MRI guided biopsy

“We either make ourselves miserable, or we make ourselves strong. The amount of work is the same.” —   Carlos Castaneda

The MRI-guided biopsy went quite well, actually. The meditation and relaxation techniques I have been practicing worked well to help me get through the experience without too much stress. Not only did I cope much better with the pain of the numbing shots and IV of contrast fluid, but to my surprise, my subjective levels of pain were less! Quite a bit less, actually!

I wore my Frida Kahlo socks, for strength. 

Just as for the MRI two weeks ago, I lay on my belly with my arms over my head. The main difference was that this time the right breast was squished behind a plate to get it out of the way. The left breast, the one that was being biopsied, dropped through a hole in the bed, where it was clamped between plates like for a mammogram. The doctor worked on the breast from the side. Like in this picture, except my face was pointed down, resting on a face cradle.

(image from www.appliedradiology.com)

The MRI technicians did a series of scans, both without contrast and with, so they could hone in on the area to be sampled. This time I asked for earplugs, and the scanning process wasn't bad at all.

I was wheeled out of the machine, and the doctor started prepping me for the biopsy. All this time I had to remain completely still so as not to shift the sample site out of the "crosshairs", so to speak. (Before I was taken to the MRI room, the doctor had told me the MRI scan from two weeks ago had seen a "tiny spot" that they wanted to sample. I was all..."Tiny? Tiny is good! I like tiny!")

This was my third biopsy. The worst part for me, every time, are the numbing shots. I hate shots. This time I had my calming mantra to sing internally to myself with each breath. It worked really well. I swear the shots hurt less than they had before. I winced a couple of times, but after that it was okay.

When the core biopsy needle was inserted, I did feel a little bit of sharp pain as it came to the final position, and asked for more numbing. Before they actually started taking the samples, I was wheeled back into the MRI machine for a final scan, just to make sure they were at the right spot.

The samples were taken very quickly...it was over before I knew it. They inserted a titanium chip that will show up on a mammogram, then wheeled me back into the MRI tube for one final check that the right area had been sampled.

And that was it! The technician kept compression on the incision for 15 minutes, during which time I slowly began moving my arms, which were stiff from being held overhead for an hour or more. The last 10 minutes in the scanner things were getting pretty uncomfortable. My cheeks were sore from being pressed into the face cradle, and my shoulders were started to get pretty sore as well. I was so relieved when they finally told me I could move again!

Now another waiting game. The results should be in by early next week. Nothing to do now but wait, and recover from the biopsy.

MRI results

It took over a week to get the results of the MRI. It turns out the nurse practitioner was on vacation last week. I thought that might be the case, with the Memorial Day weekend, and all.

I finally called her on Wednesday. The MRI found a "suspicious" structure in the left breast (I don't remember the exact term, but it was pretty vague). This area is in a new location that they hadn't seen before. The doctor wants to biopsy the area to determine whether it is cancerous. I am scheduled for an MRI-guided biopsy this coming Wednesday (because clearly the pleasure of a biopsy isn't enough...this way I get to experience the joy of both biopsy and MRI!).

No, really, I'm glad it is being biopsied. Best to be sure. I only wish the MRI had been ordered earlier in the process, before I got the earlier biopsies. My breast tissue is so dense that mammograms can have difficulty seeing through it.


Now that I know what to expect from the biopsy experience, I don't think it will be as difficult for me as the previous ones were. This means another round of waiting for test results, though. The waiting is the hardest part of this. Is it cancer? If so, will it be as easy to treat as the other malignancy? Or will they say the dreaded word: "chemotherapy"?

MRIs are LOUD

Well, I made it through this MRI!

All my prep paid off. I wasn't laughing through the insertion of the IV, but I wasn't whimpering and tense, either. Also, I should remember that insertion of an IV catheter doesn't hurt as much as a shot does. I think that's because injection doesn't happen at the same time the needle is inserted. By the time I got the injection, I was safely in the MRI tube, where no one could hear me whimper.

I brought my Nook with me for some reading material in case I had to wait, but as it turned out I didn't wait in the outside waiting room at all. Instead, I waited in the MRI area, where electronic devices were prohibited. I guess the strong magnetism can wipe out the memory, which would suck.  The next time I have one of those, I should bring some actual paper reading material. As it was I had to make due with People (Ashley Judd is getting a divorce!) and Architectural Digest (pretty!).

I have had two MRIs before, one previous breast MRI and one for low back pain. Each time I was offered a choice of either music over headphones or earplugs, and I chose the earplugs both times. This time they had Pandora (as opposed to a commercial radio station), so I decided to try it.

Mistake!

I knew the machine was loud, but without the earplugs it was REALLY loud, especially in the upper registers. Klaxon is the word I would use to describe it. I got through about three of the half dozen scans they were taking before I pushed the panic button and stopped the machine so I could ask for earplugs. I was starting to fear I was going to have hearing damage (I already have some hearing loss in the upper registers. I don't need more).

It's a good thing I didn't wait any longer. When the technician pulled me out of the machine she said she had been just about to inject me with the contrast fluid. If I had stopped after she injected me, I would have had to reschedule and go through the whole scan again. I would have been royally pissed!

Life was much better once I had earplugs.  I was able to relax and meditate. I did two types of meditation. One was The Microcosmic Orbit, which is a method of concentrating on circulating energy around the body. The other was to silently repeat my calming mantra with each breath. It was really interesting that when I performed either of these meditations I was able to relax, but as soon as I stopped the concentration, I became agitated and anxious to be done. This is the power of meditation. It calms the nervous system, making difficult situations easier.

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That was Tuesday. It's Saturday now, and I haven't heard anything about the results of the MRI or gotten a call for another consultation. They didn't tell me how long it would be for the results, but I assumed I would hear something by the end of the week, at least. Monday is a holiday. If I don't get a phone call Tuesday morning I'll call after lunch and ask when I can expect the results. I still don't have a date for the surgery. I'd like to have that so I can plan when I need to take off work.

Upcoming MRI

The next step is an MRI coming up in two days, on Tuesday. My breast tissue is so dense that the doctor wants to do an MRI so that she can better see how large the area of cancer is in the right breast. The MRI should also provide more information about what's going on in the left breast, as well. The biopsy of the left breast showed atypical cells, which aren't currently cancerous. The mammogram and ultrasound showed the presence of a mass, but it really is pretty difficult to differentiate it from the surrounding tissue.

Not only does dense breast tissue make it more difficult to see cancer, but studies have shown that having extremely dense breast tissue (which I have) increases a woman's risk of getting breast cancer. Numbers I have read have indicated between 2 to 6 times the risk of breast cancer over a woman without dense breast tissue. Yikes! No wonder I have breast cancer!

I have had a breast MRI before. That time I had an IV containing a liquid that helped show contrast in the imaging. I have a fear of needles, so for the past couple of days I have been doing visualizations and practicing relaxation techniques to help me be calmer when the IV needle is inserted. I'll be armed with a breathing technique, a calming mantra to chant in my head, and a visualization of the fear floating away from me.

My favorite, though, is simply talking to the fear. I thank the fear for keeping me safe from harm (and hard drugs), that this needle is important, and safe, so I don't need to be afraid of needles right now.

I hope this all works. I'll need these relaxation techniques again for the surgery.

The MRI machine itself shouldn't be an issue. It is loud, and I'll be in a closed in space, but they will let me listen to Pandora over headphones. I'll just listen to the Yoga Radio station and meditate. Shouldn't be bad at all.

One step at a time. That's how I'm doing this.