Stereotactic (hee, hee, hee)
Wed., June 15, 05:11 PM
I suppose I should put a WARNING on this entry. You might not like it if you’re squeamish. And if you happen to be a gentleman who doesn’t like to talk about “female” issues, go away; I’ll catch you later.
I’ve learned about something new – a less invasive procedure for women with breast anomalies. Better detection and better treatments are a great source of hope.
Many of you know that I had breast cancer last year. Even though I went through the treatments and I’m fine, the doctors like to keep checking for a couple of years. I’ve been seeing my oncologist every few months, and in April I had my first mammogram since January 2004. I’ve graduated to the big leagues now; I have to go to radiologists who are specialists in reading mammos. And they found some “calcifications.”
Radiation therapy – which I underwent for seven weeks – often causes harmless calcifications. But just to be sure, my radiation therapist sent me back to the surgeon. The spots were so small he needed a magnifying glass, far too small to feel, and he was quite sure they were nothing important. (By comparison, the original tumor looked like a light in the middle of the film.) But he wanted a biopsy.
My expression must have shown my concern, because he added quickly, “This one is different. You lie on your stomach.” Huh? Then I realized, “oh, gravity.” “Yes,” he said, “gravity helps.” And his office would arrange an appointment and let me know when.
The procedure is called a stereotactic core needle biopsy. I looked it up on the internet – fascinating. It’s computer-directed. I also asked a friend who had experienced it, and she said, “Compared to what you’ve had, this is nothing.” I had gone for my initial needle biopsy all by myself (that was a little painful), so I figured I could do this one too.
The nurses and technicians are so very nice. The tech went over the whole procedure with me, answered questions, and even showed me a tiny “clip” that is often used to mark the spot. (Because, when they take the biopsy, they have removed the old marker.)
She put me on a table with a big hole in it for the breast to drop through and made sure I was comfortable – partially on my side rather than flat on my stomach – and placed my arms and legs. I was a little disappointed that I wouldn’t be able to see the computer screen, but that was minor. Then she raised the table – like a car on a lift – and proceeded to work from underneath.
She used a plastic clamp to stabilize the breast (we didn’t want it waving in the breeze), always making sure that it wasn’t too tight and that I was okay. Then she took pictures, the digital guides that the doctor would use; when she was satisfied with the pictures, she notified the doctor that I was ready.
As soon as the doctor walked in, I felt completely comfortable; she looked like the Purple Chai! She talked to me constantly during the entire procedure, so that I would know what was going on and wouldn’t be startled. Except for the “bee sting” and slight “burning feeling” that went with the numbing medication, I didn’t feel a thing.
The doctor made a tiny cut so that she could insert the instrument that would do the work. It sounded like an automatic stapler; she warned me about the sound, so I heard it but never felt it. More pictures, to make sure nothing had moved. Then the computer guides the instrument, which cuts a little, turns a few degrees and cuts a little more… Darned thing sounds like a buzz saw, but there was no pain. I heard her clean up a little blood, but there were no problems. “I got the whole thing,” she said, “I’m not even going to bother with a clip.” She put some steri-strips on the cut, and she was done. The tech came over to rub my tightened muscles, and then I sat up.
The doctor made sure I was feeling all right, and then she left me with the tech to finish up. It was all so easy that, if she hadn’t been talking, I probably would have gone to sleep!
The tech applied a pressure bandage and gave me an ice pack. She went over the aftercare with me, let me dress, and even accompanied me out to reception, where she validated my parking ticket. And I was done.
I had no bad effects, no infection, no bruising, no pain. Once the bandage came off, you can’t even see the spot unless you knew where it is. And the doctor’s office called me to say that everything was good.
Of course, they want me back in six months for another mammogram. This goes on forever; I have this wonderful feeling that I’m being cared for. It’s all good.
While we’re on the subject, let me mention that I saw a news item last week about a hand-held device that can detect breast tumors. It may be more precise and sensitive than self-examination, and it signals the patient to see her doctor.
For the woman who tends to "grow things" and isn't sure what she is feeling and whether it's significant, the $50 device will solve a lot of problems. This is an amazing field.
