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stereotactic biopsy - who here had one?

jeancmici
Posts: 682
Joined: Feb 2001

When I noticed my lump at the end of 2000, I went for a mammogram, found cancer, and the radiologist performed a stereotactic biopsy the same day which left me bruised and with some pain but it healed up. That gave me a pathology report which I showed to two surgeons and choose the one at the cancer institute.

The one from the community hospital said lumpectomy with radiation or mastectomy w/out rad.
The second told me radiation either way so I chose the lumpectomy.

I had AC and taxol, radiation and almost two years of tamoxifen following rad. and now have mets in the lungs, liver, and bones as well as a "mildly" enlarged axiliary node in the right arm (cancer was on left) and a suspicious area adjacent to the clips left where the lumpectomy was done as well as subcarinal enlarged nodes in chest area ( Hummer - you understand that I think)

What are I leading to - wondering if the sterotactic which is outpatient, quick, and CHEAPER than the old way of removing the lump carefully and studyig it without any punching, squeezing and piercing of the lump might not lead to a less favorable outcome.

I guess I am looking for a reason I can grab hold of instead of just thinking that healthy old me who gets a cold about every 5 years, could have been assaulted with cancer cells which thumbed their noses at all the treatments.

Now I take Femara for a limited time and will be rechecked with bone scan and CT scan again and had my first Zometa 9/4 which left me in a lot of pain for several days and then a lessening of pain. Due for the next Oct. 2nd.

Thanks for your thoughts/comments.
Jean

DeeNY711
Posts: 482
Joined: Apr 2003

I had a needle-localized biopsy in 1999 on the left side that indicated benign hyperplasia, and four punches taken by core needle biopsy in 2003 that indicated lobular carcinoma. I agonized over the length of time between punching four holes in the tumor and surgery 5 weeks later, and then agonized again over the length of time between the surgery and the start of chemotherapy over 3 weeks later. From what the surgeon, the oncologist and the radiologist all said, the time element was of no consequence since the chemo and radiation is supposed to clean everything up. I share your basic concern and would add that the painful close-ups of close-ups taken by mammography in the presence of a lump may have contributed to 5 positive nodes. Hugs, Denise

blossomtime's picture
blossomtime
Posts: 98
Joined: Apr 2003

I am so sorry to hear about the tough time you are having. My experience was mammogram and ultrasound same day. The next day had needle punch biopsies in radiology. I had my mastectomy and reconstruction one week after my mammogram. Then I waited one month before starting my chemo. The oncologist told me this allowed me to heal from surgery before attacking my body with chemicals. He stated the need to wait was so prevent delayed tissue healing caused by drugs. Of course I finished treatment about 6 months ago and am hoping this will be the end of this. Only time will tell. I feel like things moved pretty quickly in fact some of it was a complete blurr. My thoughts are with you, take care.

Snookums
Posts: 149
Joined: Apr 2003

I had mammo, more in depth mammo, sonogram and only mamo showed 2 lumps. Had to have stereotactic and that was like a circus act. I am hanging in the open area and the Dr decides she needs me to turn the other way. No, really, turn completely around. I had 2 lumps on the midline of my left chest and they had put me in the contraption for a view of the outside. Thank the Lord, I was a college athlete and still mobile. I was 4 to 6 feet in the air and had to crawl around to face the complete other way???? Could they lower me and let me do it with some help- no I had to balance and turn, avoid falling in the hole/openings area. I look back and laugh now but it was a very strange biopsy. I found out my Dr got great samples. They hurt when she got them and since then, I have been told if it hurts it is usually cancer! So, I set up about 2weeks later bilat masec and recon. I am now finished with chemo and finishing my left side recon (got infected expander) so I guess what I want to say to you is hang in there, no stereotactic pun intended- I had to wait for my breasts to heal prior to chemo, had my chemo delayed and I am still fighting. It seems you are looking for some reason why you cancer got so strong so fast and who knows. I would have to put those thoughts in a box and store them up on a shelf. That isn't positive work to rid my body of this crud so, I can't afford to spend my time on it. Move ahead- let that go and give this fight ahead of you all you got! "What if"'s are real time eaters and if you want do what I do - give that up to God. He makes great decisions and I would never second guess His plan.I try to butt in but He always reminds me with a thump- He is in charge- Let go -Let Him You just Keep Fighting

hummingbyrd's picture
hummingbyrd
Posts: 965
Joined: Sep 2002

Hang in there jean, this too can be conquered, but must agree with snookums..."no undo stress".
Two questions; why did they leave clips in after the lumpectomy? My tumor was 4cm and it didn't require clips. Second, are you HER2nu + and if so have they talked to you about Herceptin?
As for the pain after Zometa, to me this is a good thing. I feel med has gone right to bone and is repairing damage. Actually helps me track my progress, as the bone heals pain decreases, soon med won't bother you at all. Have they suggested any more chemo? Xeloda, Iressa, Navelbine, etc...?
Now, as to your original question...don't fret over it what's done is done and you can't undo it.
My personal philosphy regarding cancer tumors is: go in cut IT out whole, slice it, dice it, put it a blender if you want to, but don't knick it inside of me. I had 13 out of 27 + lymph nodes. Doctors say sticking a needle in a tumor makes NO difference, it's already spread anyway. I say let common sense prevail. If you have a diaper full of...well you get the idea. Is it better to take it off and wipe the baby clean, or do we poke holes in it, look at what comes out, let baby run around house for a couple of hours and then remove the diaper? Common sense would say stirring up a hornet's nest will cause hornets to scatter, but docs tell me I'm nuts, cancer doesn't work that way. So I'm nuts, what else is new, I guess I'm doing well in my own little world, if not don't tell me. LOL
Must add to this, as you know healing to me is most definately 2 parts, physical and spiritual. Personal opinion, you gotta treat both. I do it through Christ, www.urcctc.com is my site.
However it's done bottom line is bitterness, anger, unforgiven sin (not forgiving yourself) will eat you up, as will fear. Not saying any of this applies to you. Just like HER2nu, I don't know if you are + or not, if you are it needs specific treatment. Spiritual illness needs spiritual treatment, may apply, may not, but as with other information I feel obligated to share. HAPPY to share, all info. If any of this helps you I am blessed! Please keep in touch. God bless.
hummer

jeancmici
Posts: 682
Joined: Feb 2001

Hummer,

You understood what I meant. I'm not brooding over my situation - what is, is, but I'm thinking maybe this new arrangement only aggravates and accelerates a bad situation. The diaper example is a very good one.
On the other hand, the nurse practitioner says most oncologists figure the cancer has spread via the bloodstream even if only one node is involved because they know it has already traveled. The idea then for chemo is to try to knock out most of the circulating cells to help the body attack the rest. I guess mine was just too aggressive.

I brought up this topic having known four women who had a mastectomy the old style way - removing the lump, checking with pathology, and then mastectomy at the same time. Only one had chemo but she is still well after 17 years - the other two have 25-30 clear years and the fourth went from her 70's to 101 cancer free.

Therefore cheaper, easier, quicker may not be better.

I asked about Herceptin and he said wait to see how the Femara is doing because herceptin does affect some people's hearts. My thought was 'duh' but I'll continue the discussion next Oct 2 when the Zometa is given again. I agree - Zometa does seem to have helped even with one infusion after a few really painful days.

The clips - tiny - were to delineate the area for future mammograms.

Thanks to all of you for your input and blessings on all of us in this forum.
Jean

rizzo15
Posts: 153
Joined: Nov 2002

Jeancmici. My surgeon gave me a choice of needle biopsy or regular biopsy at the beginning. And at the time I remember thinking how weird that was...I mean shouldn't he be telling me what to do? Because there are such things as "best practices." Anyhow. My husband asked him what he would do if it were HIS wife. When he said regular biopsy, that is what we did. When it came to the mastectomy vs lumpectomy decision, the surgeon already knew that we wanted the most aggressive treatment that he could possibly offer.

By the way, it will be a very good thing if you are strongly HER2+. My pathologist says that stronger positive you are, they know that Herceptin is going to work very well on you. It will, as he says, "...just melt the cancer away."

jeancmici
Posts: 682
Joined: Feb 2001

Sorry to tell you the pathologist( did you mean to say oncologist?) is wrong - have been researching the response rate of various drugs and herceptin has a response at best of
25 % and that is when combined with another chemotherapy which means 75% get no benefit except the bother of weekly treatments.

I was taken aback when my oncologist was less than enthusiastic about it as we discussed my mets and future treatments and he was right apparently.

HER2neu is not somethinh anyone wants in the 3+ range. I feel like my cancer cells must be a cousin to the energizer bunny - they just kept on going even though I got all the accepted top treatments at the time in 2001.

Jean

rizzo15
Posts: 153
Joined: Nov 2002

Hi jeancmici. Actually I did get to speak directly to the head of Pathology at my hospital. Even the department secretary said that it would be extremely unusual for any of the pathologists to speak directly to the patients because they believe that the attending physician should be the one to interpret pathology reports and explain them to their patients. However, for some strange reason, the pathologist said he was intrigued with my name because it was so unusual...and both of our last names started with the letter "I", so he has been watching my progress with more than the usual interest. He said that his next door neighbor has Stage 4 breast cancer and is HER2+ positive. So far, it had only metasticized in the chest wall. He claims he has been watching her progress closely and she has just been doing excellently on Herceptin...so he wanted to assure me that since I was HER2+, there were still things in the "arsenal" that will probably work very well and that I should have a lot of confidence in my chemo therapy oncologist, as he knew him very well.

I don't have the reference for the rest of what I learned at hand, but my husband is a research chemist/engineer for one of the Johnson & Johnson pharmaceutical companies. He has been looking up the results for Herceptin in other countries. In Italy, Herceptin is not limited to Stage 4 breast cancer as it is in the United States. Apparently they have had some very good results there too.

I don't know. It's possible that the pathologist and my husband are just trying to look on the bright side because they didn't want me to be upset or something...but I'm hoping that at least the pathologist was being straight with me.

rizzo15
Posts: 153
Joined: Nov 2002

P.S. to jeancmici. I hope that even if Herceptin isn't the right thing, some other good therapy will turn up for you. I know it sounds silly, but I saw a Nova program on PBS not long ago and they say that even the placebo effect works 20% of the time. So, my thinking is the power of the mind and religious faith alone probably count for a lot!

jeancmici
Posts: 682
Joined: Feb 2001

Please stay optimistic - I clicked into google again with the same question and got a whole new set of response rates for herceptin which were all over the place percentage-wise. My oncologist and I will definitely discuss this Oct 2 when I see him before infusion #2 of Zometa.

And I'll report what the outcome is. My doctor is highly regarded in the oncology field nationally and has been doing this since the 80's - but he too could have some biases as to quality of life vs. whatever. Who knows!

I appreciate your input to my initial question. for a short time here there was a lack of any serious discussion - now it has returned. In this way it becomes a better support group as we report our various experiences, information we read or are told by our doctors.

I am wishing you well - none of us can see into the future - but we need to hope for the best outcome.

Best wishes,Jean

hummingbyrd's picture
hummingbyrd
Posts: 965
Joined: Sep 2002

Jean, I'll have to give the Herceptin a resounding 2 thumbs up myself and strongly agree with Rizzo. I'm speaking strictly from personal experience here, as I know you've done the research.
I hope we soon see the day where patients who are HER2nu + have the option to start Herceptin as a preventative medication for metastasis. I initially requested that, but since that's not an indication I had to wait until I had bone mets to get Herceptin.
I have now been on it since Sept 14, 2001.
WOW! Praise God, only by his grace!
Just really realized its been 2 years at stage 4. Initially I took it every week up until 3 months ago. Now I take a triple dose every 3 weeks.
My personal opinion is.......the drug works.
I pray the best results for you also. God bless. hummb

jeancmici
Posts: 682
Joined: Feb 2001

Hi Hummer,

But I hope you noted that the second time I googled 'response rate for herceptin' I got articles which did not correspond to the 25% I had found the day before.

I also found information that HER2neu is more likely NOT to respond to tamoxifen - and he said that was not proven yet. I also found that tamoxifen sometimes backfires and promotes the cancer cells instead of putting them to rest and another of my doctors corroborated that she too had seen info to that effect and he did not seem to believe that either.

*I* DO KNOW that I never felt good on tamoxifen from about the third week on it. BTW did you start out treatment with AC?

I'm not feeling so great tonight which is why I am up in the middle of the night but this is getting to be interesting. I may be going somewhere for a second opinion!! Trouble is when you are sick it is not easy to shop around and who when thinking they are well shops around to discuss metastatic treatment - that is when they think they are well!!!

hummingbyrd's picture
hummingbyrd
Posts: 965
Joined: Sep 2002

I did note the improvement in your % rates that's why I was giving my 'personal opinion' rather than stats because you already had that info. You are a sharp lady, I recognize that and know you do plenty of research, so in this case I feel personal experience is going to be more beneficial to you. Nontheless, IF you get to the point you don't feel up to scouring the archives and the latest studies let me know, I'd be honored to do the leg work. Actually, I suppose it would be my fingers that would be doing the walking. LOL Seriously, this stuff works so well I don't think we're going to get to that point. IF WE CAN CATCH YOUR DOC UP TO THE 21ST CENTURY! Sorry, just had to get that off my chest. LOL Just teasing, please know I take this very seriously, joking is just one of my coping mechanisms.
My history: lumpectomy 4 cm, 13 out of 27+ lymph nodes, chemo AC and cyclophosphamide X 4, over a 5 month period because they OD'ed me with 2nd round and I almost died. Followed by 4 rounds of taxol with rad x 33 to breast 5/01. Initial diagnosis 6/00. Was on tamoxifen, had break thru bleeding 8/01 switched tamoxifen to aromasin at same time found bone met and tiny tumor other breast. Another lumpectomy, rad to breast and bone met, began Herceptin and Aredia (like Zometa). Switched to Zometa 2/02, had to go to MDAnderson for consult to get meds switched cause doc wasn't keen on Zometa. There is an even better one out there, but not approved yet in USA.
Also had hysterectomy 10/01.
Look up Femera, its in same class as aromasin and arimidex. It does nothing treatment wise that even comes close to herceptin. You can keep your same doc, I think you just need to tell him what you want to be treated with medication wise.
Shame we have to be physician and patient, but as the saying goes, 'physician heal thyself'.
Giving all the honor and glory to the Greatest Physician of All. hummb

jeancmici
Posts: 682
Joined: Feb 2001

>>IF WE CAN CATCH YOUR DOC UP TO THE 21ST CENTURY! Sorry, just had to get that off my chest. LOL Just teasing, please know I take this very seriously, joking is just one of my coping mechanisms. <<

It's amazing how hard the patients have to work these days. You had to work on your doc to get the Zometa and I'll be discussing the Herceptin again. Mine did say Zometa was the best - I checked the research and found three times better than Aredia.

Aromasin is the latest of the three and it a steroidal - other two are non-steroidal and works differently on the bone metabolism. I asked him about that but got no more information than what I told him. He said Aromasin MIGHT have a bit more of a response rate if Femara fails. Femara gets good reviews.

I use humor too - it's a teaching hospital and I had an intern sitting in. I'm sure he expected to see tears instead of my making them all laugh a couple of times - friend always sits in too.

I can't get the idea thru my head that it does not matter if bone mets are found a year earlier when not painful or a year later when pain is full blown. I said a 300 pound person surely has a harder and longer time to lose weight than the person of 150 lbs. and will not be as successful probably. I know he thought this is a tough cookie he's dealing with.

He does do email and said there was no problem if i wanted to ask a question between visits/treatments.

What a roller coaster ride - who would stand in line for a ride on this one?

Thanks for the info-
Jean

rizzo15
Posts: 153
Joined: Nov 2002

jeancmici. Saw your later posts. Sorry to see you were up until the wee hours because you weren't feeling well. Also was looking at your original post where you were talking about being the person who got a cold about every 5 years. Hey, that describes me also! For the first 50 years of my life, the biggest physical problem I had was the 24-hour flu every 3 or 4 years. Oh, every so often I needed an antibiotic, but they worked really quickly and my discomfort was brief. My grandmother was the same way. When grandma had a stroke in her mid 80's, we thought she would snap back because she was so healthy all her life. We were surprised to hear from her doctor that it is the "healthy all their lives" people that he worries the most about...because they've never had do deal with chronic or serious health problems before...and they have a tendency to not deal well with things. The long, long recovery time. The slow progress and sudden setbacks. Having the patience to "come back" again and again. The uncertainty of the situation when they'd had excellent health for 7-8 decades. He was right about Grandma. She got depressed and "gave up" really early. It was a fight to get her to do her exercises and she probably went into the nursing home prematurely.

Unlike my grandmother, Jean, I can tell that you are one of the "strong women" that my oncologist talks about. He thinks I'm one of those strong women also...at least I hope so.

So, for myself I try to keep all this in mind and just try to be persistent in trying to regain complete range of motion back in my "bad" mastectomy arm. And I'm trying to do better with diet and exercise. Trying to remember that hindsight is 20/20 when it comes to previous decisions with my breast cancer treatment.

I "fired" the primary physician that I had seen for 20+ years because she came unhinged after seeing my mammogram a year ago. She accused me of having a death wish for not coming to her sooner. I couldn't deal with that attitude. My approach is always, "Well, where do we go from here?"

jeancmici
Posts: 682
Joined: Feb 2001

Your message was wonderful to read except for me being a strong woman. The pain that I am in today leads me to figure that the Zometa has run its course and a month between infusions is going to give me a lousy week starting last night. I was great sunday and most of monday. I can take bad pain when I know it is for a short time - the thought of this and getting worse over time just about unhinges me today.

I slept the whole day pretty much and just had oatmeal now for lunch. Not eating enuf does not help. I live alone with no family and friends can do just so much - not a substitute for a good live-in family. I say 'good' because there are the hubbies who walk out in these situations.

I'm glad you got what I consider the 'good' biopsy.

I'm sorry I just flat out said your pathologist was wrong - I do that sometimes - maybe it was the 'melt the cancer away' that got me.

Anyway I am wishing you well - this question got more replies than I thought it would. Let's keep in touch.
Jean

PeggyMurphy
Posts: 3
Joined: Jan 2013

My Stereotactic Breast Biopsy was the usual type with a radiologist looking with Doppler Imaging and not really being able to see the arteries with my very dense breasts being fibrocystic.  He took the sample OK and did not hurt at all.  But on the way out, "an arterial bleeder got in the way because there are many blood vessels and the breast and its hard to see them on Doppler".  The blood rushed all over half the breast on the inside and no one knows how many malignant Grade 1 infiltrating cells from that 1.1 cm tumor are now seeding the rest of the healthy breast tissue.  And no one knows how many cancer cells are now floating around in my circulatory system in my blood supply throughout my body.  So I must have my entire breast removed instead of having just lumpectomy and radiation therapy as originally planned if the artery was not ruptured by accident.  So my advice, if you have dense fibrocystic breasts, is to skip the stereotactic biopsy and just have the lump removed surgically, or have them use the MRI guided biopsy.  Much clearer and easy to visualize the arteries, especially if they use the contrast in your veins to see blood vessels better.  I do not know why they chose to biopsy me in that way!  Many medical facilities are run by uncaring morons who are just good at marketing statements and looking good to make money on us.  So we need to protect ourselves with information.  I did not research this because they doctors all RUSHED me into this test so fast my head was spinning with the urgency of it all.  Not so, you need a week to absorb the details and learn more.

 

 

 

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