My Stereotactic Breast Biopsy Experience

Recently, I had a stereotactic biopsy due to clusters of microcalcifications found in my right breast during a mammogram. Of course, I researched the biopsy method before the big day arrived. But there was a glaring omission in my online findings—where were the stories of real women who have undergone this unusual type of biopsy? What did they think? How was the experience? Was it painful, awkward, a breeze? I went into it understanding the technical aspects and medical reasons I was having a stereotactic biopsy. I didn’t understand what the experience was going to be like or how it would feel beyond a guess. I was right. I was wrong.

I thought I’d share my experience. It’s not easy sharing something so personal, but it would have been helpful for me to read experiences. I hope this helps someone. We are all different and have different pain thresholds, but knowing what to expect or anticipate can alleviate anxiety. If you are the kind of person who is better off being surprised (I’m not) you probably shouldn’t read. Also, none of the following serves as medical advice. If you take medical advice from me, you are doomed. I can advise you about potty training and buttercream recipes, but there is no MD or RN after my name. This is simply a recounting of what a stereotactic breast biopsy was like for me.

The book the imaging place provided was helpful, but not quite enough…

From this point, there are a few tidbits some might consider TMI or graphic. You’ve been warned.

Thankfully, they don’t make you fast overnight before the procedure. They use local anesthetic, which means you won’t be starving and nervous before you go under the needles. You’ll just be nervous. The nerves you experience aren’t just from worries about pain, but it’s compounded by worries regarding the results. It’s a mentally, physically, and emotionally trying few days—but I have to say the staff I encountered were all very warm and reassuring.

They also seem to know how absurd it seems.

When I’m nervous, I laugh and crack jokes. When I saw the procedure table, I couldn’t stop giggling. It looked like a purple surfboard with a large hole. They have you climb up and lie down on your stomach with the misbehaving breast dangling down through the hole. They position you so you aren’t completely flat on your face. I was tilted slightly with my head turned sideways, one arm straight down my body, the other wrapped around a rolled towel for comfort.

They covered me with a warm blanket. Surprisingly, I was able to leave my skirt and shoes on. I was thankful they didn’t require a clothes-free environment because it was already highly-awkward—especially when they buckled me in and raised the surfboard so the radiologist and assistants could work on me from below. It’s like being a car.

The first thing they do is give you a “snug” mammogram so they can locate the suspicious area(s). The coordinates are entered into a computer, which controls the biopsy needle. You need to hold really, really still because your breast remains in the mammogram vice the entire procedure. If you shift or move, the coordinates can be thrown off. You want them to get the tissue on the first try.

After they locate the area to be biopsied, they numb you with your breast still in the vice (which is gridded with access holes). First, they numbed the skin with a small pinch. They waited a few minutes and went a big deeper. This was a bigger pinch. They waited a few more minutes and plunged the numbing medication deeper. This was actually the most painful part of the whole biopsy, like intense sharp burning. It was over quickly, though. After waiting to be sure it was nice and numb inside, the radiologist made a small slit in the skin and the machine placed the hollow biopsy needle inside. The photos I saw during my research made me think of this needle as a hollow meat thermometer. It’s chunky. The radiologist said I’d feel a lot of vibration while the vacuum sucked the tissue into the needle. It only took a minute or so for this part to be complete.

A tech took the sample and put it in a microscope x-ray machine. Instantly, an x-ray of the sample appeared on a screen. They could see the microcalcifications on the screen, so they knew they got the right area. I tried to discern what I was seeing. Did it look okay? Bad? They can’t tell you anything until the pathologist examines the samples, so it’s a helpless feeling seeing, but not knowing.

With this biopsy technique, it’s possible to bleed quite a bit. Breasts are veiny, especially near the nipple. Of course, being me, this is the first site they biopsied. The nurse held pressure on me for about ten minutes. The bleeding wouldn’t stop, so they had me flip over very carefully and it took another five minutes to get the bleeding to stop. They used steristrips to close the incision. I turned back over so they could repeat everything with the second suspicious area. It was much easier the second go-round. The bleeding stopped easily. They got that sample on the first try, too.

After both samples were taken, they left tiny metal markers inside. With future mammograms, they will be able to see areas that have already been biopsied. The markers are so small that I’ll never feel them and they won’t interfere with metal detectors.

Free from the vice, I was able to sit up slowly and regain my wits. I was slightly dizzy. They gave Tylenol to me with juice, which helped. After making sure I was steady, I was taken to get a “light touch” mammogram to make sure the markers were visible. My breast was surprisingly huge, swollen from the injected fluids and trauma. It was also numb, so it was kind of funny. It didn’t hurt at all. The markers showed up in the image. Another small triumph of the day.

Then, bandaging. They had me bring along a tight-fitting sports bra because support is crucial in the first few days after a breast biopsy, not only for comfort but for healing and preventing hematomas. The assistant put a messy wad of gauze pads on my breast (which seemed weird) and then tightly wrapped an entire ACE bandage around my chest. I felt like Yentl and almost burst into song: “Papa, can you hear meeeee?” But I did not. Out loud.

Then, she helped me shimmy into my tight sports bra. She stuffed an ice pack inside and said to leave it in my bra until it got warm. I looked totally silly when I put my shirt back on. My right side was hugely jagged, like Mt. Everest. The other side was like Death Valley. Throughout that day, I needed to ice my breast every few hours for pain, plus stay on top of painkillers. They recommended Tylenol and it was enough for me to deal with pain when the numbing drugs wore off. I wore the bandage and sports bra for 24 hours, but the moment I realized it was ouchy without hardcore support, I put the sports bra back on. It was my bff for the first week. I wore it to sleep. It especially helps because I did develop a hematoma, which they said wouldn’t be unexpected due to the location of the first biopsy.

The biggest surprise was when they told me the results would be available the next day. That’s both wonderful and terrifying. Knowing quickly is a blessing. It doesn’t give you time to obsess any more because chances are, you obsessed over the results from the moment you were told they found something suspicious. It’s good to have an end of the mystery in sight. Your life will go in one direction or another—but at least you’ll know.

This is why I completely disagree with the final bit of advice they give. They say you can drive yourself home and return to work. The only restrictions were to not lift anything over 10 pounds for 4-5 days and no heavy activity, like housework or exercise. I was so, so glad to have my husband there to drive me home. I was also glad to be able to rest that day and the next (he worked from home). Every time the phone rang the next day, my heart rate tripled and I felt faint. Finally, in the late afternoon, I saw the surgery center on the caller ID. I took a huge, deep breath and answered. Before I could say anything beyond hello, the nurse said, “You are fine. It’s fine.”

Hooray for fine!

If you don’t hear fine, I am so sorry. My prayers and thoughts are with you. Go into the stereotactic biopsy knowing although it’s a little awkward, a little crazy, a little funny, a little scary, a little painful. But you are not little in the least. You’ve already done so much by taking care of yourself, by getting that far. Who knows what the future will bring? Armed with this experience, you are more aware you can handle what life throws your way.

Take care.