Seeking information about stereotactic breast biopsy experience
September 3, 2016 10:16 PM   Subscribe

I recently had a routine screening mammogram. The radiologist recommended that I come back for a spot-compression mammogram and an ultrasound. After I had those two procedures, the radiologist recommended that I come back again for an ultrasound-guided fine needle aspiration and also a stereotactic breast biopsy. Both procedures are scheduled for this Thursday. I am getting quite nervous about the stereotactic biopsy. More inside!

The doctor only spoke to me for a few minutes, and in that time, she twice mentioned that the fine needle aspiration is just like having blood drawn. But she said nothing about the stereotactic breast biopsy.

Afterwards, I thought it was strange that she said not one word about the stereotactic biopsy, so I decided to turn to google to get an idea of what is involved. And now, I'm a bit freaked out.

For one thing, it seems that my breast will be compressed as in a mammogram for the entire time, which could be up to an hour. I find regular mammograms to be very, very painful, but the compression is just several seconds, so I just grit my teeth and bear it. But I can't imagine dealing with that kind of compression for any real length of time.

So, has any MeFite had this procedure? If so, how was it??

P.S. I do plan to call the facility on Monday to try to get more information, but it is now the wee hours of Sunday morning, and I am hoping to hear about personal experiences of women who have actually undergone this procedure.
posted by merejane to Health & Fitness (8 answers total)
I'm sorry you are going through this. I have not had this procedure, but I did just have a bone marrow biopsy, and I absolutely insisted on sedation. The doctors did not want to do it. They told me it was close to painless except for one brief moment, that it was mostly just "pressure" (what rot!), and that other people did it all the time without sedation, but I have an extremely low threshold of pain, so I stuck to my guns and told them I would not otherwise have the procedure. Even then, the doctor doing it didn't want to wait to get started when the anesthesiologist was not quite ready! (The anesthesiologist, I will say, stuck up for me, pointing out I have fibromyalgia and get anesthesia to have my teeth cleaned.) Even so, I woke up during part of the procedure and was in a lot of pain for a few minutes. I was told afterwards that these biopsies are supposed to take 20 minutes, but mine took an hour and a half because they had a lot of trouble with it, so I'm especially glad I was so insistent. So my suggestion is don't believe they have to do it the way they "always" do it. My rationale is that if they can use sedation for a colonoscopy, they can use it for a bone marrow biopsy too. They probably won't want to do it, but it's your body, and you are the one who will be experiencing the procedure. Good luck to you.
posted by FencingGal at 7:02 AM on September 4, 2016 [4 favorites]

I'm sorry you're going through this! I know it is stressful!

The fine-needle aspiration will be super easy and practically painless. They may or may not give you a shot of lidocaine for that, but honestly even without it you barely feel it (I've had it done with and without). If you feel anything, it's like a slight burn that ends quickly.

I have not had the stereotactic, but a close family member has, and there was definitely some soreness involved from the compression and pressure. I don't think it's like sharp, jabbing pains, just fairly consistent pressure for awhile. Afterward, you may have some bruisey soreness for a week or so.

Please please tell the office before your appointment that you have difficulty with the compression of a typical mammogram! They may be able to prescribe you something to take beforehand or provide at the appointment to ease your nerves, the discomfort, or both. They will not want to find out during the procedure that there is something they could have done to make it more comfortable for you and for them.

I try to remind myself when I go for uncomfortable procedures that my idea of what the pain will be is always so much worse than what it actually is. I can't remember a time where I said, "Wow, that was worse than I expected." It won't be fun, but it will be OK and you'll feel a huge weight lifted when you are done.
posted by dayintoday at 7:12 AM on September 4, 2016 [1 favorite]

I had one a few years ago. The mammogram is done while you're laying face down on a table that has a hole for your breast to fall through and then be compressed by the mammogram equipment. Mammograms don't cause me pain, so I can't comment about that. The radiologist gives a pain injection near my armpit, which wasn't pleasant, and neither was the actual procedure. It wasn't painful, but feeling the instrument inside your breast isn't a natural sensation. I'd rate the overall unpleasantness of the procedure itself as a bit more than having a cavity filled by the dentist. The recovery is unpleasant, my breast was sore for a few weeks and wearing a bra was not possible. I wore tank tops with built in support - just an extra layer of fabric with elastic going all the way around. Also, if you decide to use anxiety medication get the ok from the biopsy facility beforehand, they are very specific regarding your mental state when you sign off on having the procedure done.
posted by txtwinkletoes at 9:02 AM on September 4, 2016 [1 favorite]

I had one last year, and I think it took a grand total of 20 minutes. They probably tell you it will be up to an hour in case they need to repeat the squeezing because the image didn't work out or something.

The room I was in was dimly lit -- mood lighting, almost -- and the blinds were drawn. It felt reassuring not to be under fluorescents. I hope you get that too. I'm sure that is part of making women feel better about the procedure.

The table you lay on is really comfortable, almost like a bed or massage table. There's a hole your breast goes through so they can put the needle in before the squeezing. Gravity actually makes you feel more comfortable when you're lying down because it stretches your breast away from your rib cage.

My doc and radiologist went out of the room together to look at the images and then came back to invite me to look at them too, so you can ask to see yours right away if you want to have them explain to you what's going on.

Like txtwinkletoes, I was sore for a few days and had a tiny bruise where the needle had gone in.

If you're going to call your doc, ask them to describe the exam room to you. If it doesn't sound like mine, you might want to ask for anxiety meds.
posted by vickyverky at 11:03 AM on September 4, 2016

The compression is not as much as a mammogram - no where near. I have some discomfort from a mammogram and zero physical discomfort from the compression at the biopsy. There were pinchy injections for the pain medicine and you can ask for more at any time. The feelings were more generally invasive or uncomfortable than painful after that.

The nurses were wonderful - thoughtful and compassionate. One held my hands and talked to me the whole time.

Also, depending on the angle and location of the biopsy, your position may be adjusted. I was seated with the equipment angled towards the top of my breast that was compressed. You may be able to find out ahead of time what position they expect you to be in.

I agree that the actual biopsy time is less than an hour though there is a lot of back and forth - placing the biopsy equipment, checking the visuals, etc.

I think the worrying is worse, way worse, than the procedure. Good luck to you, sorry you have to deal with this.
posted by RoadScholar at 5:52 PM on September 5, 2016

I had one last year, and the procedure lasted under 20 minutes. I remember feeling very awkward, but I didn't feel the compression was as painful as the mammogram. After a few minutes the compression actually made my breast feel a bit numb. The insertion of the needle itself felt like someone popping me with a rubber band. It was a quick snap, but not overly painful.

One thing you may want to think about is which way to turn your head when you initially lie down. I was told not to move once I was settled. My body was face down, but my head was turned towards the wall and away from the doctor. Although this was not intentional, I think it made the process easier for me because I couldn't actually see what was happening (most importantly I couldn't see the needle). The doctor was very good about telling me what was happening along the way, I just couldn't see it.

Overall the most painful aspect for me was after the procedure. I had a reaction to the surgical tape used to close the needle insertion point. I don't think my reaction was common, and it wasn't that horribly painful. Perhaps have someone go with you to ask about how to care for the incision point.

I'm sorry you are going through this. It can be overwhelming to not only be faced with possible scary health news, but to face what appears from online descriptions to be a complicated long procedure. In my experience, it was relatively quick and more uncomfortable than painful.
posted by donovangirl at 6:26 AM on September 6, 2016

Thanks so much for the reassuring responses -- it definitely helps!

My appointment is tomorrow afternoon. I'm hoping my experience is like donovangirl's, with the compression not being as painful as a regular mammogram, and maybe even numbing my breast.

I will post again afterwards to report on my experience!
posted by merejane at 9:29 AM on September 7, 2016

So I had the stereotactic biopsy today, and it wasn't so bad!

The one difference is that I was sitting up in a chair -- no table with a hole in it. I think that might have made it easier. I was definitely comfortable sitting up.

As RoadScholar and donovangirl said, the compression definitely was not as much as with a regular mammogram. As they also said, the actual procedure was fairly quick -- maybe just five minutes? Certainly not more than ten. The rest of the time was just setting up, having the tech and then the doctor explain what was going to happen, etc.

As to pain from the actual needle, it was not fun, but it was definitely bearable. I think the burning from the anesthetic might have been worse! (And that is always bearable for me.)

Oh, also, the tech lightly rubbed my back during the procedure, which was very soothing!

In case someone does a search on this in the future and finds this thread, I would like to recommend the place I had this done. It was Park West Radiology in Manhattan. The doctor was Dr. Darwish, and the tech was Desiree. They were both great.

Finally, thank you all for your posts! They definitely helped calm me down beforehand.
posted by merejane at 2:12 PM on September 8, 2016

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