What to expect
By Sheryl
March 10, 2010
Here’s a common occurrence: I get a worried call from a friend. She’s had a routine mammogram and is told that suspicious-looking changes have appeared since her last mammogram. She will need a biopsy.
Naturally, there’s a lot of anxiety and fear of the unknown. Until the appointment gets made and the results are communicated back to my friend, she’s gone through weeks – sometimes more – of stress. (It’s not a coincidence that research has found that women waiting for biopsy results have levels of the stress hormone cortisol equal to those of women who have actually been diagnosed with breast cancer. One thing that’s bad about cortisol is that the flood of this hormone can impair immune function.)
Knowing the facts can help
So what do I tell my friend? It’s hard to say “don’t worry” when I know that’s all she’s doing. But sometimes you have to move beyond worry; otherwise you can drown in it. Sometimes you have to go for the facts, which can be reassuring. The most reassuring of these facts is that only about 20 percent of breast biopsies turn out to be cancerous.
Taking control of worry
How about this: knowing what to expect can ease the stress. Knowing what to do and what steps to take can give you back some sense of control that has been taken away, at least for the interim.
I tell my friend to get a referral to a breast radiologist who specializes in breast imaging and biopsies from her primary care physician or gynecologist. It’s especially important to check if that radiologist is a member of the Society of Breast Imaging or affiliated with a facility certified as a Breast Imaging Center of Excellence by the American College of Radiology.
Then, I suggest she ask about the various biopsy techniques. There are many. The technique that the radiologist will use is oftentimes dictated by factors like the location and size of the lump or how suspicious the area looks.
I also might explain that of all the biopsy types, a nonsurgical needle biopsy is considered to be the “gold standard” for initial diagnosis of breast abnormalities.
Where will the biopsy be performed? I tell her that many are done at a doctor’s office or breast imaging center, particularly needle biopsies. Sometimes they’re also done along with an imaging technique like mammography, MRI or ultrasound in order to pinpoint the exact area to be biopsied. Once the biopsy is finished, ice packs may be applied to minimize swelling or bruising. Recovery usually comes quickly, I tell her.
But she still might worry. She might wonder about the possibility that she will need more than a needle biopsy. She tells me that the area under suspicion is pretty large and the doctor thinks it might have to be surgically excised. Okay, I say. Then you will probably have to go to a surgeon who does mostly breast procedures. There may also be a radiologist working along with the surgeon, in order to use an imaging technique to locate and mark the area to be biopsied. The abnormal tissue will be removed and examined, then stitched, I explain. My friend is concerned about recovery and wonders if she’ll be able to go back to her normal activities. From what I know, I tell her she’ll have more discomfort and scarring than with a needle biopsy, and will probably have to rest for a couple of days and lay off strenuous activity for a week or two.
And then comes the hard part, we both agree – the waiting. It’s torture, she’ll say. I know. And for the next few days (and hopefully not longer), we’ll each hold our breath.
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