My Stereotactic Needle Biopsy

I walked out of the medical office and into the bright sunlight under a blue sky, glad to escape from the radiology equipment, computer screens, and radiologic technicians that had surrounded me for the previous two hours.  

I walked self-consciously, grateful for mobility and my strong legs.  Eighteen days earlier I'd been sitting by the bedside of Kathleen Mirante, no longer able to walk, dying of uterine cancer that had moved to her lungs.  

She has passed on to another state of being.  I am still here, emerging into the bright sunlight after a stereotactic needle biopsy with post clip.  Grateful.  

In my mammograms last Friday, three years after cancer was discovered in my left breast, there were spots of calcium in my right breast.  They are very small, seven specks in a cluster, looking like the Pleiades, fleeing Orion in the night sky. 

"These could be the sign of a tumor," Dr. Geeta Iyengar told me last Friday, recommending a biopsy.

Three years ago I lay on a table as she found the right spot, numbed the area, and shot the thin needle in, sucking out a bit of tissue from the tumor.

This time I was sitting up with my right breast squeezed flat by a mammogram machine that enabled her to pinpoint the spot on a computer screen before a needle stabbed in and sucked.  Above me hung one of the crystal chandeliers that give patients something to see while looking up.  There's one in every room. 

Actually the name of the machine is Selenia Dimensions, and it is accredited by a college:

This equipment has been accredited by the

American College of Radiology

while in service at

Medical Imaging Center of Southern California

As my breast was being pushed into place and my arm lifted away, I realized, "I'm being woman-handled."  The doctor and her two radiologic techs are women.  I felt safe and secure during it all, grateful that no men were involved.

This procedure costs $2,200 -- but I think Medicare will pay for it.

Dr. Iyengar told me to return Friday for the report after the tissue is analyzed.  I wonder why she didn't just handle it by a phone call.  Does the appointment mean that there's at least a 50% chance that it is another cancer?

Waiting to see... like three years ago.    

[Note on Friday: I received a call from Dr. Iyengar at 9:30 am telling me that the biopsy was negative for cancer.  So now I know: 
1) She tells patients to make an appointment to hear the results if there's a reasonable chance it's cancer. 
2) She calls before the appointment if the result is no cancer.]

X-ray of fluid removed from my breast today including this little patch of 7 specks of calcium

I'm very grateful for all this loving attention.  These women made me feel important.  Karen, one of the radiologic techs, showed me the removed tissue on a screen, including the seven specks of calcium.  

I think of all the women in the world who are 40 years old but don't have the opportunity to get mammograms every year and who won't receive the lumpectomies they may need.  

I think of my three paternal aunts who had breast cancer in the 1930s, 1940s, and early 1950s.  Aunt Mildred died because her cancer metastasized to her neck and the rest of her body.  Her two sisters survived into old age after surgery, but one died of ovarian cancer.

My husband's Aunt Con had the best medical care then available in New York City for her breast cancer, but it metastacized to her bones and she died in 1984.  http://www.nytimes.com/1984/07/24/obituaries/constance-hoguet-president-of-the-philharmonic-society.html

Thanks to Dr. Geeta, Karen, and Donna, aided by Selenia, I'm confident that the worst possible outcome is another lumpectomy, not a terminal illness.

Another biopsy, 3 yrs. later

Women's Imaging: orchids at the doorway, orchids inside... 

It's always a surprise.  

We show up for our annual mammogram, and the doctor sees something.

(Actually, not all of us show up.  Women who do not have health insurance or who live far from a clinic may not have that surprise until they feel a lump--much later in the growth of a tumor.)

Today after the usual two x-rays per breast, my radiologist asked for three more of my right breast, including a close-up of the lower breast.  Ten minutes later she asked for a closer close-up.

Then came the news: a patch of eight or so tiny specks of calcification.  They looked like the cluster of stars we call the Pleiades.

"Calcification is sometimes a sign of cancer, sometimes not," Dr. Iyengar said.  "We won't know until we do a core needle biopsy."

Vocabulary Lesson One for breast cancer patients: needle biopsy.

Cancerquest.org defines needle biopsy:

A needle biopsy is rarely used to obtain skin tissue; it is usually used to remove a sample from internal organs, lymph nodes, or deep skin areas. These techniques involve the use of a small, hollow needle and is sometimes aided by an imaging technique such as x-ray.  There are two types of needle biopsy, fine needle aspiration (FNA) and core needle biopsy.  They differ in the amount of tissue removed. Core needle biopsies remove a larger tissue sample than FNA.1More about these are in the sections that follow.

See also:

http://www.mayoclinic.org/tests-procedures/breast-biopsy/details/what-you-can-expect/rec-20236113

I had plenty of time to think about it between x-rays: the right breast, not the left, site of my lumpectomy three years ago.

Does that mean all the cells of my body are vulnerable to going haywire at this point in my life--coming up on 69 years?

Or is it just the cells of my breast?  Why didn't I have a double mastectomy last time?  Go for it now.

I'm so grateful for the expertise of Dr. Geeta Iyengar.  She's kind and she recommended the ultrasound three years ago that revealed my stage 2 tumor.  I think ethnically she may be from India.  I trust her completely.

It was also great to see Winona, the radiology technician who did my ultrasound three years ago and showed the tumor to me and Dr.Iyengar.  She knows me by face and welcomes me each time I show up a year later.  She's African-American and very warm-hearted.

Anyway, I'm strapping my seat belt for another ride--whether a short trip or the beginning of a roller coaster, I don't know.