Holy breast biopsies Batman!

[puncturedbicycle]

Blimey, I just went in to have some 'routine' mammograms and ended up having an ultrasound and four core biopsies. Bit of a shocker.

The doctor kept making soothing noises and saying how unlikely it was that it was anything sinister, but if that's true it seems a bit of an overreaction to take four tissue samples. I even tried to talk her out of it (not seriously, just to see how hard and fast she held her position) but she didn't want to wait.

B0££0cks, now I have to go in next week for the results. I predict the intervening period will be full of swearing.

I know this is totally off-topic but I felt like I could come here and vent a little bit.

[Clutter]

Puncturedbicyle,

Swear away! Doctor probably thought you wouldn't come back if you had time to think about it. I hope all is well eventually.

[puncturedbicycle in reply to Clutter]

Lol, cheers. I just wrote an email to a friend of mine saying if he didn't hear from me it's because I went on the lam and made a break for the border!

She said they used to 'wait and see' but if in six months it looked the same it would be six months of waiting with no resolution, and I see her point.

I'm not as worried (yet) as I am shocked! I feel just like when I was stopped at a red light and was rear-ended by another car. Adrenaline.

[Marz]

Oh dear - that must have been a shock for you. Am sure all will be well. BBD is quite common with us Hypo gals. ( Benign Breast Disease)

I had a lump removed many years ago and all was well. Just have uneven boobs - so cannot do Page 3 anymore Thyroid diagnosis came years later ....

[puncturedbicycle in reply to Marz]

That properly made me lol (the Page 3 part).

My mum was diagnosed w bc about 18mos ago, but that is neither here nor there, she is in a higher-risk group (she's 75). I am not connecting the two things in any way other than emotionally, but that's the part I have less control over.

Sorry you've gone through that. So scary, esp to get to the lump-removal part! A biopsy is one thing but surgery, bless.

[Rapunzel]

(((pb))) just to say I've been through this. Bit frightening really especially when the doctors get insistent, then the waiting, waiting...then told I must tell radiographers to write a note on, after every check that one boob comes up light and the other dark but that's just me. bo££ocks indeed.

Good to be looked after for a change, tho, isn't it ?

[puncturedbicycle in reply to Rapunzel]

Can I not swap this for someone bringing me cakes all day and night? This is the kind of looked after I can live without.

Of course I understand what you mean. Everyone was lovely, no one rolled their eyes or told me it was in my head etc etc and they were very proactive, which is encouraging.

Sorry you went through this. So scary!

[Rapunzel in reply to puncturedbicycle]

You should be able to choose that from a menu of alleviant treatments to ease the wait...of course the medics would be up in arms, then: first do no harm and all that Perhaps go for a basket of fruit and hourly bunches of flowers delivered by George Clooney instead ?

[puncturedbicycle in reply to Rapunzel]

I was explicitly told to go home and have cake and coffee. Perhaps this is what we get now we know they won't be getting that £350m per week?

George Clooney used to be handsome but why is his skin so grey now? Sounds sappy but my partner is pretty fab, so I will take the basket of fruit and the coffee/cake prescription thanks.

[Angel_of_the_North in reply to puncturedbicycle]

That's what happens when you spend your life doing espresso ads. Cake is not so good.

[Hillwoman]

I've been through this too, but eventually jumped off the treadmill because the lumps were always FBD - hypothyroidism. It's alarming that breast surgeons are not more aware of the consequences of being hypo-T. Of course, I am hoping for your sake that this is all it is.

[puncturedbicycle in reply to Hillwoman]

Yes, I did say that, that I was worried that I'd get on that conveyor belt of endless biopsies of fibrous masses and/or cysts, but she said they don't do that anymore - ?

I have an auntie who has FBD, but also one who had bc at a young age, so on balance it seemed sensible. And one thing I feel fairly confident of is that I haven't been hypo in a number of years. I'm often a little overmedicated (constant reductions in meds but still high at next test, poss because I'm on t3 which suppresses tsh). I will read up on the connection though. Thanks for the info.

Poor you, to be poked and prodded over and over. Do you worry about it, that not all masses are benign? Or do you feel you're protecting yourself from the risk of all that invasive testing? I don't have a side I come down on, I understand there are risks on both sides and it comes down to what you can live with.

[Hillwoman in reply to puncturedbicycle]

I used to think that screening programmes were A Jolly Good Thing. Then I started reading Malcolm Kendrick and others, and I've completely changed my mind. I've stopped worrying about a lot of things: cholesterol, saturated fat, bacon, BP, cervical cancer and breast cancer. Perhaps it will all come back to bite me on the bum, but I do regret all those years spent conscientiously doing The Right Thing, only to discover that this is by no means clear cut.

[puncturedbicycle in reply to Hillwoman]

No, not clear cut at all. I'm not a worrier about health stuff. But my mum had bc (she is more clean-living than anyone I know) and my gran had senile dementia/TIAs due to cholesterol. I know some people say it isn't the cholesterol, it's inflammation etc, but often these are people who aren't at risk, so I don't get into arguments about it.

[Hillwoman in reply to puncturedbicycle]

Well, if I had a family history of bc, I might make a different decision. I really wish you the best for the results.

Re cholesterol: if you do want to read up on this, Malcolm Kendrick is a very good place to start. Up to you.

[puncturedbicycle in reply to Hillwoman]

Oh I didn't mean you. I got into a barney here once about it and it turned out the person arguing about it had low cholesterol and didn't get why his/her theoretical objections to the cholesterol theories were different to the actual concerns of people who actually have high cholesterol. But I digress. All views welcome, but no preaching (again, I don't mean you).

[Hillwoman in reply to puncturedbicycle]

Don't worry, I didn't take it that way.

[Angel_of_the_North in reply to puncturedbicycle]

My dad had TIAs and strokes (as did all his brothers) with low cholesterol (under 4). Don't know if having undiagnosed PA had anything to do with it.

[puncturedbicycle in reply to Angel_of_the_North]

Yes, b deficiency is such a problem in old people.

My gran was diagnosed w uat but only when she was very old. And we know what that can do for your cholesterol.

[Marz in reply to Hillwoman]

Homocysteine can be a predictor of strokes and tia's.

[puncturedbicycle in reply to Marz]

Yes, and heart attacks too I think?

[nightingale-56 in reply to puncturedbicycle]

Bet they know this really, but they wouldn't make any money out of it! Hope you get good news about it all PB.

[puncturedbicycle]

Thank you so much ladies, I feel much better after kibitzing and commiserating here for a while. In the sad absence of cake/fruit basket/Mr Clooney etc I have just made myself a sandwich and a cuppa.

Again, it was just the shock of it that was most bothersome, and now that seems to have improved. I genuinely don't feel dread about the results (there is still time for that I guess) and I believe in being informed and proactive so I really got that in spades. xx

[greygoose]

Don't they get financial incentives to do these tests? I seem to think they do.

[puncturedbicycle in reply to greygoose]

Do you think they do or do you know they do? Because if you're just guessing, you may not realise by using the word 'incentives' you're implying that they've tested me for no better reason than their own enrichment.

If you mean that they get paid for doing work I guess they do.

[greygoose in reply to puncturedbicycle]

OK, I'll say no more.

[puncturedbicycle in reply to greygoose]

No, by all means, if that is a fact and they're violating women by doing unnecessary tests just to fill their pockets then please, that is evidence I'd like to see.

If you're saying they get paid to do outpatient procedures, then I'm sure they do.

We seem to complain here a lot that we don't get tested for things we insist are important, and I read every day in the paper that women get sent home from the gp with their lumps and bumps only to later find they have metastatic cancer.

More things get tested than return a positive result. That is true. You can't have a negative test result without a test. 80% of breast biopsies are benign. I do not know the corresponding percentage of folk who present with a problem but are sent home without being tested and find later that they have cancer.

Do you have a personal interest in this subject? Have you been subjected to unnecessary and/or injurious testing? I feel at home here and care about the people on this forum, so that is all of great interest to me; idle speculation with or without undercurrents of conspiracy theory is not.

[Angel_of_the_North in reply to puncturedbicycle]

In 2014, BMJ concluded that breast screening hadn't saved lives of the under 60s bmj.com/content/348/bmj.g366

We need better immune systems (not easy with hypo) and less pollution.

[puncturedbicycle in reply to Angel_of_the_North]

That was a small randomised study. Screening for women under the age of the national recommended screening programme is made available to them because of higher risk.

The age of recommended mammos is often in contention. Currently, six of the big organisations recommend screening is made available to women at the age of 40. That could change next year or the year after. One thing you know for sure is that what we know about cancer is the tip of the iceberg. Experts will happily tell you that they do their best but what they don't know adds up to more than they do know.

[Angel_of_the_North in reply to puncturedbicycle]

I think that tests should be available to those that want them and not thrust at those who don't. If you know you would want to be treated for a particular condition, you should be able to get the relevant tests (and the right treatment).

But the NHS should stop wasting money on those "health checks" which are basically glorified Flora adverts (and spend it on T3, active B12 and D3 tests).

[puncturedbicycle in reply to Angel_of_the_North]

Lol, my screening wasn't thrust at me. My surgery is in a torpor. But it would be nice if they used the money better so everyone who is ill or wants to know if they're ill gets good treatment. I despair at the mismanagement. And no one seems to know how to improve it.

[Angel_of_the_North in reply to puncturedbicycle]

It would be useful to be able to say, for example, "I don't want to be called for flu vaccination every year and have to ring you to cancel the appointment, I'll opt back in if I change my mind" instead of having to phone or write every year, or every three years or whatever to cancel and still get another letter asking you if you are sure.

[Angel_of_the_North]

I refused to let them do mine again, and I won't go for another mammogram -ever. How can radiation be good for you when it causes cancer? And what about needle track seeding? But as many people have said, it far more likely to be benign lumps, esp if you are younger.

[puncturedbicycle in reply to Angel_of_the_North]

That's your prerogative of course. Radiation isn't good for you, of course it isn't, I think that view is unanimous. When you're treated with radiation for cancer they give you a whole list of side effects and possible risks. And speaking of things that aren't good for you, my mother's chemo gave her life-threatening blood clots.

Where mammos are concerned the balance is thought to be worth the risk if you're in a relatively high-risk group (esp after a certain age when most breast cancers are detected). But if you're not in that group you may not feel the risk is worth it. I have bc on both sides of my family, so I feel it is.

[Angel_of_the_North in reply to puncturedbicycle]

I was fairly high risk and was diagnosed with DCIS, but refused treatment and any further mammograms etc, as I don't think I should be using up an appointment if there is someone else out there who would accept the treatment and is waiting for a scan.

[puncturedbicycle in reply to Angel_of_the_North]

Sure, that is something you can do.

DCIS is in the foreground of bc research right now and, at least in the US, it has been reclassified. It's contentious.

[Northie]

Ohhh blimmin 'eck!! That sounds horrid. I hope all comes back ok for you. I went for a mammogram yesterday and my boobs are so small I/we, the nurse and I, had to physically coax my poor boob out far enough to be clamped between the plates! Ohmerrrgawwwwd that hurt.... There I was being all ladylike outwardly with my poor boob squished to smithereens and my face doing that cheesy grin gaaaaaaah look that is so becoming of me, haha.

Wishing you genuinely well for test results, and by the way, venting is good.....and with that in mind may I join you in saying &&""??*==##$$. >€€<###*¥¥==€€.

Pheweeeeeee.... Much better,

[puncturedbicycle in reply to Northie]

Ahh, that's better isn't it? And again: £$%^@)^%%$!

Poor you! At least I have a bit to work with (not sure if that's a good thing or not as they have to get you in there literally up to your armpits).

My special spot compression mammos weren't very nice, but they have that thing where they release you as soon as the deed is done (ie they don't have to walk back to the machine). When I asked this radiographer to avoid chatting after clamping me in (like the last one did), she said she would run as fast as she could.

[Angel_of_the_North in reply to Northie]

Same here - having your chest wall squashed between the plates is not nice - I don't think the squashing can be good for your boobs either.

[puncturedbicycle in reply to Angel_of_the_North]

Well, I can only say it hasn't done my @rse any harm.

Seriously, cancer is bad for your breasts, brief compression isn't. It just doesn't feel great.

[Angel_of_the_North in reply to puncturedbicycle]

Apparently the compression bad as it has to be done with sufficient force to get a good picture and a BMJ study found that "death rates were increased by 29% in women whose breasts were squeezed during a mammogram". It's fine if your breasts are healthy, but not if there are cancer cells.

and an interesting opinion:

bmj.com/content/346/bmj.f38...

I don't trust doctors any more for cancer treatment than I do for thyroid treatment. Actually, it's a bit like thyroid - they seemed to know more in the 1920s about handling breasts roughly than they do now

[puncturedbicycle in reply to Angel_of_the_North]

Okay. Um, I hope you never get cancer I guess - ? I pretty much extend that wish to everyone really.

[Angel_of_the_North in reply to puncturedbicycle]

How do you know, can you see your arse?

[puncturedbicycle in reply to Angel_of_the_North]

Ha, the cosmetic effects of some kinds of compression aren't good, but it isn't lumpy and I don't seem to have @rse cheek cancer. Yet.

I wore one of those brilliant body sculpting things for my wedding and I saw the photos so I can report that when I can see my @rse, it looks amazing if it's suspended in elasticated underwear.

[Angel_of_the_North in reply to puncturedbicycle]

LOL! That sounds wonderful.

But even the best body-sculpting undies won't do 300 newtons of pressure (that's about 30 kg)

[puncturedbicycle in reply to Angel_of_the_North]

I haven't yet worn that underwear into the lab to research its limitations.

[Hillwoman in reply to Angel_of_the_North]

I tried to find some info about this aspect of mammograms, because I read many years ago about a study in Canada which indicated that compression could potentially cause a non-invasive DCIS to metastasise. I think the potential seeding of tumours along the needle biopsy route is also recognised. Haven't found refs, unfortunately. Must look again.

However... when I asked at the breast clinic about all these risks, I walked into a wall of denial and derision. At which point I wondered out loud whether men would put up with such a barbaric diagnostic method - after all, there are others which have not been fully researched, like thermography, elastogram, colour doppler ultrasound etc. I continued to wonder aloud about the likelihood of men submitting to testicular cancer screening that involved having their balls mashed between metal plates and then irradiated. The clinic nurse doubled up behind the doctor, whose face was very red.

[puncturedbicycle in reply to Hillwoman]

Potential for seeding is reduced when using vacuum devices. This is a recognised issue with all kinds of biopsies, not limited to breast biopsies. The technology is catching up to reduce the risk.

No one has argued, ever, that mammography or biopsies are risk-free. Even self-examination is not risk-free, as it can result in more biopsies, which aren't risk-free. On balance, the science says the risk is worth it if used for people whose risk of cancer is high enough. I know two people, both under 40, whose metastasising bc was detected on their first mammogram.

Your risk of that DCIS being spread by compression (if that risk exists as it is contentious) is only one of a cascade of risks and decisions balanced by risks that will come out of knowing it's there. If you don't find it and it doesn't spread, life is good. If you find it, you have no way of knowing if it will be invasive or not (they don't know how to tell the difference, but in the US at least it has been taken off the stages ie it's no longer considered Stage 0).

Anyway, just to clear up any misunderstanding, I'm not some kind of pr expert on mammography, just someone whose risk is recognised to be higher who doesn't want to die of bc or lose my mother to bc. I'm an individual exercising my prerogatives, just like you are. I'm not sure what you want me to say to you?

Lest this post be interpreted as a promotional post for mammography, I should clarify I was just writing about something that happened to me yesterday because I knew a lot of others here would have had this experience.

[Hillwoman in reply to puncturedbicycle]

PB, my comment was a reply to Angel, above. Sorry I've upset you. All the best for your results.

[puncturedbicycle in reply to Hillwoman]

No, not upset, just trying to be clear. I genuinely believe (know!) that screening has limitations. And I'm not promoting screening; it is the choice I made, and it is fairly well-informed, but you can make a different choice with different information, and also be well-informed.

We all make our own choices with the info we trust to the best of our abilities.

[Angel_of_the_North in reply to Hillwoman]

The oncologist who had a "chat" with me when I refused treatment said that he knew of needle track seeding in other cancers - eg abdominal, colon, but not breast - but I don't see why it should be different. He was actually OK and just said I could come back if I changed my mind

[puncturedbicycle in reply to Angel_of_the_North]

I think it may be different because of the way the tissue is taken depending on where it is in the body.

I read about someone getting cancer in their spine after a positive lung biopsy and the cause was thought to be seeding, but you can imagine the dynamics of how to get a specific area of lung tissue out vs the solid, smaller, fattier area of breast tissue.

My mum's surgeon addressed this too, that when they remove the tumor it's important to get a clear margin so you don't scatter cells. And I think the biopsy path was addressed at some other time too, maybe during radiation? That time is all a bit of a blur.

[puncturedbicycle in reply to Hillwoman]

PS. I'm sorry your questions were met with derision. That shouldn't happen to anyone. I had time to question my doctor, who answered my questions thoroughly and with respect.

[Firinne]

I had core biopsies taken after a suspicious mammogram, they couldn't find the right area, so I was told to go home, wait a month for healing to take place then go back and if they still couldn't find the area they were concerned about, I'd have to have a small op. under sedation. Thankfully, the next visit the doctor did biopsy the right area - 'Oh, well done!' was my response lol. They told me there and then it was fine and just an area of calcification. It all freaked me out so much, that's the last time I went for a mammogram. Mind you, breast cancer isn't in my family, I would go if it was but I decided to just check myself regularly for changes. Good luck, I hope you are told you're fine, as I was.

[puncturedbicycle in reply to Firinne]

Oh my word, how awful. At least this was all done as needed. And I see today it was done through a single incision, so I don't look like a pincushion.

Self examination has been argued back and forth (mainly because of the biopsies it leads to) but I can tell you my mum's surgeon recommended it. My mum's cancer wasn't found on her most recent mammo - I didn't even know that could happen ahem - but she had pain and nipple retraction, so she knew enough to check it out. Apparently that isn't common, but screening is just screening, it doesn't catch everything.

[snow31]

Thinking of you. Not surprised you want to have a rant and rant away here you can.

Fingers crossed all is ok

X

[puncturedbicycle in reply to snow31]

Thank you.