Breast biopsy - should I go under sedation or would local be ok?

[Phoenix]

I take this due to my bleeding disorder & you are correct: it is to prevent excessive bleeding & to help clotting factor 8 in the blood be more efficient.

I am sorry to hear that you have some bumps that need investigating, but it sounds like they’ve been caught early & you are in good hands. Fingers crossed they are absolutely nothing to worry about & I’ll be thinking of you. Also, I would take the local.

Thank you for that. It's reassuring to hear.

Actually, at the risk of sharing TMI, I've had the lumps for 3 years already since my explant (removal of breast implants) and a small fat transfer. They haven't felt - when I palpate them - like they've changed in shape or size. I think they're either fat necrosis or internal adhesions/scarring. But I do want them taken out and examined just to rule out anything sinister.

Thanks to you ladies, I've def decided to go the local route. x

 

[Phoenix]

I am posting about my own experience back in 2020, when a routine 3-yearly mammogram revealed small Calcium deposits about 4mm area which could be indicative of cancer brewing.

I was a pin cushion when they put a pin inside the affected breast with the aim to perform a biopsy and take out the Calcium deposits at the same time. Apparently the location of the deposit was quite deep.

Edited to add that topical pain relief was applied before they attempted to place the pin inside my breast. However, because the location was quite deep, they had to do it more than once as it was not sufficient accurate the first and second time.

I attended a day surgery and had a general anaesthetic. I can't remember if I were offered a local anaesthetic or not, sorry!

However, had I been given the choice, I would have opted for a general one as I don't particularly want to stay conscious to know what was going on.

I attended a surgery session and watched different surgical procedures as part of my HCP training a long time ago, and it was not an experience I wished to repeat.

I was not allowed to drive and had to get a friend to me at the hospital and to pick me up later when I was discharged.

The biopsy result was no sign of cancer, and my annual mammogram for the past 3 years had been all clear.

I am in UK, whether that makes a difference or not I do not know.

DK

Thank you for your informative post. I am glad that you're clear of cancer.

I am gonna go with local. Wish me luck, hehe. x

 

[Phoenix]

HI:

I've had at least 6 breast lumps removed--all under local--over the decades with no issues during or after the procedure. I will say that around the nipple--that was the most sensitive area when I had a cyst drained. Once the local is in, you really don't feel pain.

Much success to you; you appear to be in capable hands. Let us know how it goes.

kind regards--Sharon

Thank you, Sharon. I will do indeed. x

 

[Sparkles88]

Thinking of you @Phoenix , you’ve got this! Sending you positive vibes from Australia.
I had an ultrasound guided needle biopsy many years ago under local, it was bearable and only minor discomfort felt. I think the waiting around for results was worse.
Good luck for next Wednesday, we will all be thinking of you.

 

[Phoenix]

Thinking of you @Phoenix , you’ve got this! Sending you positive vibes from Australia.
I had an ultrasound guided needle biopsy many years ago under local, it was bearable and only minor discomfort felt. I think the waiting around for results was worse.
Good luck for next Wednesday, we will all be thinking of you.

Awww, thank you so much! x

 

[Dandi]

I'm so sorry to hear you're going through this @Phoenix! I am an RN in the OR, and we do lots of breast biopsies under local, sometimes with mild sedation if the patient wants it. Lumpectomies are a bit different as they can be a bit more invasive and it can be tricky to numb the deeper tissues completely, hence why they are usually a light general anaesthetic with local infiltration. But if it's quite superficial, like a needle biopsy, local is a good option, and you can always have a hint of sedation if you feel the need if there is an anaesthetist present, as sedation is perfectly safe given in controlled conditions like an operating room or medical imaging setting.

 

[dk168]

Thank you for your informative post. I am glad that you're clear of cancer.

I am gonna go with local. Wish me luck, hehe. x

Good luck!

DK

 

[Phoenix]

I'm so sorry to hear you're going through this @Phoenix! I am an RN in the OR, and we do lots of breast biopsies under local, sometimes with mild sedation if the patient wants it. Lumpectomies are a bit different as they can be a bit more invasive and it can be tricky to numb the deeper tissues completely, hence why they are usually a light general anaesthetic with local infiltration. But if it's quite superficial, like a needle biopsy, local is a good option, and you can always have a hint of sedation if you feel the need if there is an anaesthetist present, as sedation is perfectly safe given in controlled conditions like an operating room or medical imaging setting.

I just spoke to one of the nurses at the clinic and she reassured me that this Dr has performed many such procedures, most of which under local, and no one has complained of unbearable pain.

What do you classify as a "lumpectomy"? The lump to be removed is 1.5cm and the nurse still said that it's a biopsy.

 

[MissGotRocks]

Wishing you all the best Phoenix and I know the procedure will go smoothly!

 

[Dandi]

I just spoke to one of the nurses at the clinic and she reassured me that this Dr has performed many such procedures, most of which under local, and no one has complained of unbearable pain.

What do you classify as a "lumpectomy"? The lump to be removed is 1.5cm and the nurse still said that it's a biopsy.

A lumpectomy is removing abnormal tissue, often as well as a small area surrounding it, in case of spread. But quite often those lumps have been biopsied previously, and deemed necessary to fully excise. It sounds in your case like they're planning to remove the lump as an excisional biopsy. But that said, a lumpectomy would typically be bigger than 1.5cm.

It sounds like you're in the hands of a very experienced and capable team, where locals are the norm. But it's great that you're asking lots of questions and will be armed with plenty of info for the day, and know what to expect. I know it will all go smoothly for you!

Keep us posted if you can! x

 

[Phoenix]

A lumpectomy is removing abnormal tissue, often as well as a small area surrounding it, in case of spread. But quite often those lumps have been biopsied previously, and deemed necessary to fully excise. It sounds in your case like they're planning to remove the lump as an excisional biopsy. But that said, a lumpectomy would typically be bigger than 1.5cm.

It sounds like you're in the hands of a very experienced and capable team, where locals are the norm. But it's great that you're asking lots of questions and will be armed with plenty of info for the day, and know what to expect. I know it will all go smoothly for you!

Keep us posted if you can! x

Yes, the Dr gave me a choice of either removing a small tissue sample or take out the lump altogether. As the lump is quite hard and feels *not nice*, I've agreed to let her take out the lump.

Thank you soo much. I will certainly come back and post an update. x

 

[Bonfire]

The removal of a 1.5 cm lesion is more of an excision. Back in the day when I was having these done they used “twilight” sedation. Which would probably be Propofol. My biopsies were core biopsy with local.
Good luck, will be thinking of you.

 

[pearlsngems]

If you want to be super duper careful afterward (depending on how much tissue is take out, jiggling can cause discomfort) you could wear a zip front sports bra. You can wear it home from the hospital.

 

[Phoenix]

The removal of a 1.5 cm lesion is more of an excision. Back in the day when I was having these done they used “twilight” sedation. Which would probably be Propofol. My biopsies were core biopsy with local.
Good luck, will be thinking of you.

Yes, she did ask me if I just wanted the core biopsy of a small tissue sample or the excision of the lump. I opted for the latter. I am still praying that it won't be too painful!

Thank you so much. x

 

[Phoenix]

If you want to be super duper careful afterward (depending on how much tissue is take out, jiggling can cause discomfort) you could wear a zip front sports bra. You can wear it home from the hospital.

They're going to give me a compression bra to wear post-op.

I'm mentally preparing myself for jiggling, lol.

 

[pearlsngems]

They're going to give me a compression bra to wear post-op.

I'm mentally preparing myself for jiggling, lol.

That's good that they are providing one.

Because of the findings from my core needle biopsy, I had to have a full-on surgical excision biopsy in February-- fasting beforehand, O.R., anesthesiologist/ Propofol, recovery room, being driven home, etc. The Dr. even wrote a prescription for Tramadol (opiod) but I didn't take any (leery of side effects). That evening I was quite sore, but between Tylenol, ice packs and TV for distraction, I managed okay. The next two days I had minimal pain and Tylenol was enough. By the 3rd day I didn't have any pain unless I bumped it (or jiggled ).

At the pre-surgery consult, my surgeon had suggested I purchase a zip front sport bra, so I bought 2, which I wore day and night after surgery for about 10 days. It made a real difference; I felt secure and able to resume my activities without worrying about unwanted movement causing pain.

I had been told to wear PJ's to the hospital and I'd be sent home with some sort of compression wrap-- so I didn't bring the sports bra to the hospital-- or any bra-- but they didn't provide anything! It's surprising how much movement just being in a car causes-- I felt each bump in the road. So consider bringing a bra to the hospital just in case they don't provide one after all.

Oh, and the pathology report biopsy from the excision was benign. In fact, the core needle biopsy sample was also benign but showed a condition that carries a high risk that there is actual cancer in adjacent tissue. The standard recommendation in that case is to remove a larger tissue sample to be sure there is no cancer.
Now I'm just back to my normal mammogram schedule.

The worst part of it all was waiting for results.
And the worst pain would be paying for it, if one didn't have good insurance.

 

[Slickk]

@Phoenix I could not read any responses because I did not want to go back (in my mind) to the biopsy (several in a day) I had. Suffice to say, I would definitely be sedated if I had to do it again.
Wishing you the best of luck for an easy and clean procedure with good results. Virtual ((Hugs)) to you.

 

[MamaBee]

I’m glad you are following through and having the whole lump taken out. I did the same. It gave me peace of mind..I hope it all goes well for you.

I had an excisional biopsy when I was in my thirties... I found a hard lump in my breast. The doctor tried to aspirate it in the office but no fluid came out. He sent me for a sonogram..which didn’t tell us much. I had the excisional biopsy under sedation..It was too deep to do it with a local. I was really out but would wake up a little and mumble to him. He laughed and said I was really funny..It was benign..He closed the incision with staples. It was a little sore but not bad at all..Tylenol took care of any soreness.

Big hugs!

 

[jaysonsmom]

I don’t have any experience to share, but wishing you all the best @Phoenix ! Speedy, easy, pain free recovery and benign findings!

 

[Bonfire]

Just popping back to say, since the doctor assured you that this can be done with only a local than you should feel pretty confident going that route. I do think because you are so scared of pain that they should give you Valium or Xanax or something beforehand. Definitely ask.

 

[Elizabeth35]

I had ultrasound guided core biopsy with local anesthetic. It is absolutely painless. No pain afterward but I was bruised.
I had planned on returning to work afterward my AM biopsy but my manager made me go home.
They sent me home with Ace elastic bandages around my chest which I kept on until work the next day.
You will be fine!
No need for general anesthesia.

edit to add: surgeon did remove my benign fibroadenoma during the procedure.

 

[Phoenix]

Just popping back to say, since the doctor assured you that this can be done with only a local than you should feel pretty confident going that route. I do think because you are so scared of pain that they should give you Valium or Xanax or something beforehand. Definitely ask.

They said that they would.

 

[Phoenix]

I had ultrasound guided core biopsy with local anesthetic. It is absolutely painless. No pain afterward but I was bruised.
I had planned on returning to work afterward my AM biopsy but my manager made me go home.
They sent me home with Ace elastic bandages around my chest which I kept on until work the next day.
You will be fine!
No need for general anesthesia.

edit to add: surgeon did remove my benign fibroadenoma during the procedure.

This is super reassuring to hear!!n Thank you soooo much.

Glad to hear that your benign fibroadenoma was removed and that you're ok. x

 

[Phoenix]

@Phoenix I could not read any responses because I did not want to go back (in my mind) to the biopsy (several in a day) I had. Suffice to say, I would definitely be sedated if I had to do it again.
Wishing you the best of luck for an easy and clean procedure with good results. Virtual ((Hugs)) to you.

I spoke with them again and they assured me that local would suffice. It's only 1 lump albeit a slightly larger one at 1.5cm.

Thank you soo much for your good luck wishes and hugs. x

 

[Phoenix]

I’m glad you are following through and having the whole lump taken out. I did the same. It gave me peace of mind..I hope it all goes well for you.

I had an excisional biopsy when I was in my thirties... I found a hard lump in my breast. The doctor tried to aspirate it in the office but no fluid came out. He sent me for a sonogram..which didn’t tell us much. I had the excisional biopsy under sedation..It was too deep to do it with a local. I was really out but would wake up a little and mumble to him. He laughed and said I was really funny..It was benign..He closed the incision with staples. It was a little sore but not bad at all..Tylenol took care of any soreness.

Big hugs!

Thank you sooo much. x

I think mine is not too deep. I can palpate it with my fingers. I really hope it won't be too painful under local. Yikes!

I'm glad that yours was taken out and that it gave you peace of mind.

 

[SomethingNew]

I didn‘t read all the posts but I went through exact same thing about two years ago. My lump was very close to the surface, about the size of the pinky nail. I did local as well. first two days was painful but not bad afterwards. Make sure after your wound is healed, massage constantly otherwise you have scar tissues built up under your skin. sending you lots and lots of good vibes.

 

[AprilBaby]

I took xanex an hour before my biopsy and I didn’t care what they did.

 

[Phoenix]

That's good that they are providing one.

Because of the findings from my core needle biopsy, I had to have a full-on surgical excision biopsy in February-- fasting beforehand, O.R., anesthesiologist/ Propofol, recovery room, being driven home, etc. The Dr. even wrote a prescription for Tramadol (opiod) but I didn't take any (leery of side effects). That evening I was quite sore, but between Tylenol, ice packs and TV for distraction, I managed okay. The next two days I had minimal pain and Tylenol was enough. By the 3rd day I didn't have any pain unless I bumped it (or jiggled ).

At the pre-surgery consult, my surgeon had suggested I purchase a zip front sport bra, so I bought 2, which I wore day and night after surgery for about 10 days. It made a real difference; I felt secure and able to resume my activities without worrying about unwanted movement causing pain.

I had been told to wear PJ's to the hospital and I'd be sent home with some sort of compression wrap-- so I didn't bring the sports bra to the hospital-- or any bra-- but they didn't provide anything! It's surprising how much movement just being in a car causes-- I felt each bump in the road. So consider bringing a bra to the hospital just in case they don't provide one after all.

Oh, and the pathology report biopsy from the excision was benign. In fact, the core needle biopsy sample was also benign but showed a condition that carries a high risk that there is actual cancer in adjacent tissue. The standard recommendation in that case is to remove a larger tissue sample to be sure there is no cancer.
Now I'm just back to my normal mammogram schedule.

The worst part of it all was waiting for results.
And the worst pain would be paying for it, if one didn't have good insurance.

Thank you sooo much for your detailed post. x

I went to the hospital yesterday to get fitted for the compression bra. I was told that I'd only be wearing a compression wrap post-op and that I wouldn't need the bra until day 2. I really hope that there won't be too much jiggling on the car ride home. Anyway, I only live like a 15-min ride away so fingers crossed I will be ok!

So glad that you were cleared of cancer and that you're back to normal mammogram schedule.

I was shocked at the costs and thought I'd have to pay out of pocket. But luckily, my insurance is covering it.

 

[Phoenix]

Just wondering if anyone knows if there should be an anaethetist present, given that the procedure will be done under local. My understanding is that there will not be.

Also, is anyone here on LDN (Low Dose Natrexone)? Just wondering if I should stop that too (was told to stop all meds and supplements for 5 days pre-op, except for my thyroid meds).

 

[pearlsngems]

For a local no anesthetist would be needed, since it's just an injection.

If you were told to stop all meds (over the counter included) except thyroid, I would not vary from that unless your doctor told you otherwise. So, if you think you should keep taking that specific med, ask your doctor.