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Biopsy marker migration and pain...4 years post biopsy?

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Valarina61
Valarina61 Member Posts: 2

Hi,

I guess I should start with a little history. I am 49. I had both breasts lifted and augmented (saline) in 1994. I had a TAH in 2000. Generally healthy but suffer from GIRD (have had several esophageal dialations) and the occasional hernia. Over the years my breast implants had encapsulated to the point where it was painful just to hug people. I decided to have them replaced... so 5 years ago they were replaced with silicone submuscular. They are small and are placed high so that most of my natural tissue falls below. Very happy with them. I have had annual mammograms for about 10 years. Four years ago there was micro calicfications found in my right breast so sent for a biopsy. They did a repeat mammo at that time and found 3 more areas so I had 2 biopsies on each breasts. At each site they placed a clip. Everything was benign and have had no problems since.

Six weeks ago I woke up with a searing pain in my right breast (outer lower quadrant). It came and went for the next week or so. I made an appointment with my N.P. She did a breast exam and said she felt a lump at 7 o'clock (same breast). I could not feel it. Sent for a mammogram at the end of that week. There, they did an exam prior to mammo. Examiner didn't feel that lump but felt 2 small hard areas just off of my areola (same breast). Had mammo... then they did an u/s. Didn't speak to radiologist but was told everything was fine and to follow up with doctor. Called N.P. for an appt. because still having pain and now breast in that area has become larger. She prescribed 10 days of antibiotics and would schedule an MRI. Waited 8 days and didn't hear anything. I did another BSE and found a hard pea sized (but elongated) lump between the 2 spots nurse had felt at time of mammo. Reported this to N.P.'s office when I called about MRI. Insurance refused to pay for MRI so asked did they want me to have biopsy with this new lump or what? They would call back... but didn't. So I called and made an appt with N.P. My appt was Wednesday. N.P. didn't realise that I had silicone so that is good cause insurance will pay for MRI since that's the case. N.P. did exam found the same lump I did and noticed my breast is getting even bigger. After exam I asked her if it was possible for a biopsy marker to migrate. Her response left me reeling!!! Yes, it is. One of yours has moved didn't anyone tell you? ARE YOU SERIOUS? Why wasn't I told and isn't it possible that this is what the problem is? "Mmmmm... I don't think so. I don't know anyone who has experienced pain from a biopsy clip." She went to get my mammo and u/s report but of course they weren't in my file. When they find them they will fax them to me. Now I am waiting for MRI appt. Has anyone else had this problem? I haven't found much info on line. I would appreciate any feedback.

Sorry this is so long but wanted to give as much information up front as I could. 

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  • leaf
    leaf Member Posts: 1,821
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    Yes, markers can move.  This woman had a 4cm movement in 10 months.  Since this is a case report, that would make me think that this is a large movement. http://www.ncbi.nlm.nih.gov/pubmed/11687696  It looks like a more common movement is about 4mm over several months. http://www.ncbi.nlm.nih.gov/pubmed/19137493

    That doesn't mean that's what your breast lumps and/or pain are due to breast clips.

    Breast pain is quite common.  They often can't find a cause. http://www.mayoclinic.com/health/breast-pain/DS00760

    This one woman appeared to have an allergic reaction to her titanium clip, but she had an extensive history of allergies, and had atorpic dermatitis shortly after breast clip placement. http://www.ncbi.nlm.nih.gov/pubmed/11180773

    So while it is possible your pain is due to the breast clip,  I find no Pubmed references to any association between breast clips and breast pain.  

    Of course, your breast pain is distressing.  It must really affect your quality of life.  But I wouldn't jump to the assumption that your breast clip is definitely causing the pain.  

  • Valarina61
    Valarina61 Member Posts: 2
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    Leaf,

    Thank you for the reply. I too read the same "articles" that you posted. To be honest my first thought when the burning pain started was it felt similar to when I had my biopsies done. (My right breast never completely got numb). But when I researched it I couldn't find much. So I put that thought aside. I then researched other causes of breast pain and really found nothing that fit.I am just at my witts end from the worry and uncertainty. This pain is new and only in that area. However, the lump I have found doesn't hurt just the tissue around it. I haven't felt any enlarged lymph nodes but have had pain on and off on that side under my arm, in my elbow and around my collar bone. My gut tells me that it is something to do with one of the markers but I could very well be wrong because I don't yet know where it has moved to. I guess my jumping to conclusions is wishful thinking that that is all it is and then it could just be removed. Again, thank you for taking the time to research and respond.

  • leaf
    leaf Member Posts: 1,821
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    I sure hope your breast pain resolves very soon, and all your lumps are Boringly Benign.

  • nanasusie4
    nanasusie4 Member Posts: 1
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    Hi, I also had biopsies done in both breast 1 year ago. They did not find cancer. Thank God. I had to go in a few times  for check ups. I have had pain in the right breast now for awhile Right around the sight. I often wondered if it wasn't the marker. I go tomorrow to have another mamo and going to ask what they think. If i get a good answer ,will let you know. The pain is burning and sometimes sharp quick pain. Very scary to me.TTYL.

    Sue

  • brogers2000
    brogers2000 Member Posts: 1
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    Hello,


    I just had a biopsy on my left breast for micro calcification they found after all the mammogram's I had, etc. It was 10/16/13 and now today I have a pain in my left breast as you explain. I had a biopsy marker put in but they told me right after when they do the mammogram to check on the marker that it had moved and it is not in the place it should have been. I barely started having the pain when I had my menstrual cycle on 11/6. So I called the nurse from the breast care where I had my surgery and she said for me to call my doctor after my period is over if I still had the pain because it could be an infection inside. So of course now I am on my 2nd day of antibiotics and the pain hasn't subsided at all. I have a feeling it is the biopsy maker too. What can be done about that? Anyone find out if this does cause infection inside just wandering around? Not feeling very happy. The biopsy itself didn't feel as painful as what I feel now. :(

  • django
    django Member Posts: 1
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    Wow, oh, wow.  I'm so relieved to hear of others who are suffering from the same problems.  I had a mass removed from the upper quadrant of my left breast approximately four years ago, followed up, of course, with a good ole' titanium clip.  

    Fast forward to now, my left breast is much different and larger than the right, and the pain to the left outer quadrant is so severe at times I just sit and cry.  I cannot lay on that side and I have trouble moving that arm around.  My little boy sat next to me one day, leaned his head on me and I almost went through the roof because of the shooting pain.  I do feel a slight "sumpin-sumpin," but in all honesty, just because the pain is such a searing, stabbing type, I can't help but wonder if it's the clip.  Maybe it was bored where it was and decided to go sightseeing.  

    Of course, this little tidbit of "oh yeah, the clip MIGHT migrate" was never mentioned at the time.  Yay!.  

    Brogers, I feel for you.   I do think there are a lot of us in the same boat here.  

  • P_CZ
    P_CZ Member Posts: 1
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    Well....it's clear from all my searching on the interwebs that these titanium clips do indeed migrate.  That's what I think is happening in my left breast.

    I had a biopsy a month ago...and was having the usual nominal pain of recovery.  Then, the searing pain/burning sensations started.  Intermittent, and thankfully, fairly short in duration.  Now, as of a week ago, I have a tiny oblong lump under the healed incision point.  Scar tissue?  Migrated clip??

    I went to the breast center again today where two nurses looked at it, and they agreed that it might've migrated up the biopsy tunnel to my skin over the last couple weeks.  (It was properly placed in the beginning, as shown on mammography.)

    I go back tomorrow to have another mammogram to see where it is (where's Waldo??)...and I expect to see it is now located under my skin.  If it has migrated, I believe I can safely assume the pain was due to the movement of that little sharp-ish piece of metal.  And if it is right under the skin, where the doc would only have to nick the skin under a local anesthetic (same as in the biopsy) to remove it, I'm going to ask that it be removed.  I hope that's possible, as I don't intend to go around with this thing under my skin forever...lol.

    Pam

  • kathy744
    kathy744 Member Posts: 1
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    I just had an ultrasound guided core needle biopsy 5 days ago, the pain was unbelievable. The radiologist said he couldn't numb anymore because then he couldn't see the nodule. He inserted a titanium marker. The first couple of days after I couldn't feel the marker, all of a sudden if I move the wrong way or sit too fast it feels like it is cutting through me. I jogged up the stairs yesterday to answer my phone and the pain was very bad and then I get a feeling of electrical shocks to my nipple. The biopsy came back as low grade cancer so the nodule will be removed and they better remove the marker at the same time. I am now scheduled for a stereotactic biopsy for calcifications in a different area of the same breast, I am going to tell them not to put a marker in. If it is cancerous the whole thing will be removed anyway. I believe my marker is moving already.

  • leaf
    leaf Member Posts: 1,821
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    I have no doubt you had intense pain during your biopsy. When I had brackets placed before my excision, I had pain of at least 9/10, although this is quite uncommon per a survey I did here. No one should have to go through that kind of pain.

    I think it is much more likely that you are having pain from your biopsy than pain from your breast marker. Obviously, they use a needle that cuts breast tissue when you have a biopsy. It is common to have pain at the site of most surgeries. It is common to have 'electrical shocks' after a breast biopsy/surgery. I had a marker inserted after my core biopsy, and the marker was removed at my excision. I certainly had plenty of 'electrical' sensations after my excision, and there was no marker present. Most people think its because nerves in the breast can be cut when you have a biopsy or excision. The 'electrical' sensations gradually decreased over time (several months-years) for me.

    If a breast marker can help prevent putting in a bracket (like a pin so the surgeon can locate the 'area of concern'), personally, I'd rather have a breast marker put in. Before my excision, I had 2 brackets (pins) inserted. This was more painful than my previous core biopsy (partly I'm sure because of the attitude of the radiologist). You may want to talk with your radiologist whether they'd need to put brackets in if they end up needing to excise this area.

    Every person is different, so your situation, choices and preferences may be different than mine. I just want you to have less pain.

  • Indianscout
    Indianscout Member Posts: 1
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    I am on here on behalf of my wife.She had a biopsy done a year ago on her right breast.Ever since then she has had pain on that side of her body,breast, shoulder and neck area .She has been to many doctors and they cannot find the reason behind the pain. My wife thinks she may be allergic to the titanium clip that they put in her breast but all the doctors say it cannot be that. They say it's like a million in one chance that she is allergic to the clip.Of course the doctor who did the biopsy took offense to my wife thinks that possibly she is allergic to the clip.My question is has anyone had the clip removed and if so who was the doctor they used for this procedure??Any help would be greatly appreciated.

  • moderators
    moderators Posts: 7,940
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    Dear indianscout, We are sorry for what brought you here but glad that you reached out. There are several topics on the issue of titanium allergy on the boards. This particular thread has not seen recent activity. You can use the search function on the blue tool bar and type in the words "titanium allergy" and see other threads and other posters and perhaps reach out to some. Be sure to use the quotes to get the best responses. The Mods

  • djmammo
    djmammo Member Posts: 1,003
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    Indianscout

    I have removed biopsy markers as an outpatient using the stereotactic biopsy device targeting the metallic marker as it it were a small group of calcifications. Not sure if insurance will pay for it but you can ask.

    That being said I have never seen anyone react to or have symptoms related to the biopsy markers from the many hundreds I have placed. They are sterile and inert. They incite no inflammatory response. Even if it did, symptoms would be limited to the breast itself and not the body/shoulder/neck. Don't let the possibility of a titanium allergy keep you from working up her symptoms which may be caused by something else. Also some markers are surgical stainless steel, they are not all titanium.

  • Elaineg001
    Elaineg001 Member Posts: 1
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    Dear Indianscout, I have exactly the same problem, had a core needle biopsy 6 months ago with Titanium Clip inserted and I have been in constant pain ever since. No Doctors believe me, that it can be the clip, but I believe it is, and like your wife I have seen many Drs. I also have pain in right side of my body, shoulder neck etc and Drs cant tell me whats causing it. Feel like my life is on hold. I have pleaded with Drs to remove the clip but they have refused. I hope your wife has had some better news.

    All the best

  • pklimitchek
    pklimitchek Member Posts: 1
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    I have been having issues since my biopsy. I have been to my doctor numerous times with breast pain and swelling in my armpit. I was told to quit caffeine, that does not help. I have had a mammogram and an ultra sound within the last two weeks, all is good, but still have the swelling and the pain. I was told that it could not be the marker it is still in place. Funny thing is I never had this problem until I had the biopsy. I am waiting for and appointment to see a breast specialist. Hopefully, that will resolve my issues or maybe head me in the right direction. I am tired or feeling miserable.

  • moderators
    moderators Posts: 7,940
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    Hi pklimitchek,

    We're so very sorry to hear of your troubles, but we are sending good thoughts your way and hope for a resolution soon! Please keep us posted with what your breast specialist says, and if/when you find relief!

    --The Mods

  • Kellyh1234
    Kellyh1234 Member Posts: 1
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    I had a biopsy a year and half ago. I've had pain and swelling in my arm pit off and on. I could feel my clip moving. It was confirmed via mammogram/MRI but it "didn'tmove far" (but close to my skin). Yesterday i realized I have a nice sized hard lump. I'm sure it is scar tissue since the clip is in that area and I can feel it move. Well it did move. My body scars super easily.

    I also have had unexplained pain in my right side. Sometimes tingling and loss of strength in my right arm too. I assumed it was from my scoliosis. My chiropractor said it was muscular and it seems to stem from my armpit/shoulder area. Now I wonder if then clip/scar tissue is pressing on something it shouldn't.

    Also, I disagree about not having allergic reactions to biopsy clips. I went to Advanced Radiology in MD and they were completely unaware that only 2 of the 6? Bard biopsy clips were actually titanium. They actually used a nickel based one - wing shape - even though I emphasized nickel sensitivity - for one location but luckily it was removed within a month (excisional biopsy papilloma). The biopsy pathology report said the tissue around it was inflamed. The other one they used was also not titanium but an alloy mix that supposedly contains less than 1% nickel. Biodur 108

    Bard specifically advertised in Sept/Oct 2017 that it made multiple shapes in multiple metal types. Wing is InConel625, which is a nickel based alloy. Search bard ultraclip and scroll to the bottom where they list the material used for the clip.

    Your biopsy reports should tell you what shape marker was used.

  • aodoms
    aodoms Member Posts: 2
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    Hi! I had the clip inserted in my left breast 2 years ago and within the last 18 months I have had extreme pain on my left side, breast, arm, neck and upper back.  I have a tingle in my arm and sometimes numbness.  I swear I can feel the clip moving but the doctors keep telling me the pain is not coming from clip and its rare the clip moves. My breast burns and aches and sometimes I have to adjust my arm to relieve pain in my breast and pain in my under arm area.  Not only is pain bothering me physically. mentally also bc the first thing doctors say is n ot its not the clip.  I am wondering if I should have agreed to clip.  The pain is almost unbearable.

  • aodoms
    aodoms Member Posts: 2
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    Same here.  The doctors just seem to blow me off.  Each doctor , and I have been to 4, tells me NO ITS NOT THE CLIP.  I can actually feel clip moving.  The pain in my breast, neck, arm, and back is almost unbearable. My breast, armpit and arm also burns. I get massage after massage but nothing eases the pain.

  • alicebastable
    alicebastable Member Posts: 1,940
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    When I had my biopsy last June, I told the radiologist performing it that there has been a question in the past about me being allergic to some metals, but I'd never been tested. She did the biopsy without placing a clip. In fact, since the biopsy kit included the marker, she decided to take it apart so the ultrasound tech, the nurse and I could all see what it looked like. Tiny!

  • djmammo
    djmammo Member Posts: 1,003
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    aodoms

    You can ask to have the clip removed. Some radiologists will remove them using the stereotactic biopsy device. It can also be surgically removed.

    If you have it removed let us know if the pain goes away. If it does not go away see a neurologist regarding the pain that remains.

  • Kim52
    Kim52 Member Posts: 1
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    I now know I’m not going crazy. I had lumpectomy with two clips placed 5 months ago for DCIS.  I had 21 radiation treatments  approximately four weeks after radiation I started with some swelling under the arm. Then pain in my breast, neck, arm and back. I have intermittent pinching, stabbing pain also under the arm.   I also believe it’s the clips.  I can’t imagine how you’ve been dealing with this for four years.  It’s so draining both physically and mentally. What should I do?!

  • djmammo
    djmammo Member Posts: 1,003
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    Kim52

    Were the clips placed before or after the lumpectomy? If they were placed at the biopsy, and you had a subsequent lumpectomy, they were probably removed.

  • tdinallo
    tdinallo Member Posts: 4
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    I had a biopsy done in 2013, and did not have a lumpectomy. Since then, I know the biopsy marker I had - which was placed in a completely different location from the breast, has since travelled upward very close to my nipple. It is slowly become more inflamed and formed a lump with redness and swelling very close to the surface of the skin.The pain seems to be more 'burning' like, and sometimes wakes me at night. I know for certain its the clip. Before the lump developed, I was able to feel the "ribbon" shaped marker clip just under my skin, and as the years have gone by, I clearly see how my body is rejecting it. I also was researching that it is very common for markers to travel, and when they do, they can tear or break capillaries, which can cause internal bleeding to develop, thus forming a sac of blood filled fluid, otherwise known as a hematoma. Hemoatoma's can resemble the look and feel of a tumor, but obviously not malignant. My struggle is - going to a Doctor to have the clip removed, which is now surrounded by swollen tissue. I also struggle with Doctors and finding one who is reputable with genuine honesty and not quick to negate patient input.

  • djmammo
    djmammo Member Posts: 1,003
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    tdinallo

    Have you had any imaging recently? An ultrasound would show a hematoma or abscess if one has formed around the marker.

    Here is a photo of the ribbon and other markers in comparison to a penny. I am impressed that you can feel that.

    image

  • tdinallo
    tdinallo Member Posts: 4
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    I was able to fill it - absolutely - as it was very close to the surface of the skin - and yes - about that size as your image describes. I regret I ever allowed them to place it in me!

  • djmammo
    djmammo Member Posts: 1,003
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    tdinallo

    If its right under the skin and palpable it should be very easy to remove even without imaging.

  • tdinallo
    tdinallo Member Posts: 4
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    Even if the tissue around it is swollen and inflamed?

  • tdinallo
    tdinallo Member Posts: 4
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    Are you familiar with hematoma's? (I'm sure you are) I have been reading much about them and for what I am dealing with, its a likely possibility.

  • djmammo
    djmammo Member Posts: 1,003
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    tdinallo

    If its swollen and inflamed then it might be infected and should probably come out. Hematoma's form at the site of the biopsy and they do not migrate with the marker.

  • Lupe769
    Lupe769 Member Posts: 1
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    I recently had a double biopsy. It was painful and I felt the sharp pain most of the comments are talking about.

    What is it with this MARKERS?

    Why are doctors pushing for patients to have them inserted in our breast? Is it job security at our expense?

    The doctor who did the biopsy made a mistake and lost one of the markers. Of course I panic. She stated that it probably came out with the needle. Well she had to go back and inserted a second Marker.

    A day later I felt sharp pains around my nipple. I am sitting here with two hard lumps that I did not have before the biopsies and frustrated.

    They are big and swollen after two weeks of medication.

    Now they are also turning pink. YES infection....

    I don't want to see another incompetent doctor.

    I cancel my appointment and file a two page complaint.

    I as well as others believe it is the markers.

    Had a few surgeries in my life. Open surgeries and nothing feels like this.