6 min read
What was my biopsy experience?
It was like I had always known. No—I don't have a family history of Breast Cancer. Yes—I have children, breastfed them both (twins) for over a year. All the things that supposedly could increase my risk of breast cancer I didn't have, yet I still had a feeling that one day—sooner than later—it would happen to me. But, I would hopefully find myself in the Pink Survivor community. At the age of 41, I had a discharge out of the left nipple, had my first mammogram. I was told it was microcalcification. The year after that, no discharge but still microcalcifications seen. By my third year of screening mammograms, the left nipple discharge returned and now those microcalcifications were a small mass needing biopsy.
I can remember waiting in the “Women’s Lobby” at the breast imaging center in my lovely oversized pink smock. I was surrounded by various closed doors, some women getting their annual mammograms, some getting ultrasound for their pregnancy. I was sitting waiting my turn for a biopsy, I can remember hearing what was going on behind one of those not so soundproofed doors. There was a woman, crying. I cannot remember exactly what was said but I heard her muffled speech through her tears—something along the lines of, “I don't want to lose my breast...oh my God!” I sat there wondering what her story was. As a Nurse Practitioner myself, I have been in that “room” of uncertainty with a few of my patients before. I can remember one woman asking me without hesitation, “Am I going to die”, We sat there together, on the phone (due to Covid-19 she had a telemedicine appointment) crying. As all that flashed in my mind while I was waiting in the lobby, I heard them call my name, “Monika we are ready for you now”.
What You Need to Know About Ultrasound Guided Biopsy
Breast biopsies are usually done on an outpatient basis by a trained radiologist.
You will be positioned lying face up on the examination table or turned slightly to the side.
The radiologist will use a needle to inject a local anesthetic into the skin and more deeply into the breast to numb the area.
Usually an ultrasound technician will assist and use the ultrasound wand (transducer) and press on the breast to locate the lesion to be biopsied.
A very small nick is made in the skin at the site where the biopsy needle is to be inserted.
The radiologist, monitoring the lesion site with the ultrasound probe, will insert the needle and advance it directly into the mass.
Tissue samples are then removed using one of three methods:
- In a fine needle aspiration, a fine gauge needle and a syringe withdraw fluid or clusters of cells.
- In a core needle biopsy, the automated mechanism is activated, moving the needle forward and filling the needle receptacle with breast tissue. This process is repeated three to six times.
- With a vacuum-assisted device (VAD), vacuum pressure is used to pull tissue from the breast through the needle into the sampling chamber. Without withdrawing and reinserting the needle, it rotates positions and collects additional samples. Typically, eight to 10 samples of tissue are collected from around the lesion.
What will I experience during and after a breast biopsy?
You will be awake during your biopsy and may have a little discomfort. When the radiologist injects the local anesthetic, you will feel a prick from the needle and some pressure followed by a mild burning sensation from the local anesthetic being injected into your skin. The anesthetic usually works within several seconds. You will likely feel some pressure when the biopsy needle is inserted and during tissue sampling, which is normal. You shouldn’t feel pain. If you do, be sure to let the radiologist know so that they can give additional numbing medicine.
As tissue samples are taken, you may hear clicks or buzzing sounds from the sampling instrument. These are normal.
A marker may be left inside the breast to mark the location of the biopsied lesion. If a marker is left, then an additional mammogram may be taken after biopsy for marker visualization.
If you experience swelling and bruising following your biopsy, you may be instructed to take an over-the-counter pain reliever and to use a cold pack. Temporary bruising is normal.
You should avoid strenuous activity for at least 24 hours after the biopsy. Your biopsy facility will outline more detailed post-procedure care instructions for you.