Thursday, November 11, 2010

Hurry up and wait...

The doctors have decided that I may need a mammotome biopsy. My mammogram x-rays will be sent over to the hospital where they will be evaluated to see if the mammotome biopsy can be done. If so, they will schedule it. If not, other options will have to be explored. A breast biopsy using the Mammotome Biopsy System offers a minimally invasive alternative to an open surgical biopsy, the most common method, which can leave scarring and result in disfigurement of the breast. Through the use of imaging methods such as X-ray or ultrasound, a breast abnormality or lump can be detected, even in its earliest stages. Using the same imaging methods, a physician can guide a Mammotome probe into a suspicious area of the breast to gently collect the abnormal tissue through one small, ¼-inch incision. With this system, a breast biopsy can be performed in an outpatient setting under local anesthesia. A doctor can make a precise analysis with minimal pain, scarring and recovery time. The biopsy procedure takes less than an hour, and patients can return to their normal daily activities immediately. The patient lies face down on a special table with the breast protruding through a hole in the table, which allows for a clear mammographic image of the area. The table is connected to a computer that processes digital images. Placement of the sampling device is guided by a computerized system using x-rays. The procedure involves the one-time insertion of a probe directly into the area of the breast that appeared suspicious based on a physical exam or an abnormal mammogram finding. The doctor guides the probe through the use of ultrasound or stereotactic imaging systems. Once inside, the Mammotome gently vacuums out suspicious tissue for analysis.
The entire procedure looks like this: First, the skin of the breast is cleaned. Then, a small amount of local anesthetic (lidocaine), similar to what one might have at a dentist’s office, is injected into the skin and deeper tissues of the breast using a small hypodermic needle. Under stereotactic or ultrasound guidance, the radiologist or breast surgeon positions the special breast probe into the area of the breast where the lesion (abnormality) is located. Afer the probe has been properly positioned, a vacuum line draws the breast tissue through the aperture of the probe into the sampling chamber of the device. Once the tissue is in the sampling chamber, the rotating cutting device is advanced and a tissue sample is captured. The tissue sample is then carried through the probe to the tissue collection area (a standard pathology tissue cassette). After a tissue sample is captured, the radiologist or surgeon then rotates the thumbwheel of the probe, moving the sampling chamber approximately 30 degrees to new position. The entire cycle is repeated, until all desired areas have been sampled (typically, eight to 10 samples of breast tissue are taken 360 degrees around the lesion). When a sufficient number of tissue samples have been collected, the radiologist or surgeon will remove the probe and apply pressure to the biopsy site. An adhesive bandage will be applied to the skin nick. In some cases, a small sterile clip will be placed into the biopsy site of the breast to mark the location in case a future biopsy is needed. This microclip is left inside the breast and causes no pain, disfigurement, or harm to the patient. After the biopsy is complete, the tissue samples will be sent to the pathology laboratory for diagnosis.
This is what the instrument looks like:

The surgeon tried to reassure me by telling me that 80% of biopsies result in a benign diagnosis. To that, I replied, "Have we met? I always fall into that small percentage!" He just smiled and told me not to jump the gun. This is so emotionally exhausting! When will they learn to listen to me?


  1. Starting over having to kick the ass of the same crap all the time is exhausting. The entire thing sucks. But I am excited to hear how your interview goes tomorrow!

  2. You have my prayers. But for a physician to really listen?? What planet are you on?? I know they think my back pain is elusive and I should be magically healed by now... I belong to that small unfortunate percentage as well. I miss you Tami!