8/7/13 - Fine Needle Aspiration, Ultrasound Guided Core Needle Biopsy & BRCA Testing

Fine Needle Aspiration of the Breast - FNA

For those of you that may be facing a FNA, I want to share my experience so you know what to expect. On June 4th my surgeon did the procedure in her office. She inserted a needle directly into my breast where the tumors were located. No numbing medication was used, and I did not feel any pain when she inserted the needle. I did feel a slight pinch when she moved it around, but it was very minor. She tried to collect fluid from the lesions. My tumors were solid, but she was able to remove a few cells for the biopsy. In my experience, the procedure itself was very easy. I was in a fair amount of pain for weeks after the aspiration. Not just in the area of the aspiration, but all throughout my breast. My tumors hurt from the start, and I knew poking at them wouldn't be pleasant. I had some bruising that lasted for several weeks.  My surgeon called me with the results of that biopsy on June 10th - atypical cells - suspicious of malignancy. I spent the better portion of that week dissecting the terms "suspicious of malignancy" vs. "highly suspicious of malignancy". I thought I still had a pretty good chance of the tumors being benign. In denial or positive thinking?

Ultrasound Guided Core Needle Biopsy

My experience with the core needle biopsy was much different than the FNA. I had an ultrasound guided core needle biopsy on  June 27th. I was still pretty sore from the FNA, so I'm guessing it may have contributed to the procedure being more painful. The test was done in the Department of Diagnostic Imaging. I had to undress from the waist down and wear one of those highly fashionable paper gowns. A doctor and a nurse performed the test. My surgeon also came down to support me during the procedure. I'm betting she thought I would chicken out. Lucky she was there, because I probably wouldn't have gone through with it, if it weren't for her insistence.  I had to lie down on my right side, while the doctor injected a series of numbing shots into my left breast. For me, the injections were painless. The doctor proceeded to take a core out of the first tumor. I heard a clicking sound and felt a tremendous amount of pain. I was sure I would not be able to continue on with the test. After much coaxing and many more shots of lidocaine, my surgeon convinced me to continue. The next core taken was still painful, but not as bad as the first. Next they inserted a clip to mark the lesion. The clips help the surgeon locate the tumors when you have your surgery. The doctor continued on to the next tumor and got four cores out of that lesion. I didn't feel any pain when they did the second tumor. He also inserted a clip in that one as well. After the biopsy, the nurse applied a pressure bandage and gave me an ice pack to apply to the area. You'll never guess what comes next? Squishogram! Apparently they like to make sure the clips have been placed correctly. It's all so barbaric. It almost seems kind of comical what we have to go through. I'm thinking we need a Saturday Night Live skit for this one. I'm really trying to maintain my sense of humor through this whole ordeal. Oddly enough, I wasn't as sore after this procedure as I was with the fine needle aspiration. It felt like the pressure in my breast was relieved after this test. However, I did bruise pretty badly and it took over a month to heal. I was prescribed an antibiotic, along with pain medication. I'm not one for pain medication, so I only took two. One when I got home and one when I went to bed for the evening.

BRCA1 and BRCA2 Testing

Next step was to meet with a genetic counselor on July 9th. They like to go over your family history and decide whether you need testing for the BRCA gene. In my case, they decided to do the testing. This is just like a normal blood test. They send away for the results and it takes three weeks. I just received results of that testing on August 5th. The test was negative, meaning I do not have the BRCA1 or BRCA2 gene mutation. This is good news for our whole family. Women with a BRCA mutation face a 60–87% lifetime risk for breast cancer and a 20–54% lifetime risk for ovarian cancer - much higher than the general population.

So far, these are the tests that I have experienced. I hope this can give you a guideline of what to expect if you're in a similar situation. I'm finding that not everyone's experience is the same. If you need a core needle biopsy, make sure they give you plenty of lidocaine and give it a chance to take effect. Don't be afraid to ask for more. There is no reason we should suffer during  these tests. It's a scary thing to go through these procedures. However, I got through them and so will millions of women after me. Once they are over, our memories will fade and life will go on. That's what I'm counting on. The biggest obstacle for me is turning off my brain. If someone could come up with an off switch, I'd be good to go!

And now for my update:

August 9th I have an appointment with my HMO Oncologist. My OC doctor recommended this Oncologist, because the first one I saw was not very receptive to working with the OC doc. He also didn't agree with his treatment plan. As stated in my previous post, my OC doctor wants me to start chemo right away. He suggested 4 treatments of Taxotere & Carboplatin with 6 months of Herceptin. Hopefully this new Oncologist will be on-board with this plan and we can move forward. In the meantime, I'm praying these cancer cells aren't having a grand ole party throughout my body. On one hand, I'm anxious to get started with treatment, on the other hand, I'm content to delay and live my life like nothing is wrong. Makes no sense, huh? It's amazing how good I feel, which makes it difficult to wrap my head around the fact that I have cancer.

Thanks for checking on me!

Beppy :)

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