A Step-by-Step Guide to Navigating a Breast Biopsy Experience
Step-by-Step Guide to Navigating a Breast Biopsy Experience
By Lisa Schechter
This year, when I went for my routine mammogram, my usual expectation of a normal report took an unexpected turn. Check out part one of this series, “Navigating Uncertainty, Part 1, My Experience In “The Waiting Room.”
When my mammogram results led to a biopsy, I was gripped with fear about both the what ifs as well as the unknown of what a biopsy would be like. Unlike the many “what to expect” guides when you are pregnant, there was a lack of “what to expect” guides for a breast biopsy. So I put one together to help guide people navigating the experience, hoping that others going through similar situations can feel less alone and know how and where to get the support they need.
Step 1: Initial Discovery
Upon receiving a notification about your mammogram and ultrasound results, take a moment to process the information. If you come across any concerning terms like “suspicious finding,” remind yourself that further investigation and information is needed before jumping to conclusions, and more often than not, something that needs further evaluation on routine scans isn’t cancerous. According to Dr. Robyn Roth, Founder of @theboobiedocs, about 10% of women who go for screenings get called back, so out of 100 women, 10 will get called back. Out of the 10, 6 of them will be told everything is benign (less than 2% chance of it being cancer). Two of them will need a biopsy, and about 80% of biopsy results end up being benign.
Step 2: Understand the Procedure
Speaking to friends can be incredibly helpful, but remember that each case is very individual and your experience will likely vary from those of your friends. So, hear about their experiences, but also know that it may not be exactly the same. One of the most interesting things I learned from a friend who has had multiple biopsies was the wide variety of biopsy types and procedures. I truly had no idea.
When I called my friend who had shared her biopsy with me several years ago, she told me how sorry she was that I had to go through it. But her second comment was “which kind are you having?” She proceeded to tell me “there’s the fine needle aspiration which is a small needle to remove some cells, and then there’s the core needle biopsy to remove a small amount of tissue which requires leaving a clip (biopsy site marker) in the biopsy cavity…” My head was spinning. Needles? Clips? Ultrasound-guided, x-ray-guided, or MRI-guided biopsy? All I knew was that I had something suspicious that needed to be examined but never realized how many different ways there were to do that!
It was also important for me to understand why I needed this biopsy. The day of my biopsy, my radiologist took me to his office, and we looked at my imaging on his large screens. He explained everything he was looking at and what he liked and didn’t like about it. Most cancers have irregular borders, which mine did, are solid, which mine was, and have posterior shadowing (meaning they block the sound waves from passing through). He was optimistic overall, because my lesion did not have that classic shadowing. He explained to me that everyone has unusual-looking things inside their bodies, (especially within female breast tissue because of hormonal fluctuations), most of which are NOT cancer. But, unfortunately, some of them are. Most of the time, he can make an accurate diagnosis from viewing the ultrasound, but occasionally he can’t, and that is when a biopsy is required. My scan was one such occasion. He felt that there was a good (80%) chance that it was NOT cancerous but the remaining 20% chance was still very real, and it was scary to go through the “waiting room.” He promised to send my results ASAP.
Step 3: Biopsy Procedure
As a biopsy newbie, I was unsure of what to expect or the various types of biopsies performed. When speaking with my radiologist, he explained the procedure in detail: I was going to have a core needle biopsy with a clip. I’d be numbed throughout, ensuring I wouldn’t feel anything. The biopsy would be guided by ultrasound, using a needle device with a tiny “vacuum,” collecting tissue samples from the suspicious mass, emitting a sound similar to a pencil sharpener. His description was 100% accurate.) Additionally, they’d insert a small marker, or “clip,” for future monitoring and localization in case it would need to be removed. Again, he reassured me it wouldn’t be painful. (And no the clip won’t set off metal detectors at airport security. I really did ask that!) Any soreness afterward would be comparable to post-dental work once the anesthesia wore off. While they might use a fine needle to drain fluid if necessary, it seemed unlikely based on my ultrasound suggesting a solid lesion.
I was quite nervous going into the biopsy, especially since I had heard from others that their biopsies had been painful. Keep in mind that what may be painful for one person, may be perceived as minor discomfort for you, and vice versa. I was pleasantly surprised that for me, the experience mirrored the doctor’s description and was uncomfortable, but not painful. From start to finish, the biopsy took about 30 minutes.
Step 4: Post-Biopsy Care
The aftermath was pretty much as expected.There were two things that I wasn’t prepared for, though. 1) The bandage was filled with blood – I panicked and of course called my doctor, who assured me that even a small amount of blood can fill the bandage, so that was totally normal. 2) The soreness was worse than I had expected. The doctor had recommended wearing a sports bra after, which was key and very helpful, especially being able to tuck ice packs into it. I had to attend an event that night. I was sore but ok. The truth is, I was more emotionally sore than physically sore, because the “waiting room” is a hard place to be. Try as I may, the “what ifs” have a strong pull. Distraction is great. My husband surprised me with a beautiful necklace, and the few friends who knew sent me flowers. These things didn’t take away the anxiety, but it did make me feel less alone.
The soreness went away after a few days, but I was bruised for approximately two weeks. In general, I bruise very easily, but other people I know did not have any bruising at all. Everyone’s experience is different.
Step 5: The Waiting Room
While it may be fairly common to need a biopsy, until you have the results it’s very hard not to think about the “what ifs.”
When I was going through my biopsy, I didn’t yet know that I could call Sharsheret for support. After I got my results and subsequently spoke to a Sharsheret staff member, she explained that she, too, had had some scares over the years and had undergone multiple different types of biopsies (that I never heard of) and she spoke to a Sharsheret social worker herself. The best advice she had received was “don’t be a creative writer, be a journalist.” There are so many ways your story can go. You can only manage the news you have. Remember that there are so many different possible outcomes. Yes, cancer is one of those options, but there are many others, too. Easier said than done, but great advice, nonetheless.
The waiting is not fun. I’m not going to lie. It was probably one of the most anxiety ridden moments of my 47 years.
When the doctor called to tell me my results, I almost didn’t want to know. Obviously, I wanted to know, but at the same time I didn’t want to hear that the news was not what I was hoping and praying for. It was also my birthday, so I knew it was either going to be a really good birthday, or a really different kind of birthday.
Note to self: Don’t schedule my next screening exam so close to my birthday if just to give myself the gift of avoiding additional unnecessary anxiety!
Step 6: Call Sharsheret At Any Stage
One of the most valuable things that came out of my entire journey was learning that I actually could call Sharsheret while I was in this “waiting room.”
At the time, it didn’t even cross my mind to call before getting results. I almost felt “guilty”, as if I couldn’t even imagine taking away time and resources from others who were navigating a confirmed journey while I was having (what thankfully turned out to be) just a scare.
What I learned from my conversations with Sharsheret after I received the best possible news I could have asked for, is that Sharsheret is there for you through it all! Sharsheret can be part of your journey from the time you go for your first mammogram and await those results, for ultrasounds, for all different types of biopsies, and for understanding your results.
Knowledge Is Power
It’s the fear of the uncertain that is scary. Knowledge is power. And strength is what gets us through challenging times. Sharsheret is there to give you strength. They can teach you, they can comfort you, they can walk you step-by-step through what to expect. It may not be wrapped up in a cute little “girlfriend’s guide,” because, let’s be honest, there is nothing cute about cancer or being scared that you may have it. But Sharsheret can give you the strength, knowledge, and support to deal with whatever the diagnosis is.
And that is what I want every woman to know. And I’d like to normalize talking about it so we feel less alone. Not everyone is a sharer but sometimes sharing can feel therapeutic, and we can all benefit from therapy.
My outcome was the best one possible, and for that I am grateful.
The views expressed on the blog are those of individual users and not necessarily the views of Sharsheret. The information provided here is not a substitute for medical advice or treatment and should not be used to diagnose or treat a health problem. Always seek the advice of your physician or qualified health provider.