Wednesday, July 13, 2011

Stereotactic Core Needle Biopsy

No, Karma didn't have a SCN biopsy ~ although I suspect her expression looks somewhat like mine did when I was informed that I needed one!  I had a Stereotactic Core Needle Biopsy done on my left breast yesterday. 

Prior to my procedure, I did quite a bit of online research and was not concerned about discomfort during the biopsy.  All of the literature I read said that it is relatively pain free ~ other than the "pain in the neck" from laying in the same position for so long.  The neck pain was real!  I was concentrating SO hard on not moving and trying to relax my neck and shoulder muscles because my neck was cramping up on me horribly.  I almost asked for a shot of lidocane into the back of my neck!

I'm getting ahead of myself here.  I want to make this a somewhat educational post so I'll start at the beginning...

When I arrived at the hospital, accompanied by my "Princess" (oldest daughter, Pam) we were escorted to a cozy waiting  room and I was given the key to a locker and taken to the changing room where I was instructed to undress from the waist up and snuggle into a soft, comfy robe.  In just a few minutes, a smiling nurse came to take me to the procedure room.  There, we sat down and the nurse explained what would happen during the biopsy.  She was warm and reassuring and open to questions.   As I said, I had done some Internet research on SCNB and even watched a Utube video on it, so I felt calm and prepared. 

When the nurse had finished explaining everything, including what options we faced if the biopsy results are positive, the doctor came in and went over every thing again.  At that point, I signed a  consent form. 

Let me tell you:  there is no graceful way for a half-naked woman to climb onto the table used for a SCNB.   You really don't even want to try to picture it!  Let's just say that the nurse suggested that I 'mount it like a horse'.  Once I'd found a reasonably comfortable position (lying on my stomach with my left arm at my side and my right arm above my head), the doctor and technicians began. 

The doctor administered 'lidocane' (a numbing agent) prior to inserting the large biopsy needle.  Just as when getting a local before having dental work done, this feels similar to a mosquito bite.  Doctor Ellis advised me that if I felt any more pain that the sting of the local anesthesia I should let him know.  With the guidance of the mammograms being taken as the procedure was done, Dr. Ellis injected lidocane in first one site, and then another.  Except that when he injected it into the second site, I felt the mosquito bite and then a bee sting!  I informed him of the more intense stinging sensation and he said that there must be a nerve in that spot and withdrew the needle. 

Returning to the original site that he had numbed, (and giving the second site more time for the lidocane to take effect)  the doctor extracted a number of biopsy samples.  I am happy to say that I didn't even feel the samples being removed!  I was so relieved that I actually said:  "this is better than having to go to the dentist!"   (I confess to having a true phobia about going to the dentist ~ but STILL!) 

We had to wait a few minutes while one of the nurses took the samples in to Xray ~ to make sure that they did, indeed, contain the crystallized cells we were looking for.  I had to stay lying perfectly still, on my stomach and was unable to move even my arms or head.  My neck was beginning to get extremely sore.

When the nurse returned and confirmed that we had captured the suspect cells, the doctor informed me that when there are multiple suspicious areas (apparently I have three) they like to remove samples from at least two of them. 

No problem.  Other than a very sore neck, I was doing fine.

The machine thumped and bumped as it took more mammograms and the doctor & staff got the needle lined up to penetrate just the right spot.  I felt the mosquito bite as Dr. Ellis injected the lidocane.  I joked that I wished he could give me a shot of lidocane in my neck!   Unfortunately, before the mosquito bite subsided, I felt the bee sting...and then excruciating pain!  I am not exaggerating when I say that it felt like someone had grasped my nipple firmly in a pliers and was trying to tear it off through the inside of my chest!  Needless to say,  I did NOT lay still...

If my left breast had not been held between the panels of the built in mammogram machine, I think I would have hit the ceiling.  And then ran out of there as fast as my legs could carry me!

As it was, the doctor immediately withdrew the needle ~ without having collected a sample.  He was SO apologetic  ~ explaining that I apparently had a very powerful nerve running through that area of my breast and he must have 'hit' it.   I was still in intense pain and the nurses were trying to calm me and help me up off of the table.  Everyone felt terrible.  What had been a very simple, almost painless procedure had turned into a nightmare.    The doctor assured me that he had never had this happen before.  I felt like I must just be a big baby but the nurse assured me that there was clearly a nerve involved and that the doctor had simply never hit a nerve before.  She said that anyone else in the same situation would have reacted just as strongly ~ if not more so. 

The bad news is we only got samples from one location.  I'm not sure if that will be enough to assure us that the other two areas are safe if this biopsy comes back negative.  I know I will NOT have another Stereotactic Core Needle Biopsy performed!  Dr. Ellis said that if we have any doubts, I will probably have to have a surgical biopsy done. 

Today, I am still sore but not as bad as I was last night.  I'm using ice packs (fortunately I have plenty of them left over from my arm!) and taking ibuprofen.  That keeps me reasonably comfortable.  By tomorrow I should be pretty much back to normal.  What ever that is!

The doctor will call me tomorrow with the biopsy results...

I did some more research online last night.  Looking for information on "pain during a SCNB".  Most of the sites I visited said that it is very unusual ~ less than 2% of the women surveyed who have had the procedure have complained about significant pain.   So if you ~ or someone you know ~ ever needs to have a breast biopsy done, please don't let my experience make you aprehensive.  For the VAST majority of women, it is a relatively pain free procedure with the main complaint being neck pain!

I guess I'm just lucky...


  1. Wow Nancy you really did have a heck of a time! I had one done way back in the late '80's and they used a regular mammogram machine so I had to stay standing up with my head sideways for the 3 punctures they performed. As it turned out my shadow was scar tissue from a case of mastitis I had had when I was breastfeeding. I did feel the punctures and the aspiration of the cells felt weird, but overall it was not horrible. I guess for me the worse part was I am terrified of hospitals, needles and doctors so I was nearly frozen with fear!!!
    I will be watching for your results tomorrow and I will say a huge prayer tonight that there is nothing wrong!
    Take care and God bless!
    Tina xo

  2. This really was unusual, Nancy. I had a breast biopsy years ago and there was no pain. What a shame.
    I hope that all comes out well for you. No one should have to go through pain like that.

  3. Ouch is right! Sorry you had such a painful experience. Keeping my fingers crossed for good results to come back to you!
    I love the sheep photos that accompany the text.

  4. Anonymous10:11 PM

    Liked the juxtaposition of sheep with compatible expressions. Hoping for more comfort for you and a negative biopsy. Thanks for taking the time to tell us about it.

  5. Nancy, post me at my email addy, we'll have a chat... eileen at knotallthat dot com


  6. Anonymous12:52 PM

    I have a friend who also had an excruciating experience with that. So you're not alone.

  7. Anonymous8:52 PM

    My biopsy was quite painful too but improved significantly when they used more lidocaine. I do not think mine was as painful as yours though.

  8. Anonymous3:52 PM

    I read a study (online at Pubmed) that said that 13.5% of stereotactic needle biopsies are cancelled before completion because the women can't tolerate the pain. How many others try tolerate it and are traumatized? Based on this, severe pain has to considerably more common than we've been told? There is not adequate warning about this procedure.

    1. Interesting...

      Thanks for sharing!



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