May 21 2014

About that biopsy…


When we last saw Our Intrepid Heroine, her surgery was cancelled when MRI images taken just before the needle localization procedure showed up some new, ambiguous areas in the same breast.  An attempt to biopsy the new areas then and there was foiled when OIH “vagalled out” (as the nurses later referred to the vasovagal reaction).   This due to the bizzare, uncomfortable, physically squeezed and painful nature of the set-up.

The biopsy was set for another day, when they would drug Our Intrepid Etc. into blissful indifference, in the hopes that she just wouldn’t mind or notice or be bothered by all of that.  But — oops.  Nope, vasovagal comes to visit again.  No biopsy that day either.

So now…

They decided to do a biopsy NOT in that horrible squashed position in the MRI, but just using ultrasound.  Lying on my back, instead of my stomach.  And able to move any part of my body I liked except, you know, the thing they were going to jab.

They planned on doping me up again (having apparently put me into the category of people who react badly to medical procedures), but figured I’d be fine, since I had a biopsy before under exactly those circumstances, when I was first diagnosed back in December.  I had NO problem then.  So at my request, we skipped the intravenous meds.   (The med nurse did put an IV line with saline, just to have a line in place, just in case I turned out to be wrong.)  And that’s how we proceeded.

And the ultrasound tech plied her ultrasound wand, and…

Slight problem: They couldn’t locate the new areas in question.

There was nothing there.   Nothing showed up at that location, on the ultrasound.

This was always a possibility, as MRI’s are much more sensitive than ultrasound.  Sometimes too sensitive.  Sometimes causing the radiologist to flag as odd something that’s hardly there at all.

But now the biopsy doc had a quandry: what do we biopsy?

She put in a call to my surgeon, while I chatted with the ultrasound tech and the meds nurse.

The biopsy doc came back after a bit, saying that my surgeon suggested that we biopsy what remained of the original tumor — and also put in new clip at that location.   (The clip is a little metal marker that shows up nicely on x-rays, which helps identify a tumor’s location clearly; I had already had one put in during the first biopsy back in December.)  The difference in the location of the first clip and the new clip would supply some information on the size of what would be removed.

And that’s what we did.  And I handled it fine.  Piece of cake.  No problems.

Of course, with that done,  I now had no idea what the game plan would be…  I had an appointment with the surgeon for Wednesday (today), by which time my surgeon would have the results of the biopsy.

And until that time, Sabine and I were just in limbo.  What was happening?  We didn’t know.  What were we going to be doing?  No idea.  Whole constellations of possibilities arranged themselves for our perusal, and many scenarios were played out in our heads.

And today, when the surgeon walked into the exam room, he had this in his hand:


Yes, that's what it says.

Yes, that’s what it says.


The critical phrase here, in case you missed it is:

“No evidence of malignancy.”

This is the original tumor being biopsied.

Or, what they believe is the original tumor.   Since the chemo first shrunk it down to a third of its initial size, and then went on shrinking it down until they could no longer refer to it as a “mass” and then called just it an “area of enhancement” with a “small focus of nodular enhancement”.  Which was about 3×3 millimeters.  Which was all that was left of the tumor.  And that bit is what we biopsied.   Which now has no evidence of malignancy.


Well, yeah… we did it.  We carpet-bombed that sucker to Kingdom Come.

I can’t actually say I have no cancer, because there might be  — I don’t know, say, three cancer cells just to the left of what that biopsy needle grabbed.   But you know, really, effectively, in essence — we won.

I’m pretty stunned.  So is Sabine.

We got some champagne.  Drank the whole bottle.


The good stuff.

The good stuff.

What next?

Well, we still need to do the surgery; a lumpectomy to get rid of the debris, so to speak.  That will happen the first week in June.  And we’ll test what gets excised, to see if there was any cancer at all left in there.

And then radiation therapy, because that should knock out any bits that might be floating around in my system.

Of course, surgery’s no fun, and radiation’s no fun.   But I’m perfectly happy to go through it all.

Because, this is all clean-up.  Basically, we won.

I want some more champagne!