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To Biopsy or Not To Biopsy?

Although I am choosing to get a stereotactic biopsy today on (from?) my left breast due to a constellation of stars on my first mammogram, it was by no means a foregone conclusion. There were things to consider first.

“So, what is this procedure?” I asked the receptionist at the imaging center when I booked the first appointment.

“Oh, it’s nothing!” she assured me. ” I had one during my lunch hour and came back to work in the afternoon!”

I eyed her. She had perhaps 6 inches, 50+ lbs., and two or three or four cup sizes on me. She looked pretty robust. However you measure, it was quite a bit more breast to work with than I have.

“So it’s a needle?” I have a pretty severe needle phobia. I was trying not to let it show by acting all casual and nonchalant and psyching myself up inside to face a needle. “And they, what, suck out a sample?” Needle biopsies, my husband would point out to me later, have become controversial as they may actually cause an encapsulated cancer to spread.

“Oh no,” she assures me. Oh good: no needle. “They’re going to make an incision, insert a vacuum tube and suck the grains out.”

An incision? A tube?

“Um,” My questions were starting already. “How are they going to close the incision afterward and keep out infection? Stitches?”

Nope. Steri Strip Skin Closures. Hypo-allergenic strips of surgical-grade tape that you leave on to keep a wound closed until they roll up and fall off, maybe ten days. Houston, we have a problem: Adhesive bandages, including hypo-allergenic ones. Leave ’em on me for more than a day and I start to hive. So much for the “hypo-allergenic” claim. Two days will be intolerable, not to mention that the inflammation of the hives will create an environment not conducive to healing the wound.

They call in a surgical tech who tells me that perhaps we can do Steri Strips for the first day and then return the next day to have the strips exchanged for paper tape. Well, yeah, I tolerate paper tape slightly better, but not for longer than a day. They won’t discuss stitches. Now I’m looking at follow-up care.

It’s really nothing, they both assure me. Unless, they accidentally nick a vein and cause a hematoma — a massive bruise, in other words. But that’s very rare, they say earnestly. We’ll give you a compression bandage to wrap around your breasts if this happens. It hardly ever happens.

A possible hematoma? You mean, a “side effect?” Yeah, I’m familiar with “unlikely side effects” from medical procedures. Two weeks flat on my back after a withdrawal of spinal fluid that most people “go right back to work after.” Six weeks of agonizing dry sockets after removal of my wisdom teeth. And more, of course. With side effects like these, you develop a healthy fear of being poked and prodded.

Oh, and one more whammy: “You shouldn’t lift anything for about two weeks.”

I tried to digest this. It became quite clear that this procedure best not be scheduled two days before a cross-country flight to an active family vacation at the shore with seven children under seven years old

The breast surgeon filled in the rest of the details. I’ll be lying on a table with my breast hanging through a cutout, smashed with mammogram paddles. They’ll use radiation to make a couple of images in order to locate the spots on several planes. More radiation from medical tests that I’d rather not be exposed to, all things considered.

Will I be sedated, I asked? I have MS and I’m dangerously sensitive to anesthesia and ibuprofen. No general, she said, just a local anesthetic like lidocaine injected directly into the site. A big, long needle, in other words.

And, they’re going to deposit a titanium chip as a marker so that the follow-up surgeon will know where to go, if necessary. I can choose not to get this piece of metal, but then if the biopsy came back malignant the surgeon would end up taking more tissue during a subsequent lumpectomy than she would have had to if the marker were there.

I called on my resources and I’m going into this well prepared, I think. I’ve got my homeopathic arsenal ready: hypericum to help heal the puncture wound quickly, if I’m in a lot of pain an hour later bellis parennis will help heal the tissue trauma, and arnica in case there’s bleeding or bruising.

Oh yes, and a prescription of valium for my nerves. That one’s not homeopathic, of course, but I will be grateful for it nonetheless!

So many of you have written and left comments that I feel surrounded by good energies. I’m honored and so touched to connect with you through my writing and cooking. Thank you for sharing your strength with me today. I’ll let you know how it goes.

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