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excisional breast biopsy excisional breast biopsy

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Unread 12-04-2006, 06:19 PM
excisional breast biopsy

Can anyone that has had an excisional biopsy for micro-calsifications....tell me about their experiences...please! I am seeing the surgeon tommorrow for consultation ....and I read the notes on x-rays that I just picked up with the recommendation of this procedure.

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Unread 12-04-2006, 08:46 PM
excisional breast biopsy

I've had three (?). An excisional biopsy is also a lumpectomy. Generally it's an out-patient procedure. My first was in September '91. It was a biopsy. It was done under general anesthesia. (Benign results.) Second was in December '02. That was a lumpectomy after a needle biopsy resulted in DCIS diagnosis. That too was under general anesthesia. It was supposed to be out-patient, but I ended up spending one night in the hospital which was OK by me. And the third was in November '05. It was a biopsy with benign results. But because "it" was so small and aparently not deeply located (though still not palpable), the surgery was done with twilight sleep (sedated consciousness?). That's good stuff. It's over, you come to, eat and drink a little right away, and -- you're ready to roll.

Any questions, ask away. I have had plenty (enough) experience in this area.

Mary D.
Unread 12-04-2006, 09:42 PM
excisional breast biopsy

Thank you Mary. It's a lumpectomy? Did you generally feel better the next day? Is there a recovery time? How about scarring?
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Unread 12-04-2006, 10:30 PM
excisional breast biopsy

If it's an excisional biopsy, the whole of whatever it is is taken out whether or not it's known beforehand what it is. So therefore it can also be a lumpectomy. An incisional biopsy is a surgical BIOPSY when only a sample of tissue, tumor, whatever is removed as opposed to the whole thing.

I do have a scar from each of the surgeries. I don't remember much about the biopsy in '91. Just too long ago. Have a visible scar on my upper right breast.

The next was the lumpectomy after needle biopsy resulting in DCIS. The tumor was on the large side -- 4 CMs. Three inch scar to my outer left breast, kind of under my arm. Really not terribly noticeable. (Four years later at least. Was certainly ugly when it was fresh.) As I said, I ended up in the hospital overnight. Had a drain in for a week. But really was not bad at all. Had no problems related to it.

The scar from last year's biopsy is visable -- near the one from '91. That was small and not too deep so only needed twilight sleep. That was my first experience with it. (Surgery took only 25 minutes.) I could not believe it. Out of surgery, come to, eat and drink a little, get dressed, and -- go. All on your own. If you've never had general anesthesia, you can't imagine the difference. General is something else.

I hope I never need any biopsies or surgery again because of the reason it's needed -- not because the experience of the procedure is anything particularly bad. I've never had a particularly rough time with any surgery. Had the TAH/BSO almost 17 years ago. I really breezed through all that.

Mary D.
Unread 12-05-2006, 12:43 PM
excisional breast biopsy

I've had two lumpectomies (aka excisional biopsies). Both of mine were done after stereotactic biopsies for microcalcifications which had already resulted in diagnoses of DCIS and LCIS (ductal carcinoma in situ and lobular carcinoma in situ) as well as ALH and ADH (atypical lobular hyperplasia and atypical ductal hyperplasia). One was almost three years ago, and one was this past summer.

Both of mine were done as day surgeries, with wire localization procedures done early in the day and the lumpectomy in the afternoon. Both were done using general anesthesia, because in both cases, the calcifications were too far in towards the chest wall for the surgeon to feel comfortable using light sedation (aka Versed cocktail). In both cases, I woke up quickly, sat up in the recovery area for about an hour or so, and was sent home as soon as I could sip some tea and get up by myself.

My first lumpectomy did not result in a great amount of pain. I got a shot of toradol in the OR, and was able to manage the small amount of pain at home with Motrin. I was able to drive the next day, and within two weeks felt pretty well recovered. The incision was circumareolar (around the edge of the areola) and was barely visible once it healed. No problems at all from that procedure.

My second lumpectomy was different. Since it was my second one in the same breast, same diagnosis, the surgeon was much more aggressive and removed a much larger 'slab' (about 2cm x 4cm x 10cm), all the way down to the chest wall. Also, because of the type of radiation I was planning to do (Mammosite brachytherapy), some rearrangement of the remaining tissue was done in order to create a cavity for the catheter used in the radiation. All that trauma led to the formation of a large hematoma post-operatively. The hematoma caused quite a lot of pain and took several weeks to resolve. However, I elected to only use Celebrex (a prescription anti-inflammatory) for pain and managed pretty well on just that. The incision for that surgery was also circumareolar, and is healing nicely, except that I have a major indentation where the catheter was placed for the radiation which may or may not level out in time.

I guess what I'm saying is, compared to the other surgeries I've had, the lumpectomies were relatively easy, both in terms of pain level and recovery time... but there is considerable variation depending on where the suspicious area is and how aggressive your DR is. Incisions can be visible or almost invisible depending on where they're done and how well you heal.

One question, though... is there a reason your DR is going straight to an open (excisional) biopsy rather than doing a core needle biopsy, such as Mammotome/stereotactic biopsy, first? The stereotactic biopsy is much less invasive, done in a Radiology facility under little or no sedation, and results in even less pain and disruption in your daily routine. It's often used as a first line diagnosis in cases of suspicious microcalcifications identified via mammography, and having one doesn't preclude further excision afterwards if the diagnosis warrants it. Given a choice, I would opt for the stereotactic biopsy first, just in case the diagnosis comes back benign and I'd have avoided having another surgery.

Good luck with your appointment! Let us know what the surgeon says, OK?

Unread 12-05-2006, 05:13 PM
excisional breast biopsy

In 1999 I had a mammatome biopsy of my left breast. That is done with a local. It took a little over an hour and I had them set up a mirror so I could watch. In 2000 that breast showed drastic changes so my surgeon did an excisional biospsy/lumpectomy which was done under general anesthesia. The surgery was done in the morning and I went home at about 8pm. I am a high school coach so I went back to coaching within a day or two. In 2003 my right breast started acting up so I had an excisional biospsy/lumpectomy. Unfortunately, after my lumpectomies it was determined that I did in fact have cancer that required mastectomies on both breasts. I have since finished treatment and have had reconstructive surgery on both breasts. Lynn

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