Biopsies

Biopsies have gotten a bad rap over the years. When your doctor suggests a biopsy, it does not necessarily mean that you have cancer. Many a pesky, benign cyst has been found on biopsy. Biopsies are not extremely painful and for the most part, are outpatient procedures, or surgeries. Please remember that the pain levels cited are my own opinion. I am neither a martyr nor a total wimp.

Fine needle biopsy - They dab some anesthetic on the area of the breast to be biopsied, and then insert a very fine needle into the breast. The surgeon removes the needle, deposits the cells on a slide and that's it. The doctor can't tell anything at this point. The slide has to be sent to cytology to be examined. Pain level: about the same as an injection, perhaps less, since the area is numb.

Large needle biopsy - Your breast gets anesthetized and the surgeon makes a small cut and inserts a bigger needle to take out a sampling of the lump. Sample is sent to pathology. Pain level: With the anesthetic, like an annoying paper cut and then an injection.

Stereotactic biopsy - Sometimes the lump only shows up on the mammogram and can not be felt from the outside. I've never had this type of biopsy. A mammogram is done. You lie face down on the table. Your breast hangs down below the table through a cut-out in the surface. A computer calculates where to insert the needle. Again, your breast area is numb and except for the fact that you are face down, the pain level should be comparable to the needle biopsies. If you have a sense of humor, this procedure is pretty comical looking.

Guide Wire biopsy - When the lump is not palpable, but is visual on mammogram, they sometimes do this procedure. You hop up on the ultrasound table; they apply some gel to your chest and they run the scanner around to find the spot, while watching the computer monitor. When they find the spot, the radiologist inserts a small needle and then does some fancy threading by putting the guidewire through the needle. Then you must proceed to the mini operating room suite. (That is where it was done in the breast center where I was treated.) The nurse wants to make sure you do not dislodge the wire, so she must secure it. My nurse placed an upside-down paper cup over the wire (I swear I am not making this up!) and then proceeded to place wads of adhesive tape across my chest. Pain level: The ultrasound is non-invasive and not painful at all. The needle wasn't any worse than any other needle - remember, the breast area is anesthetized. Inserting the guidewire was a bit odd - you can feel the pushing and pulling, but no real pain.

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