Breast biopsy - should I go under sedation or would local be ok?

[Phoenix]

So Dr found some lumps in my breasts and wants to biopsy the biggest lump. She wasn't overly concerned but said that I should have a biopsy just to rule out the Big C. Ultrasound and mammogram have been done. I gues biopsy is the next logical step.

It's going to be Ultrasound-guided vacuum-assisted biopsy (not core biopsy). She's going to remove the biggest lump (about 1.5cm in diameter) and not just a teeny tiny bit of tissue. She asked if I wanted it removed and I said definitely yes.

Now, she said it'll be done under local. I am petrified of pain!! She said the only pain I should feel would only be the painkiller injections. I am still appprehensive. I saw the freaking needle (more like a gigantic cannula!!). Sedation wasn't offered as an option. Should I insist?

 

[Begonia]

I don't know the answer but thinking about you thru this and focusing on the best possible outcome!
Hugs to a sister <3

 

[HockeyMama]

There are risks with sedation. If she thinks she can do it pain free with local injections (which do burn), I would follow her advice. If you are mostly nervous, and you have a driver to accompany you, in the US we offer patients something in the valium family to relax them. Best of luck.

 

[Phoenix]

There are risks with sedation. If she thinks she can do it pain free with local injections (which do burn), I would follow her advice. If you are mostly nervous, and you have a driver to accompany you, in the US we offer patients something in the valium family to relax them. Best of luck.

I just googled the risks of sedation. Wow! Scary!

When you say "burn", on a scale of 1-10 where would you rate the burn? I don't even like it when I have to have blood drawn on the inside of my elbows for tests.

What in the valium family could I ask for? Not sure what they carry here but I can ask.

Someone will be with me. But I am still freaking out! lol

Thank you.

 

[pearlsngems]

I don't generally write about my health but here goes.

I needed an ultrasound-guided core needle biopsy in January (not vacuum assisted; the lump was only 6mm x5mm.)
I got a local anesthetic injection.
The anesthetizing injection is a little painful but not that bad. The anesthesia is injected slowly as the needle is inserted, to provide pain relief along the way, so you don't feel too much. (Getting a Novocaine injection for dental procedures hurts more.)

I could not feel anything at all during the biopsy itself. The breast is numb!

They sent me home with an ice pack in my bra. I had no pain (zero) after that. None! I expected to be sore afterward when the anesthesia wore off, but I didn't feel a thing. I was surprised but gratified. But it's good to be ready with an extra ice pack at home just in case, and Tylenol.

The vacuum assisted biopsy removes more tissue so they have a bigger sample, which is good-- but I expect the local anesthesia would work just as well.

I drove myself home, no problem.

 

[doberman]

The stronger the anesthesia, the greater the risk. Go for the local. You can do this.

 

[HockeyMama]

I just googled the risks of sedation. Wow! Scary!

When you say "burn", on a scale of 1-10 where would you rate the burn? I don't even like it when I have to have blood drawn on the inside of my elbows for tests.

What in the valium family could I ask for? Not sure what they carry here but I can ask.

Someone will be with me. But I am still freaking out! lol

Thank you.

Drug names are so varible overseas. Do y'all have something called valium there? Because if you do I would just ask for "something like valium" because you are anxious. I don't know how things work there, but in the US we would absolutely provide that for a patient. The drug class is "benzodiazepines" or "benzos".

Pain scales are relative! I'm not sure what your one and your ten is. I think @pearlsngems ddescribed it well, it would be very similar to dental injections. It just lasts seconds. The not knowing is worse than the procedure... hopefully you can get scheduled quickly so you don't have to fret as much.

 

[Phoenix]

I don't generally write about my health but here goes.

I needed an ultrasound-guided core needle biopsy in January (not vacuum assisted; the lump was only 6mm x5mm.)
I got a local anesthetic injection.
The anesthetizing injection is a little painful but not that bad. The anesthesia is injected slowly as the needle is inserted, to provide pain relief along the way, so you don't feel too much. (Getting a Novocaine injection for dental procedures hurts more.)

I could not feel anything at all during the biopsy itself. The breast is numb!

They sent me home with an ice pack in my bra. I had no pain (zero) after that. None! I expected to be sore afterward when the anesthesia wore off, but I didn't feel a thing. I was surprised but gratified. But it's good to be ready with an extra ice pack at home just in case, and Tylenol.

The vacuum assisted biopsy removes more tissue so they have a bigger sample, which is good-- but I expect the local anesthesia would work just as well.

I drove myself home, no problem.

I feel sooo much better reading this. Thank you!!

I wasn't thinking about an ice pack. But what a great idea! I am going to get myself a huge pack of Panadol (I don't think we have Tylenol here) to take before and after. They offered Anarex but I refused as I think I had problems with it previously.

I hope I am making the right decision to go with the vacuum assisted biospy because that lump is pretty large.

 

[Phoenix]

Drug names are so varible overseas. Do y'all have something called valium there? Because if you do I would just ask for "something like valium" because you are anxious. I don't know how things work there, but in the US we would absolutely provide that for a patient. The drug class is "benzodiazepines" or "benzos".

Pain scales are relative! I'm not sure what your one and your ten is. I think @pearlsngems ddescribed it well, it would be very similar to dental injections. It just lasts seconds. The not knowing is worse than the procedure... hopefully you can get scheduled quickly so you don't have to fret as much.

I am not sure if they carry valium. I will ask.

Haha, I'm a total chicken when it comes to pain. Dental injections are HORRENDOUS to me.

The procedure is scheduled for next week, Wednesday. I wanted it to be done asap. You're right, I'd rather just have it done for peace of mind, asap.

 

[springerspaniel]

Hi @Phoenix! First of all, I am so glad you are getting these checked.
Secondly, acetaminophen (paracetamol/tylenol) is a good pain reliever. If you can tolerate it, you might also consider ibuprofen, which will address the inflammation itself due to the disruption of fluids in the area around the biopsy. (You can actually take both together or alternating if the pain lasts longer than a few hours).
Third, valium's generic name is diazepam, and as @FornasettiLover (what exactly is a fornasetti anyway????) said, is in the class of benzodizepines. Diazepam is longer acting than other benzodiazepines, however, and you might consider asking for a shorter acting medication like lorazepam or anything that they would consider to be an anxiolytic (even diphenhydramine, an antihistamine, might help). Just please make certain these meds cooperate with any other medications you may be taking.

I will be thinking about you next Wednesday--please let us know how you are doing afterward.

 

[pearlsngems]

They told me to avoid ibuprofen (or any other non-steroidal anti-inflammatory drug, even aspirin) as it is slightly anticoagulant.

 

[Phoenix]

Hi @Phoenix! First of all, I am so glad you are getting these checked.
Secondly, acetaminophen (paracetamol/tylenol) is a good pain reliever. If you can tolerate it, you might also consider ibuprofen, which will address the inflammation itself due to the disruption of fluids in the area around the biopsy. (You can actually take both together or alternating if the pain lasts longer than a few hours).
Third, valium's generic name is diazepam, and as @FornasettiLover (what exactly is a fornasetti anyway????) said, is in the class of benzodizepines. Diazepam is longer acting than other benzodiazepines, however, and you might consider asking for a shorter acting medication like lorazepam or anything that they would consider to be an anxiolytic (even diphenhydramine, an antihistamine, might help). Just please make certain these meds cooperate with any other medications you may be taking.

I will be thinking about you next Wednesday--please let us know how you are doing afterward.

Thank you sooo much.

I will ask them about these meds.

On the subject of inflammation, I am thinking of eating pineapple in the days leading up to the surgery and the days post-op. Is this a good idea?

And I shall definitely come back with an update. Thank you again. x

 

[Phoenix]

They told me to avoid ibuprofen (or any other non-steroidal anti-inflammatory drug, even aspirin) as it is slightly anticoagulant.

Interesting. They've given me some anti-blood clotting meds to take on the day of the procedure and a few days afterwards. Should I be worried?

 

[pearlsngems]

Interesting. They've given me some anti-blood clotting meds to take on the day of the procedure and a few days afterwards. Should I be worried?

Huh...are you prone to blood clots? (You don't have to answer that.)

I'd just go with whatever they give you. Remember, this is a common procedure and they know what they are doing. And any recommendations they make are because they have your medical history.

 

[springerspaniel]

Interesting. They've given me some anti-blood clotting meds to take on the day of the procedure and a few days afterwards. Should I be worried?

What have they given you, if you don't mind my asking?

 

[Phoenix]

Huh...are you prone to blood clots? (You don't have to answer that.)

I'd just go with whatever they give you. Remember, this is a common procedure and they know what they are doing. And any recommendations they make are because they have your medical history.

No, not at all.

Very strange. I shall ask them tomorrow. Thank you for pointing that out.

ETA: I just checked. I got it the other way round. They've given me cyklokapron. I am a total idiot! lol

 

[HockeyMama]

Some of this stuff depends on your history and what other meds you are on. I would defer to your MD for pain control other than compresses, etc... Generally speaking, cold compresses and over the counter pain medicine will be more than enough.

(Fornasetti was an Italian artist who created a line of really distinctive and super funky home design items. I have absolutely no idea why I chose that name, I don't use it anywhere else.)

 

[Phoenix]

What have they given you, if you don't mind my asking?

Haha, I am an idiot!

They've given me cyklokapron. I just checked. So it's to prevent prolonged bleeding, right?

 

[pearlsngems]

Haha, I am an idiot!

They've given me cyklokapron. I just checked. So it's to prevent prolonged bleeding, right?

Well that makes sense. It's to prevent prolonged bleeding, so it's not an anticoagulant (which means anti-blood clotting)-- just the opposite.
In other words, appropriate clotting is good, prolonged bleeding is bad. Hence avoiding ibuprofen, which interferes with appropriate clotting.

 

[Phoenix]

Some of this stuff depends on your history and what other meds you are on. I would defer to your MD for pain control other than compresses, etc... Generally speaking, cold compresses and over the counter pain medicine will be more than enough.

(Fornasetti was an Italian artist who created a line of really distinctive and super funky home design items. I have absolutely no idea why I chose that name, I don't use it anywhere else.)

I don't think the breast surgeon who's doing the procedure is giving me meds based on my medical history. I hadn't seen her for 3 years. I'm just chicken when it comes to pain, any kind of pain.

Love your screen-name.

 

[pearlsngems]

You will do fine!

I watched the procedure on the monitor-- it was actually interesting. And I chatted with the interventional radiologist while she did the procedure.

 

[springerspaniel]

Haha, I am an idiot!

They've given me cyklokapron. I just checked. So it's to prevent prolonged bleeding, right?

You're not an idiot--this stuff can be complicated, even for docs and NPs. This is used primarily for people with hemophilia, buut can be used off-label for surgical procedures for others to prevent prolonged bleeding.

 

[pearlsngems]

The worst part is waiting and wondering.
Waiting for the procedure.
Waiting for the pathology report.

Do something fun and distracting while waiting. Maybe start a new book.

 

[Austina]

If it were me, I’d go with local. If it’s comparable to dental pain relief, then I’m sure you’ll be fine. I used to tell patients who were afraid of the injection, to try and relax, breathe deeply, and slowly count to 10 as it’s being administered. I can tell you they always said, “Oh wow, that wasn’t anywhere near as bad as I was expecting”

Good luck with the procedure, and sending lots of good vibes for the best possible outcome.

 

[Ally T]

Haha, I am an idiot!

They've given me cyklokapron. I just checked. So it's to prevent prolonged bleeding, right?

I take this due to my bleeding disorder & you are correct: it is to prevent excessive bleeding & to help clotting factor 8 in the blood be more efficient.

I am sorry to hear that you have some bumps that need investigating, but it sounds like they’ve been caught early & you are in good hands. Fingers crossed they are absolutely nothing to worry about & I’ll be thinking of you. Also, I would take the local.

 

[TooPatient]

I just googled the risks of sedation. Wow! Scary!

When you say "burn", on a scale of 1-10 where would you rate the burn? I don't even like it when I have to have blood drawn on the inside of my elbows for tests.

What in the valium family could I ask for? Not sure what they carry here but I can ask.

Someone will be with me. But I am still freaking out! lol

Thank you.

As a fellow blood draw and all needle freak out person, let me also mention that ANY full sedation requires an anesthesiologist and an IV. Not just any IV, but a surgery sized IV. I have gotten to where I can manage regular MRI sized IV without much anxiety, but the ones for anesthesia are NOT fun. They are a larger gauge thing. Had to have one for the lumbar puncture I insisted on being out for and again for the spine surgery. Both were exceptionally miserable.

Anyway, just passing along so you can weigh your options. No experience with a biopsy so can't add anything there. Good luck! Will be thinking of you!

 

[dk168]

I am posting about my own experience back in 2020, when a routine 3-yearly mammogram revealed small Calcium deposits about 4mm area which could be indicative of cancer brewing.

I was a pin cushion when they put a pin inside the affected breast with the aim to perform a biopsy and take out the Calcium deposits at the same time. Apparently the location of the deposit was quite deep.

Edited to add that topical pain relief was applied before they attempted to place the pin inside my breast. However, because the location was quite deep, they had to do it more than once as it was not sufficient accurate the first and second time.

I attended a day surgery and had a general anaesthetic. I can't remember if I were offered a local anaesthetic or not, sorry!

However, had I been given the choice, I would have opted for a general one as I don't particularly want to stay conscious to know what was going on.

I attended a surgery session and watched different surgical procedures as part of my HCP training a long time ago, and it was not an experience I wished to repeat.

I was not allowed to drive and had to get a friend to me at the hospital and to pick me up later when I was discharged.

The biopsy result was no sign of cancer, and my annual mammogram for the past 3 years had been all clear.

I am in UK, whether that makes a difference or not I do not know.

DK

 

[HS4S_2]

I also had it done with local numbing. It was much worse in my head prior to the appointment than it was at the actual time of procedure. It stings for a short time and then numb. I did bruise but it was not painful.

 

[canuk-gal]

HI:

I've had at least 6 breast lumps removed--all under local--over the decades with no issues during or after the procedure. I will say that around the nipple--that was the most sensitive area when I had a cyst drained. Once the local is in, you really don't feel pain.

Much success to you; you appear to be in capable hands. Let us know how it goes.

kind regards--Sharon

 

[Phoenix]

You will do fine!

I watched the procedure on the monitor-- it was actually interesting. And I chatted with the interventional radiologist while she did the procedure.

I could barely look at the needles when the Dr was showing them to me yesterday.

Thank youuuuu for your encouragement and help. x