Breast biopsy and then waiting

[lucsnowe]

I wonder if anyone has any experience or advice they can share... I need a breast biopsy after a mammogram showed calcification in one breast. I'm really worried, not about the biopsy itself, but about the results. The consultant I saw didn't really have any words of real reassurance, just said it was a "toss up", so now I've made the terrible mistake of looking up breast cancer and secondary breast cancer on the Internet. I know no one can tell me all will be well, but does anyone have any advice or experience of the implications of calcification?

Bump! Can anyone respond to this?

Bump!

Hello I don't know any thing but didn't want to leave you unanswered

Good luck sweetie

Thank you for getting back to me! It is very sweet of you to answer. I thought someone must have had some experience of this. Surely calcification isn't that unusual? Maybe it is.

Hi lucsnowe - I've had a quick look and it seems likely to be harmless. But even if it cancerous I gather it would be DCIS - pre-cancerous and non-invasive - so easily treatable with surgery alone. It's understandable to be worried but it does sound as though even the worst case scenario would still be something that can be sorted.
I don't think you could possibly have any secondary cancer from something like this as it wouldn't be invasive.

I don't know about calcification either but do have breast cancer and I do know that even if it is that there's lots they can do. Chances are it's not though of course :) good luck

Thank you KitKat and Malteserzz. And thank you for your reassurance. I had read about calcification online too, and had felt reassured, but the consultant said there was a possibility it could be invasive. My mum died of breast cancer so I am terrified, although I don't think she had calcification. Malteserzz, how did you find you had breast cancer? How was the diagnosis reached?

lucsnowe, Zombie has been going through this process for the past month. This will be a very long post, but I'm copying all the relevant posts from the thread in Chat that has been running.

Valpollicella Wed 05-Mar-14 00:05:00

With Zombie's permission, I'm starting this thread

As many of you know she has had a hideous time through her treatment for cancer.

At the point where she was maybe out of the woods she has been asked to see her surgeon on Friday. Unexpectedly sad

Can we all squeeze her together so her limbs don't go flailing
and do what we vipers do best?

I cannot bear the thought of her going through all the treatment s again after coming out of it before

Prayers, fingers crossing or whatever welcome right now

IamtheZombie Wed 05-Mar-14 13:51:24

I had my annual check-up appointment with my surgeon on 31st January. At last year's appointment she had told me that the protocol for mammograms had changed and I wouldn't need one before this year's appointment. On the 31st I was advised that the protocol had changed again and they would send me an appointment for one. She then examined me and all seemed well. There was absolutely no mention of another appointment this year after the mammogram. It was all "See you next year" chat.

I had the mammogram last Tuesday, 25th February. The radiographer told me that if I hadn't received a letter with the results in about 2 weeks I should ring my surgeon for them.

I had an Oncology Clinic appointment last Thursday. The oncologist also examined me and all seemed well.

That is why I was so shocked and upset yesterday when I opened the letter from the hospital to find an appointment for this Friday morning. All I could think was "Oh, fuck, the mammogram must have shown something that they're concerned about".

I'm doing my best to be positive. If there is a problem it's been discovered at a very early stage.

I'll know for certain with 48 hours.

IamtheZombie Fri 07-Mar-14 13:41:37

The mammogram showed new areas of micro-calcification. Now, all that micro-calcification indicates in and of itself is that there has been damage to the breast tissue, but not what has caused the damage.

I will therefore need to have a biopsy to determine whether the cause is benign or malignant. If it's benign they will just monitor me more closely. If it's malignant it's almost certain to be Ductal Carcinoma In Situ (DCIS). DCIS is what I had in this breast 21 years ago. That time it was treated with a local excision (essentially a lumpectomy without the lump) and 6 weeks of radiotherapy. If it is DCIS again, I've told my surgeon that I'd prefer a mastectomy to another local excision. She agrees that would probably be the best course of action.

I should receive an appointment letter early next week for the biopsy. It will be carried out under local anaesthetic in the mammography department. They will be able to do a needle aspiration biopsy while visualising the breast using the mammogram machine.

After that I will be sent another appointment to see my surgeon and discuss what happens next.

So, not the news I wanted but pretty much the news I was expecting. I'm actually fine with it (for now). I've gone into pragmatic one step at a time mode which usually serves me in good stead.

IamtheZombie Tue 18-Mar-14 14:06:59

The appointment letter for Friday arrived in today's post. The biopsy procedure will be a Stereo Core Biopsy.

It was a Core Biopsy that diagnosed the cancer in my right breast. No mammographic imaging was required that time as the lumps were palpable. So at least I know exactly what to expect from that part of the procedure.

When I previously had DCIS in the left breast I had to undergo a Wire Localisation Biopsy. That involved about an hour with the breast in the mammography machine while they took a series of images to locate the microcalcifications and position the tip of the wire in the centre of the affected area. I was then whisked up to theatre for an operation to excise the tissue. I am extremely grateful that technology has moved on so much in the last 21 years.

For anyone who may be interested - or have morbid curiousity ;) - here is a link that fully explains the procedure:

www.radiologyinfo.org/en/info.cfm?pg=breastbixr

IamtheZombie Fri 21-Mar-14 15:43:29

Once I had stripped to the waist and donned the extremely fetching gown I was seen by the doctor who would be doing the biopsy. She showed me the mammogram so I could see the area that they are concerned about. She then explained step by step what would happen this morning.

Next they took a straight side to side shot which together with the top to bottom shot and the diagonal shot from a few weeks ago gave them more of 3 dimensional target.

I had a short wait while they planned the procedure. Then I was taken back into the mammogram room. I had to lie on my left side on the very edge of the trolley/table and they moved me over to the mammogram machine. They got my breast positioned properly and I then had to NOT move at all until the procedure was over. The doctor cleaned the area she would be going through and gave me a couple of doses of local anaesthetic. Five minutes later she started with a very small incision. Then out came the collection of biopsy needles. She took about 8 or 9 samples with minute adjustments in position between each one.

The final step was making me the proud owner of a tiny titanium tag which was inserted into the area that had been biopsied. That will show up on any future mammograms so that they know exactly where the biopsy was done.

They then converted the table into a chair and I had to sit there for about 5 minutes before going to dress. There was another 10 minute wait and then one of the radiographers checked for any problems and I was out the door.

Getting my results depends on how long it takes pathology to thoroughly analyse the biopsy results. The multi-disciplinary team meet on a Tuesday. If my results are back in time to be discussed at next Tuesday's meeting, I will get the results from my surgeon next Friday. If not, they will be discussed the following Tuesday and I will see my surgeon that Friday.

IamtheZombie Fri 28-Mar-14 14:00:02

I have Grade 2 invasive ductal carcinoma. The results for hormone and HER2 sensitivity aren't back yet.

My mastectomy is scheduled for Thursday, 17th April. In the next week or two I will have an ultrasound examination of the axillary lymph nodes on that side. Those results will help my surgeon decide whether to do a sentinel node biopsy or a full node clearance at the time of the mastectomy.

As I had radiotherapy to this breast 21 years ago when I had DCIS, I cannot have any further radiotherapy.

It is too early to tell whether or not I will need to have more chemotherapy. My surgeon said "You may well be heading towards more chemo but we just don't have enough information yet". That decision will be made once the hormone and HER2 sensitivity results and the full histology results on the tissue removed during the mastectomy are back.

Although it's not what I wanted to hear, it is pretty much what I was expecting to hear.

IamtheZombie Wed 02-Apr-14 13:47:03

I was seen by the same lovely doctor who did my biopsy 12 days ago. I asked her to please be completely honest with me about what the ultrasound revealed.

She explained that she would be looking for signs of any enlargement or irregularity in shape in the lymph nodes. She didn't talk much while actually carrying out the ultrasound. When she finished she said that there are a few nodes that are slightly enlarged / thickened. One reason for that could be an after effect of the biopsy. The only way to find out is to biopsy the nodes. She asked if I wanted her to go ahead do that today. I said yes.

So, armpit injected with local anaesthetic and then 2 samples taken. I didn't feel a thing with the first sample but OUCH on the second one. The pain only lasted a second or two. Poor doctor was very upset that she had hurt me.

Because the biopsy hadn't been pre-planned, I'm not sure when I'll get the results. One of the radiographers popped into the Breast Clinic for me and left a note for my Breast Care Nurse. I may get a call to come back this Friday. If not, I should get them next Friday.

Those results will probably determine whether my surgeon does the sentinel node biopsy or a full node clearance during the mastectomy. There's a huge difference in the post-operative help I'll need depending on which is done.

Quite frankly my gut is telling me that this is a nasty little bugger. The fact that it developed out of nowhere within 14 months to the point of being invasive instead of in situ and now the increasing probability that there is lymph node involvement are not good signs.

I found mine myself, a lump in my breast. Sorry to hear about your mum. You're welcome to come over to the tamoxigang thread on here, we have people who come while they're waiting for results, were good at handholding

Iamthezombie, thank you very much for sending your posts. I really appreciate it. I am so sorry to read about the anguish and trauma you have been going through. Have you good support around you? Do you have someone to attend your appointments with you? I do hope the results from the biopsy on your nodes are good, and that the mastectomy goes smoothly. Wishing you all the very best.

Thank you, Malteserzz. I will do that.

I just hope I haven't scared you, lucsnowe. It is scary and the waiting is horrendous. Once you know what you're dealing with you can take charge of it.

I have a lot of friends and family, some nearby others far away. No one is currently going with me to my appointments. I was diagnosed with Grade 2 and Grade 3 tumours in the other breast in November 2011. I had an immediate mastectomy followed by 6 cycles of chemotherapy, 3 weeks of radiotherapy and 18 cycles of Herceptin. My TwatH walked out on me for another woman about 5 months before my last Herceptin treatment. His loss, not mine. [spits]

I'm putting together a rota of people who will help in any way they can / come stay with me post-op, etc. I will be fine and well looked after.

Thank you for your good wishes. Just promise me two things.

One, you will do as malteserzz suggests and let the tamoxigang help you through this.

Two, you will PM me if there is anything at all that I can do for you.

[ZombieHugs]

Thank you, Zombie. I will do both of those things. I am shocked to hear about your husband. It was clearly his loss. How were you diagnosed with the tumours in your right breast? Did you find a lump yourself? Is that cancer related to what you are going through now, or are they separate issues? I am pleased you have some support around you. The rota definitely sounds a good idea.

I had a lump. Which I stupidly ignored for a long time. I was also overdue for a smear test. I finally plucked up the courage to ring my GP. I booked the smear first and then said "Oh, btw, I've got a lump in my breast." The receptionist INSISTED that I came in immediately for an emergency appointment. So, 2 hours after ringing the surgery I was seeing a doctor. She referred me to the Breast Clinic. I was there 2 weeks later. Checked in at 8.30am. Mammogram and ultrasound completed by 9.15am. Saw the surgeon at 9.45am and she did a biopsy. Told to go have a coffee and return at 11.00am. Left the clinic at 12.00 noon with an arm full of literature and an appointment for the mastectomy 12 days later.

They don't know yet whether the 2 cancers are related.

Thank you for your reply again, Zombie. So did they have the results for the biopsy on the day they did it? Is that not unusual? Were you pleased that things moved so quickly? It sounds like a very overwhelming time for you. Did you have two lumps? I am just wondering because you said that you had a grade 2 and a grade 3 cancer in that breast? It is good to hear from you because you sound so up front and up beat about it all, which helps to make it less frightening, although I am still frightened. I can't actually see how to get on the tamoxigang thread. It does not seem to be part of general health?

Yes, luc, the surgeon asked pathology to process the tissue immediately and the results were back in less than 1.5 hours. I think that is highly unusual and must have meant that the mammogram and ultrasound results really concerned her. I was very grateful (albeit extremely shocked) that it proceeded so quickly. It's the waiting and anticipation that really get to you.

There were 2 lumps although I was only aware of 1. One was a ductal tumour and the other was a lobular tumour. I can't recall now which was which stage.

I didn't get the information about the grades, the hormone sensitivity status or the HER2 status until the follow up appointment about 2 weeks after the surgery. I then saw the oncologist 2 weeks after that which was when it was confirmed that I would need chemotherapy, radiotherapy and Herceptin. As far as they could determine, the mastectomy had removed all of the active cancer - there was a clear margin of healthy tissue around both tumours, no evidence of vascular invasion and the lymph nodes were clear. They just wanted to make sure they mopped up any stray nasties.

It is scary but I take the stance that my physical and emotional energy is better spent on getting healed rather than wasting it falling apart and bewailing my situation. I DO have my moments but I do my best not to let them take over.

Here's a link to the current Tamoxigang thread: www.mumsnet.com/Talk/general_health/2032328--Tamoxigang-counting-down-to-Easter-eggs-thread-48?msgid=45896859

How did you get on lucsnowe ?