about your diagnosis with. Be sure she understands that each case is different, and how much results vary from one woman to another.

Would love for you to keep us updated.

I have a choice of implants or a tissue transplant. I am strongly considering a tissue transplant but understand the recovery is much more difficult. It is helpful to hear from someone who actually has been through it. When all this is done, will my clothes still fit or will they fit differently? Will I still have feeling in the reconstructed breast? I meet with the plastic surgeon in mid-January. I keep wondering how I won't end up lopsided if he doesn't do work on both sides. I have visions of one girl looking new and perky and the other looking 51 and, well............not perky. I know these are vain questions and I am supposed to focus on my health but I don't want to end up deformed looking. I know, that probably sounds bad in the big scheme of things.

I did suggest to my husband that we explain to the cruiseline what is going on. In fact, I think I took out travel insurance. I should probably check. We already have purchased airline tickets, as well, and will have to talk to the airline to see about a refund. If they won't refund, we do have a timeshare in Kissimmee and perhaps a vacation lounging around the pool would be workable. I don't know. At least it wouldn't be as active as a cruise. My gut is telling me we may just want to put this off until school is out and we can rebook then when things are getting back (hopefully) to normal.

The people on this thread are truly helpful. Thank you for being there.

Paintnolish - I am so sorry to read what you are going through. I can't even imagine going through any of this with a new baby.

 

[snappy]

Paintnolish, I doubt your husband would be allowed into the room where you have the biopsy. But it is good for him to be with you beforehand in the waiting room, and then afterwards when you are done with the procedure. I think it was good thinking to start with the bottle. Were you able to reach the lactation specialist?

Mermom, the size of the invasive component of your tumor (if any) and whether or not there is any cancer detected in lymph nodes will help the doctors know if you need chemo. Radiation more depends on whether there are clean margins found.

As far as clothes fitting, my experience was different in that my reconstruction was delayed two years. I had to wait for a few months to be fitted with a prothesis since I needed a large one to match the unaffected side, and my incision had to heal before it could handle the weight. So I used a light weight form that really looked fake, along with some soft shoulder pads from shirts I used to wear years ago. With reconstruction they give you a soft bra that has velcro that you tuck bandages in until it heals. After healing you can get a real bra. You can discuss size with the plastic surgeon.

I imagine usually the unaffected side gets the lift and reduction for women of a certain age. It really helps for fitting bras and being symmetrical. I saw three plastic surgeons and all three recommended the work on the unaffected side. I don't think it is a vain thing, it is important for your back, neck and shoulders, and your overall posture for that matter for you to be balanced.

My mom was 78 when she was diagnosed in 2008, at that age only the implant was recommended. She opted not to have the unaffected side worked on when she had her mastectomy and immediate reconstruction to reduce the amount of surgery. I think she would have been better off having the other side modified back then as well. She never has had the saline implant traded off for the permanent silicone one, and at this point I doubt she will. Probably isn't the wisest path for her to have anesthesia now unless medically necessary, since she has been having other health issues for awhile.

I wish i could offer you more feedback on taking the cruise. It might be fine, you never know. It really depends on how your body deals with this much surgery, and if you have any complications. Although it is major surgery, it isn't like heart surgery, or lung surgery, no vital organs are involved. But infections do occur.

The critical time for flap surgery is during the first day or two when the blood supply to the flap is being established. Once that blood flow is robust, you are past worrying about losing the flap. The stomach will hurt, they will give lots of pain meds, but the healing takes time. The drains are a bit of pain to deal with, and when they are removed you will start feeling like yourself again. I needed my husband with me 24/7 for 8 days. After that I started enjoying my independence again.

There are a couple of steps with the reconstruction, so it is an ongoing process. Expect to see the plastic surgeon for about a year, if you want all the trimmings so to speak. Feel free to pm me if you need more info on some of this. My plastic surgeon had a book of pictures of patients with result from both the tissue flap and implant surgery, before surgery, about 1 month out, and then further on down the line. I found that helpful.

No, you will not have any feeling in the reconstructed breast. A mastectomy requires the cutting of the nerves, so while their is no feeling, there is also no pain. There is numbness under the arm where the nodes are removed, and I have numbness in my stomach where the flap was removed.

It is not pins and needles numbness, however, so not bothersome.

 

[luvmarypoppins]

Happy almost 2012 everyone!!

Mermom - I am glad your dd took it well. I dont know what to say about the trip. I know another poster Marci went on a ski trip between chemo treatments. She just rested all the time but wanted to be with her family after her dr. ok'ed it. Although I have another kind of cancer. We waited till almost a whole year before we went back to Disney (7 operations later). Its a personal decision and I am sure you will take everything into consideration. Wishing you all the best.

paintnolish - I just cant imagine what you are going through. I know after I had our 3rd ds then 3 days after that my sister suddenly died, so between the hormones and dealing with all that and then the drs. telling us it could be genetic and my kids could have it to, I think I was ready to go off the deep end.

I am so glad you are going tues. too. Glad your dh will be there for moral support. Mine is always with me . I dont know what I would do without him. As Linda said about the fibroidadenoma. I did have one of those and it was oval, the size of an egg. I will pray this will be the case with you as well. Hang in there! Tears are ok too. I am sure it will be hard to wait for the results but we will be here for you.

Well we are gong to church tonight for a little get together. Snacks and a white elephant gift exchange. Ds20 is joining us after work. The others are going to parties. Dh leaves for China again on Friday, sigh, sigh.

GAGWTA. Blessings to you all always.

 

[MerMom60_94]

Just popping on to wish you all a happy new year. I hope 2012 brings you all good health. Leslie

 

[paintnolish]

Happy New Year, ladies! No tears today...okay, I teared up but no actual crying.
Pea-n-me: Thanks again for all of your help, with this and my peeing dog! You still have to watch her! If she is not under direct supervision, she has to be in her crate. She's such a sweet, gentle girl, though. She hadn't peed on the floor in a long time until...I got up with the baby at 1 a.. and dd was up. I told her to go to bed, and she said she had been but had let the dog sleep in her bed (she is supposed to be in her crate-thought dh would take care of that!) and the dog peed in her bed!!!! She's never done that or on anything other than the floor and that's not very often. Grr! Poor dd.
Snappy: That's ok if dh isn't in the room and it'd be better for him if they said he couldn't. He got a little woozy during my epidural! I can handle the physical part of the procedure just fine. It will be nice not to be alone before and after.
Mermom-Thanks for the virtual hug.
Luvmarypoppins: I am praying and praying it's a fibro whatever. I keep feeling the lump. It's so surreal that something so tiny can cause this much stress!

Anyway, here's to a happy and HEALTHY New Year to all!

 

[wdw4us2]

Happy New Year to all and welcome to our new members!

I had two doctor's visits this past week - one with the Miami doc and the other with my local oncologist. Miami doc says no surgery for me in the future as he can't get to the worst part of the cancer without causing a multitude of other problems. So, I am back on the chemo roller coaster again this Friday. This time, I will be on Abraxane. My infusions will be every third Friday with hydration the following Monday. My local oncologist wanted to do every three weeks with one off, but I told her I don't think I can tolerate that. The mass near my diaphragm has become noticeably larger during my chemo break and has started becoming painful in the past two days. Supposedly, the chemo will work to shrink that tumor as well as battling the rest of it.

I can't believe I'm starting another new year on chemo. This fight is never ending in my case.

 

[Pea-n-Me]

Happy New Year everyone!

I have been sick for almost a week now. Finally starting to feel a little better. Still a little junky and wheezy.

Lisa I can sense your frustration. I am sorry you're going through this. Hoping for some good news for you this year.

paintnolish, I had to think about the dog peeing situation I might have to check old threads. I respond to so many dog threads I can't always keep them straight, lol. (Once I re-read it I'll totally remember it!) Glad you've stopped crying.

I was wondering how Hulagirl's mom was doing? Hopefully everything went well, I don't think she's come back to either thread she had yet.

GAGWTA

 

[snappy]

Sorry you are facing yet another round of chemo, Lisa. You do sound frustrated as Linda says. I hope you get some relief fast from the discomfort, and that spacing out the treatments makes them tolerable.

I assume you will be starting this Friday. Please post and let us know how you are doing. Bad time of year to have upper respiratory issues.

Going over to mom's right now to share cabbage, black eyed peas. Can't get anyone else here interested in going with me, lol.

DH figured out that a loose connection made some of our LED net lights fail. I am glad that we won't have to replace them but wish we had figured it out earlier. Our "display" looked a bit cockeyed this year, after the first week or two, when random string sets would not come on.

DH got me a Bose sound dock for my iPhone. I think he is trying to keep me from booking a presidential unit at WBC for awhile sine I bragged about the Bose system in the bedroom and the Bose surround sound one in the living room.

Hate to tell him but it won't work.

Helped my mom figure out how to get her tins unit the PT gave her for pain relief last night. Had to do some emergency trouble shooting. Heck, I just read the instruction book. She is getting a little helpless but sure seemed to appreciate it. I am certainly not mechanical go I guess there was magic involved too.

GAGWTA

 

[luvmarypoppins]

Happy 2012!!

Lisa - so sorry you have to be on the chemo coaster again . It stinks! I can relate to you being frustrated too. After operation 5, even my aunt said, wow you cant catch a break can you. I said, yeah you are right. My faith helps me alot. I hope this chemo interval is good for you and that it will shrink the tumor so you can be comfortable. My prayers are with you.

Laurie - dont know if I would like those foods. Are they a tradition or foods for good luck etc?

Linda - sorry you have not been feeling well. I hope you recover quickly. Tea and chicken soup, my go to's when I feel like that and add in the vicks too.

New Years Eve was nice. We went to church. ds24 came. Ds20 had to work so late so he just came at the end. They all went to parties later. The white elephant gift exchange we had was fun.

We stayed up late to watch the show from Times Square and waited for the announcement. Even dh said it was a bummer. Glad we booked the bounceback rates when we were there.

We put little critter in his ball in the kitchen while we were eating lunch. All of a sudden ds21 noticed we didnt hear him. He sees he has gotten out. Omg! He saw him and threw a box over him. He is in his cage now. I didnt think he could get out of the ball but apparently it became undone.

I have been having the cramping and pain again. I read another lady who was postng a thread on this also. I took a deep breath when someone posted that the results of this for her mom was uterine cancer. I am praying that will not be the case with me after the sono and biopsy. I did read my radiation could cause secondary cancers but it would be more like leukemia but the gyn already told me she has been wrong in the past even though she told me she does not think it is. I am having some doubts right now. The 19th cant come fast enough for this.

GAGWTA.

 

[snappy]

Must be a southern thing, then MaryAnn, about the cabbage and black eyed peas. I did not realize that it was a regional deal.

Does anyone else have a traditional New Years dish or two?

Yes, it is supposed to be for good luck.

Have to admit, we also had gumbo and DH grilled chicken breasts and fresh salmon. So we have normal food for the week.

DD21 and DS23 were both in New Orleans for New Year's eve. It was supposed to be the #1 spot people wanted to be for New Year's. Weather was fantastic. I saw fireworks on the river as I left mom's house last night after my visit with her. I just parked and watched the fireworks in the sky over the levee. It was a nice show, and I did not have to deal with crowds.

Dd16 was even at a friend's house last night so it was nice after all the commotion of the last 2 weeks to have a quiet house, no cooking to do, and nobody to "entertain."

DH and I lead exciting lives.

 

[paintnolish]

Spoke with the lactation consultant. She said there's not really any reason to NOT bf ds but I could pump and dump once on that side if I wanted to be cautious. She said to feed him before the procedure and then pump what was left. After the procedure, it was fine to feed him on the unaffected side as soon as necessary.
Getting nervous. I want to get it over with but then the dread of waiting sets in. Dh and the kids return to school Wed., so the day or 2 waiting is going to be horrible. I am terrified of getting bad news when all alone.
So how bad is the procedure?

 

[snappy]

Spoke with the lactation consultant. She said there's not really any reason to NOT bf ds but I could pump and dump once on that side if I wanted to be cautious. She said to feed him before the procedure and then pump what was left. After the procedure, it was fine to feed him on the unaffected side as soon as necessary.
Getting nervous. I want to get it over with but then the dread of waiting sets in. Dh and the kids return to school Wed., so the day or 2 waiting is going to be horrible. I am terrified of getting bad news when all alone.
So how bad is the procedure?

Glad you got specific info about breast feeding.

I wish you well tomorrow with the test. Glad your DH will be with you. If you are alone when you get the results, check in with us, we will be here for you.

The test is not really painful. It is a little strange to be on that table with your breast positioned as it needs to be. There will probably be a number of people in the treatment room. I was shivering, not sure if if was from the room being cold or just apprehension so one of the nurses offered me warmed blankets. This nurse also positioned a CD player close to my ear and played nice relaxing music. You may want to consider bringing an iPod if they allow it.

My stereotactic core needle biopsy took awhile as I had multiple areas that needed to be tested. Also, there was a lot of discussion in my case between the radiologist and the nurses as the area that was close to the skin surface was very difficult to access with the needle. I was really glad I had the music to drown out the words as I did not understand what they were saying. It was easy to jump to dire conclusions when there was no reason to. They were very diligent and were able to test all ares.

Afterwards I just used ice packs. Bags of frozen peas work well too, per one of our long time posters here, Ann.

I will tell you that my sister had a surgical biopsy a month or two after mine and her biopsy was more involved, and a lot of tissue was taken out. That type of biopsy is more invasive but is done when there is a large area of concern.

Good luck, Sweetie.