Me, My Breasts, and I: Excision

Well, it has been almost three months since my last post on the topic of my breasts, Me, My Breasts, and I: Results. At that point, I had my ultrasound biopsy results, and a referral to Dr. Janet Ihde, a breast specialist.

Several women I spoke to were very high in their praise of Dr. Ihde. One did warn me that I shouldn’t expect my appointment to run on time, though. Well, that was true enough. At my first consultation, after about a 45 minute wait, I did not even speak to the doctor. Instead my appointment was with a Nurse Practitioner, a kind of pre-consultation, before I did this all over again in a week or so with Dr. Ihde. The NP was quite professional and informative, though, and spent a lot of time with me and answered my questions to my satisfaction.

At my next appointment, after I had waited nearly an hour, I was informed that the doctor had a personal situation and would not be able to see me that day. While I understand that shit happens in everyone’s personal life that is beyond their control, I was not happy. I had to take time off work again the following day for a rescheduled appointment.

I went into my third appointment with kind of a bad attitude. I felt a bit angry and negative about it, because of the waiting and the rescheduling, and hey, these are my breasts we’re talking about here! A little respect please.

And then I met Dr. Ihde, and everything was fine again. She was warm and competent, and she listened. She even explained her “personal issue” from the day before. She explained everything thoroughly, and answered allΒ  my questions, including my main one: Why? If it is so small and benign, and not bothering me, why does it have to be removed? (Answer: Although the needle biopsy showed the intraductal papilloma as benign, and it usually is, it needs to be removed and the whole thing biopsied to be certain.)

She wanted to schedule an MRI, just to get a better look at the tumor, but my insurance company, in their ever-wise control of my health, turned it down. We were straight on to the surgery. (The doctor’s office told me that they frequently turn it down when there is no cancer diagnosis, so I guess, in a way that was a good thing.)

Originally scheduled for January 31, then moved back to the 30th, I went in for pre-op last Friday. There I registered, sign a lot of waivers, paid my deducible, gave blood, had an EKG, gave urine, and, finally, had a chest x ray. I got my pre-op instructions, no blood thinners, no food or water after midnight on Sunday since I would be having general anesthesia.Β  I was having my surgery at Desert Regional Medical Center in Palm Springs, which is not convenient to La Quinta at all, but a good choice apparently because they are better with OR scheduling (and all the people, every one that I dealt with, were very nice). But still, a long drive (about an hour in the middle of the day).

The term for my procedure is needle localized wide excision left breast lesion. A description from the Mayo Clinic website:

Surgical biopsy. During a surgical biopsy, a portion of the breast mass is removed for examination (incisional biopsy), or the entire breast mass may be removed (excisional biopsy, wide local excision or lumpectomy). A surgical biopsy is usually done in an operating room, with sedation and a local anesthetic. If the breast mass can’t be felt, your radiologist may use a technique called wire localization to map the route to the mass for the surgeon. During wire localization, the tip of a thin wire is positioned within the breast mass or just through it. This is usually done right before surgery.Β  (I did the highlighting – this is what I had done. And although “breast mass” sounds huge, they just cut out a little tiny piece.)

About this wire localization. I had to arrive at the El Mirador Imaging Center, which is on the Medical Center campus, at 7:45 to have the procedure done. Alan drove me, of course, and waited until I was called in. Although I had had the procedure explained to me, seeing it in action was a whole other story. First, I was seated in a “Princess Chair,” a high, rolling chair that would be used to keep me comfortable (and still). Then, three questions, which I would hear over and over through the day, “What is your name,” “What is your birthday,” “Which breast are we working on?” I got all the answers right. Although after this first part, answer number three would be very obvious.

As the procedure was explained to me, although a tag had been left in my breast during the original biopsy, they needed to pinpoint the location exactly for the doctor. To do this, first the area would be locally anesthetized, then a needle would be inserted. Using digital mammography, the radiologist would make sure that the needle was in the exact spot. This could take several attempts. Then a blue dye would be injected into the area. Finally, a wire would be inserted through the needle and would “hook” the tag/tumor, to insure that the doctor would have no trouble finding the right location.

For women who have had one, imagine having your mammogram last 45 minutes. On one breast. If you haven’t had one, just imagine (men or women) your breast in a vise for that amount of time. Oh, yeah, while someone is sticking a very long needle in you.

Actually, while it was uncomfortable, it wasn’t painful (thank you lidocaine). I was fortunate that they found the correct spot on the first attempt. After it was complete, I was rolled away from the machine, complete with a three inch dart sticking out of my left breast. In order to protect it, they used an advanced technique: They taped a Styrofoam cup over it. Yep. Fortunately, they wrapped a sheet over my shoulders for the wheelchair ride to the hospital, so I didn’t have to show off my third breast to the public. For public it was, no hallway or back entrance, we rode down the elevator, through the parking garage, across the driveway to the main entrance. Whee!

Once there, I was delivered to Pre-Op. Brenda, my very nice nurse, told me that there was another surgery scheduled before mine, and that Dr. Ihde wasn’t there yet. Surprise, late again! She dug up a couple magazines and I settled in to wait. What else can you do? Reading made me sleepy, so I even dosed off for a while.

Shortly before it was time, Dr. Ihde came by to check on me. She also put a little X on my left breast (just in case that dart sticking out wasn’t enough). The anesthesiologist also came by and told me what to expect. A little relaxation, a little pain medication, a little anti-nausea drug, then sleep.

Finally, I was rolled into the operating room. I noted the time on the clock at 11:20, meaning I’d been waiting over two hours. I also noted a very cool bulletin board labeled “Our Pets” which was full of pictures of dogs and cats. Great idea! I think they had one of their (human) kids too, but I didn’t take as much notice of that.

Once in the OR, I was slid onto the operating table. I had time to notice the large lights and to see that this wasn’t an operating theater (no Kramer dropping junior mints into me!), but a low ceilinged operating room. Then a drowsy, cloudy feeling, then nothing.

When I woke up in the Recovery room, it was a little before 1:00. As I opened my eyes, my post-op nurse, Roy, was right there to see how I felt, get me some ice chips and juice, and call Alan to let him know he could come to pick come to pick me up. I was a little sore, had a huge headache, but other than that felt okay and happy to have it over with. I had a huge bandage on my left breast (I’d bump into things with it!). My post operative instructions were simple. Eat lightly at first, preferably soup or something like it, keep my bra on, don’t shower until Wednesday, and call the doctor’s office to make an appointment for Friday. Oh, and I was given a prescription for Vicodin, which I did fill, because you never know, but only needed one.

What I really needed was my migraine medicine, because my headache was getting worse as the day went on. We picked up some soup at Von’s where my pharmacy is (Amy’s vegan Lentil Soup), then finally headed home. That drive from Palm Springs seems especially long post-op!

When we got home, I heated up the soup while Alan went back to pick up a sandwich for his lunch (I really needed to get home!). The first few bites of the soup were great. I was so hungry. But then, the nausea started. Either from the anesthesia, or the headache or a combination, I had to head quickly to the bathroom. Afterward, I felt a little better, so I finished the soup, drank a couple glasses of water, took a vicodin (I’d already taken the migraine pill and was hoping it would start working soon), and climbed into bed.

Although I managed to get some sleep, I spent the day and night up and down. My headache did not go away. I took another pill, but it was time that finally got rid of it. After finishing the soup, I soon vomited it back up. I tried a banana a little later in the day, but couldn’t keep that down either. I kept trying to drink water to battle dehydration, and I guessed that worked because when I finally stopped vomiting, I had to pee every hour or so. Oh, and my breast ached.

I finally woke up about 5:00 am, headache gone, craving coffee (I’m sure the lack of it helped kick off my headache). I felt surprisingly good. Amazingly good after the coffee. My neck is sore today, probably because of some weird sleeping positions I assumed through the long night. Other than that, I’m feeling fine. And my breakfast of toast and cereal stayed down just fine. I did spend the day taking it easy. I took a nap, lazed around for a few hours, then started up the computer to write this post.

Now, I am writing this on Tuesday, the day after my operation. My appointment with the doctor, where I will find out the results of the biopsy is on Friday. I hesitated as to whether to post this now, or wait until the results, but I really do feel confident that they will be benign. If they are, I’ll edit this post with the results. If they are not…well, we’ll see.

In the meantime, please think positive thoughts for me.

UPDATE, UPDATE, UPDATE!!!

Results are back and they are benign! WooHoo! I was feeling very positive, but still, what a relief to hear those words. I do have a hematoma, which explains some extensive bruising (sorry, no pics. While I do bare most of my life, I do have my limits, but believe me, EXTENSIVE bruising). Oh, and yes, my doctor kept me waiting for an hour, but she walked through the door, her first words were, “It’s benign.” Okay, forgiven.

Thank you all for your support!

From the Happy Breast Book. If you would like to purchase a copy of the Happy Breast Book or have questions about breast health, contact Cheryl Chapman.

 

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Comments

  1. says

    I’m sending you loads of positive vibes!!!!! I think you are an amazingly positive person, and you will reap what you sow!!

    I agree, that is a cute idea to have a pets board, you can’t help but smile when you see peoples pet pictures…for me, more so than kids.

    • says

      Thanks. You’re right, I am very positive. I hardly feel worried about hearing the results tomorrow. I’m just assuming they will be good news. Thanks for the good vibes though, you can never have enough of that.

      Seriously, I loved that bulletin board. Thinking about doing something similar at work (I have a small staff, though, I might have to combine the kids and pets thing).

  2. Sherri Hansell says

    Hi Debbie:

    Thank you for the informative posts on intraductral papillomas and your excisional biopsy. After a stereotactic biopsy in Dacember 2011, I was told that my intraductral papilloma was benign. I thought that the clip in my breast would be used for future mamograms. Yeah! However, my obgyn forwarded my results to an oncologist. Thinking all was ok I made the appointment and couldn’t get in to see the doctor for month. Imagine my surprize when I went to the appointment and she said that I had to have an excisional biopsy and that she was ready to schedule it that day! Everything she said after that was blur. I said “no” and that I had to think about it. I found your blog that day. It is the best and most honest description that I could find of the procedure. I appreciate your honesty and am glad that your diagnosis was benign. This week I am going back to my obgyn and the surgeon to ask a lot of questions!

    Sherri

    • says

      Thank you, Sherri, I’m glad that my story helped you start to figure it all out. My husband sometimes feels that I share too much, but when I get comments like yours, I knoow I’m doing the right thing.

      By the way, one of the things I haven’t shared is photos or remarks about the amazing bruise that is just now starting to fade. Not only was my left breast completely dark purple, the bruise extended all the way to the nipple on my right breast, also my left armpit and lower rib area. This apparently is not normal, but because I have a hematoma caused by their missing small “bleeders” during the surgery. My doctor said it is nothing to worry about, but two attepts to drain it have failed, and my left beast is still swollen and quite hard. Hence the pictures in case this is something that does not correct itself.

      Other than that, at two weeks since the surgery I feel fine. I go back in two weeks to have it checked.

      Good luck with your treatment, whatever path you choose.

      Debbie

  3. Emily says

    Hi! I just read your post. I had a double excisional biopsy done the first week of March (a week before my wedding and honeymoon, great timing there, huh?) and I was just wondering if the hardness you experienced resolved and how long it took? I am almost 3 months post op and where there was a noticeable divot (if I felt for it) where the largest tumor was removed however it is now hard and feels ‘filled in’ and under the arm where a smaller tumor was removed there is also another hard lump. I got benign results but can’t help feeling paranoid that my breast still feels so hard, increasingly so even. Sorry for rambling. I was just curious if your swelling and hardening resolved. Thanks!

    • says

      Hi Emily,
      It took months (and I’m sorry I can’t remember how many) for the hardness in my breast to go away. It was right under/next to my nipple, and I think it was at least six months. It feels perfectly fine now, though there is a slight tilt (I guess, that’s the best word I can come up with). I like to think it gives my breast a little quirkiness :-).

      If you are really concerned though, you should talk it over with your doctor. There could be scar tissue that may need attention, plus it could settle your mind that there is nothing wrong.

      I’m kind of getting a giggle, remembering how bruised I was for about 3 weeks after my surgery. That must have been an interesting wedding night πŸ˜‰
      Debbie recently posted..Gyro Spiced Seitan and Quinoa Bowl. #Vegan RecipeMy Profile

  4. Candice says

    Hi Debbie

    Just wanted to say thank you for the post. I am having this surgery on Wednesday and I was happy to read about the procedure first hand. I was really concerned about recovery time and since I’m a runner and you are a runner I wondered how long until you started running again? Glad everything came out good for you. Thank you again for sharing your experience.

    • says

      Hi Candice,

      One of the nice things about having a blog is that you can go back when your memory fails and see what you wrote. I can’t remember what my instructions were, but I see that I rode my bike on February 4 and I ran on February 7. I don’t know if that was the first time I ran after the surgery, though, but it was only a week in any case. I think the instructions were that it was okay when it felt comfortable.

      Good luck on your surgery! I’m sure it will go well.
      Debbie recently posted..The Dog Rescuer: Called into Action in San DimasMy Profile

      • Candice says

        Thanks Debbie,

        I look forward to getting back on the road again, as I am sure you can relate to, and as i am preparing myself this morning for my surgery your response is making me feel better about getting back to my life quickly. Thank you again for your response as I am sure you know, since you have been there, it has helped to ease my mind about my surgery and recovery this morning.

  5. VL4 says

    Wow I am going through the exact same thing and have the excisional surgery next week. Hope my results come out as positive as yours did. Helpful to read about the process thanks for sharing.

    • Debbie Woodruff says

      I’m glad I could help. Good luck with your surgery. Sending good thoughts for everything to come out well!

      • says

        So the excisional biopsy went very well. You are right as the most uncomfortable part is the 5 minute mammogram for the wire placement. Yikes that took my breath away but everything else was relatively easy and painless. As I get easy motion sickness and nausea I was set up very well by the anesthesia doc and had no problems with recovery. I just needed some ice packs and extra strength Tylenol. Got the results today and no cancer. I do have LCIS and will seek an oncologist for preventative protocol. Thanks again for the info and encouragement.

  6. Pat says

    Loved your descriptive post of your experience. Happy to hear your results were good. I am scheduled to have bilateral wide excision next week. Biopsies also can back B9 but type that can at some point change and need to be removed:(. Feeling better after reading these posts!

  7. Pat says

    Well, had my surgery yesterday and overall feeling very relieved that is over with. Hopefully, won’t have to do that again. The worst part of the procedure for me was putting the wires in. I was in radiology for about an hour and half because they had to do both breasts and it took quite a while for the radiologist to get them in the right positions. It was very uncomfortable. The actual surgery you are asleep so can’t complain about that. After the surgery, I felt stabbing pains, but ice packs really helped. I took tylenol and went home and slept for about three hours and after that kept the ice packs refreshed through the night and feeling really good today πŸ™‚ The biopsy results were ADH (Atypical Ductal Hyperplasia) which is a benign mass so hoping the full results will come out the same. I will report back next week when I get the results. Feeling very positive!!

  8. says

    Still sending positive thoughts your way for good results!

    I actually had to re-read my post to remember what the pre-op procedure entails. Which hopefully means that the discomfort of getting those wires put in will soon be a cloudy memory πŸ™‚

    I am happy for you that your surgery went well, are feeling pretty good, and that it is looking good for positive results.
    Debbie Woodruff recently posted..Food for Fitness Friday: Vegan Recipe & a Fast and Furious WorkoutMy Profile

  9. VL4 says

    Pat hope you get great results. I got mine at my post op appointment and needless to say I had a very anxious week. Keep those positive thoughts going.

    • Pat says

      Just got back from my post-op appointment and they said both papillomas came back benign. Very happy about those results. Now I just have to followup in six months. All is good :). Have to say reading these posts really helped my stress level. Thanks for starting the blog about the procedure Debbie! Btw I also run mostly 5Ks, but was back running three days after the procedure which felt good to be back in my normal routine.

  10. Regina says

    I had an excision biopsy to remove a papailloma 11/20/13. It was benign with clear margins. I still have quite a bit of swelling and pain. The papilloma was deep on the underside of the left breast. I am having problems finding a properly supportive bra and basically only have no pain if I “hold” my breast when I walk. Which obviously isn’t appropriate for public! Also I still tire very quickly. I am starting to worry that I am not recovering as I should be. I do not have a fever or any redness at the incision site.

  11. Josephine says

    I had an excision biopsy for removal of a papilloma the end of Oct 2013. After one week I got the path report, it really surprised me – no papilloma was found in the specimen. The surgeon asked me to wait 2 months for ultrasound. I did it today, the papilloma is still there. I can’t believe I have to go through the whole procedure again. The surgeon mentioned properly the wire loose before the surgery.

  12. Josephine says

    Thank you Debbie. I still think positive and thank you for sharing your experience. Could I update you for the progress?

  13. says

    Just had this surgery done on 2/19/2014, and I must say I read your blog beforehand. It helped me to get a better understanding of what I would have to endure leading up to and after surgery. Thank you for sharing your story with us.

  14. says

    Just had this surgery done on 2/19/2014, and I read your blog before hand. It really helped me to be aware of what to expect before, and after the procedure. Thank you so much for sharing your story with us…

  15. Josephine Chow says

    Hi Debbie,

    Finally, I have it done again on February 17; and just got the pathology report yesterday. They removed the papilloma and everything is fine; what’s a relief!!

    This time I don’t have the mammogram after the wire-localization; because that may be the reason for the loose wire happened in the first surgery.

  16. Sheryl says

    I had an excisional biopsy on 3/13/14. Following the surgery, I felt pretty good with the exception of bruising and tenderness near the incision especially when touched. Now, my breast feels sore and firm, and looks swollen to me. I came across your blog looking for answers as to whether this was normal. It seems your procedure was very similar to mine. Although, to locate the lumps to allow them to insert the wire in the proper place I was given a mammogram, then an ultrasound, then back to the mammogram and then the wire was inserted. The mammograms were the worst part for me. Had I known, I would have asked if it was ok to take Tylenol. I received my results the following day, benign. Thank goodness. My follow-up appt. isn’t until 3/31, so I will be calling my Dr. soon to ask about the firmness. Anyway, your info was very informative. I wish I would have found this prior to my surgery!

    • says

      I am so happy that your results are benign. My breast was pretty swollen and hard for quite a while. It was really bruised from the hematoma too (the bruise really was frightening and it lasted for weeks). I sure it is all a part of the normal healing process, but it’s always a good idea to check with your doctor to be sure. I’m glad my post was helpful, sorry you didn’t find it until afterwards :-).
      Debbie Woodruff recently posted..Be a Better Blogger. Go to Blog School.My Profile

  17. Scarededucator says

    Hello! Thank you for posting….I feel that I have been reading so much on this topic but your posts are really making me feel better. For my situation, they have not found anything that is causing the bloody discharge so that is why they want to conduct a duct excersion. I am scared to death because I have never had any surgeries…..needless to say has anyone on your blog waited to have this done? Also I know my doctor said there is a 15% chance of it being cancer that is why they do the procedure. I don’t know I’m just scared right now!

  18. Terri says

    I’m having surgical consult on monday and have already been told I will need an excisional biopsy. I watched the video of the surgery on you tube….made me squirm…ouch!!!
    I am nervous for the procedure and the recovery, but do feel better after reading your blog and all the posts of other women who have already undergone the procedure. Very relieved to see that everyone had benign results.

  19. Kim says

    Thanks so much for this blog. I’m in the process of having this exact procedure scheduled, and it really puts my mind at ease to have an idea of what’s coming. The result of the core needle biopsy was benign, but they still want to remove the little mass, along with the larger mass at the same time. So incredibly nervous about the pain, because the core needle was pretty painful.

    • Terri says

      I had the needle biopsy and I agree it was quite painful. Mine was also benign showing an intraductal papilloma, but my doctor wanted to remove it along with surrounding tissue. I had that surgery about a month ago under general anesthesia and the post-operative pain wasn’t too bad. Nothing like the needle biopsy. I think I only took pain pills a couple of times mostly so I would sleep well. All the pathology is negative and my incision is healing really well. The only thing remaining is some residual bruising and hardness in the breast tissue at the surgical site which I understand will soften with time. It was all very scary for me, but the outcome has been good. Good Luck!

  20. Tri-girl says

    Hi Debbie,
    This blog was just what I needed today, so thank you for initiating this conversation. I’m especially happy to hear that you’re also a runner. I run regularly through the NJ winters and knowing that you were starting to run in less than a week post- procedure is very reassuring to me. My procedure was just scheduled for 2/6/15. The breast surgeon was fine with postponing it until after a half marathon in AZ in January. The fact that she was so agreeable to delaying it until after my scheduled races were over, told me that she wasn’t overly concerned. If she really thought it was cancerous, I doubt she’d tolerate postponing the procedure for almost 3 months. Happy trails to you!

    • says

      Good luck with your procedure. And your half marathon! Is it Rock & Roll AZ? I have a few blogging friends doing that race.

      How nice to have such a cooperative doctor. As you say, it shows that she is not too concerned.

      I hope you’ll keep me up to date on how it all goes. I never realized when I wrote this post how it would turn out to be so helpful for so many women. It makes me so happy whenever I hear from someone that it has helped.
      Debbie Woodruff recently posted..Vegan Recipe: Indian Lentil Cakes with Cucumber Mint RaitaMy Profile

      • Tri-girl says

        Hi Debbie,

        I’m following up after my excision on February 6th. I met my breast surgeon yesterday to get my results and it was a papilloma, as she thought. The doctor allowed me to postpone the procedure until after the AZ Rock and Roll Half Marathon so I did run with my husband in his first half. He did a great job and I predict many destination races in our future! The down side to postponing this procedure was that I had 3 months to search the internet on diseases of the breast. Too much time on my hands! The worst part of the the whole experience was trying unsuccessfully, to put it in the back of my mind until February. I have some bruising and soreness a week post removal. The doctor recommends 2 compression bras on my first forays out on the road. I’ve already planned a trail race in Kentucky in April and a trail run in the Smoky Mountains in May. Running trails is where I found my peace so I’ll be returning soon. We also did a little running in the desert around Tucson and Bisbee so that was a little bit of Heaven! Thanks again for sharing your experience dealing with a papilloma. It did reassure me!
        Peggy from NJ

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