Lumpectomy Lounge....let's talk!
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Hi, diagnosed with Ductal Carcinoma In Situ (DCIS). Had my biopsy and breast mammogram. Getting ready for surgery; meeting with Doctor on Monday to discuss the plan. I have heard that immediately before surgery, there are 4 shots that are given to the nipple area that send some type of dye into the breast. I am not sure what this is or what it is for. I was told that you cannot be put to sleep, you must be awake for these injections and they are extremely painful. Does anyone know what this might be and is it given to everyone prior to surgery? I am terrified enough right now just hearing that I have cancer and I have to have surgery, etc. Appreciate anyone that experienced this or know of this. Thank you!
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Liz1985, that’s strange... I was under anesthesia when they injected the dye. Did you ask them why they said you have to be awake for it?
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Liz1985, welcome to the best place you don't want to be. Take a deep breath. I also was worried about the shots. I had numbing shots for the wire locator placement and that went okay. I'd heard that the shot for the dye (to locate your lymph nodes) was painful but my surgeon (not a nurse, the SURGEON), gave me a shot of lidocaine first and I never felt the dye shot.
You might benefit from reading Dr Susan Love's Breast Book. It is loaded with information. And when we start out on this unwanted journey we usually know nothing and that makes it hard to ask the questions we need answers to - we don't know what to ask. That book will help. And of course ask here.
One thing you might want to consider is to have the least amount of surgery possible. Don't rush in and assume that a mastectomy is the only way to go. It isn't. And once your breast is gone, nothing can replace it.
We'd love to know where you are located, all the information you have on your diagnosis. Go to your profile and fill everything in that you know and then click the tab in the upper right SETTINGS and make each and every item public! Then we'll remember all about you
Good luck. Keep asking questions!
HUGS!
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Hi Liz1985,
Is it the day before? For me I went in the day before my lumpectomy when they were also going to take out 1-3 lymph nodes. The dye is used to see which lymph nodes first drain the area of the tumor. It is blue and radioactive and helps the surgeon locate the lymph nodes. Then they remove the most reactive to do pathology on to check for cancer cells. They also used a needle to inject numbing medication immediately before the surgery but I was happily in lala land from the anestiethic drugs and don't remember a thing.
If it is the dye the day before I am happy to report that I barely felt a thing from the injection. If you are unsure of why they are having you do something definitely make them explain it all clearly to you. I was just diagnosed in September and I totally understand how stressed you are right now. I am very sorry you are going through this. Take care!!
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I didn't have the dye or wire placement. Instead, I was injected with a radioactive seed into the tumor site (felt only the local, which was barely a pinprick); and then with a nuclear isotope tracer to highlight the sentinel nodes. That was quite painful (into the nipple & areola) but only for a few seconds; mixed with lidocaine, it was faster and hurt a bit less than cortisone shots I've gotten into my knees and fingers before & since. I did have to lie there and massage my armpit for 15 minutes to get the tracer flowing, but they had a nice Americana mixtape to keep me occupied while I did so. My friend who had DCIS (and opted for BMX) was given a strong topical anesthetic cream called "Emla," applied to the nipple & areola half an hour before the shots, and she said she didn't feel the needle at all. Maybe you can message your surgeon's office ahead of time and request some.
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Pontiac Pegg, thank you so much for replying. I don't have a pathology report yet. Just have the results they provided via phone. Ductal Carcinoma DCIS In Situ. The nurse navigator advised that everything would be covered during our meeting on Monday with the breast surgeon and her. Thank you for advising where to load this info; I will do that and continue once I get more information. Right now I am so terrified of these shots near the nipple that are suppose to be excruciating. Based on your message it sounds like these shots are to locate the lymph nodes. Am I to assume the dye leads them to the lymph nodes? Cant they see the lymph nodes when they go in to remove the cancer? I will ask these questions on Monday of the Dr. Do they do this for all patients having breast surgery? I will most definitely ask the surgeon to give me a lidocaine shot prior to anything, but do they have to do it in the nipple area? Or why can't they just put you to sleep and then do the shots with the dye? I am so stressing right now with all the waiting and my anxiety is high. Thank you all for being on this site and talking to everyone that is going through this tough time
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Liz, it appears that the dye is done at different times by different surgeons. They really can't "see" the lymph nodes. My surgeon thought she was removing 3 and found that 2 others came along for the ride. And they need to know which ones are closest to the cancer. As Sandy mentioned, different methods are used.
I found the surgery was quite doable and the only pain pill I took was in the recovery room. Then I used Tylenol. I also took it easy. I had my sons in to help out since I was caring for my disabled husband that required a lot of lifting which I wasn't allowed to do. It IS major surgery so take the time you need to recuperate and don't push. Listen to your body!
The surgeon and surgical staff should be concerned with your comfort at every stage. Mine were. I even walked to the operating room (which was very empowering). Where are you located?
HUGS!
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Thank you! I will be sure to discuss this with my doctor on Monday. Im based out of Chicago suburbs. Just wish this was over with already! Thank you for being a friend! I can do this!
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Lymph nodes are tiny and contrast poorly with the surrounding tissue. Lymph vessels that feed them are also parallel to capillaries. It is important to be able to visualize them, either by staining them blue or having them "light up" via radiograph &/or Geiger counter or all three, so the surgeon knows which of them to biopsy while you're under anesthesia. The first nodes in the chain that take up the dye &/or the tracer are the "sentinels," which would be the first place tumor cells would spread if they do spread. Without these aids in identifying them, the surgeon would have to remove an entire layer of lymph nodes for biopsy, an axillary node dissection--which is what they used to do before sentinel node biopsy was developed. The more nodes removed (especially unnecessarily), the more risks of lymphatic system problems down the line. Sometimes some non-sentinels are "stuck" to the sentinels like clusters of grapes and cannot be left in place, so that's why they get removed--but far fewer than in a dissection. (I had 2 sentinels, each having one "hitchhiker," removed).
Why can't they just wait till you're asleep? It takes a while for the blue dye and the isotope tracer to reach the sentinel nodes (hence that armpit self-massage to speed things up), and if they were to wait till you were "under" to perform both shots you would be under general anesthesia for an inadvisably longer time--not just tying up the surgeon, staff & OR but also increasing risk (and expense) to you. And yes, it has to be into the nipple area, because that's where the lymph vessels start, fanning out to nodes in your armpits (the target area), chest & collarbone. It's not that bad. With the Emla cream having taken effect, it's possible you wouldn't even feel the lidocaine.
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Liz, you really want to connect with ChiSandy as she is in Chicago and is very informed. You won't go wrong. And she's a great person on top of it all! Brains and beauty in one package.
HUGS!
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Liz, where in the 'burbs? I had my surgery at NorthShore Evanston Hospital, and my friend, who lives SW of Joliet, had hers in Oak Lawn at Advocate Christ (where my husband is a cardiologist). Both hospital systems have topnotch breast cancer surgeons & oncologists.
(Peggy, I'm blushing)
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ChiSandy; thank you for that great explanation. Is it only one shot that they give you or is it multiple shots? Can the surgeon give you a lidocaine shot in the breast area much like the one they give for the biopsy to numb the area so the dye shot near the nipple is not felt when given? Are these dye shots given directly into the nipple or the area around the nipple? Also, the EMla cream.....is that used prior to the lidocaine shot? Thank you for helping me understand this better.
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Having mine done at Northwestern Central DuPage Hospital as I live in Carol Stream.
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I want to insure I have this correct. Is the Emla cream given first in the nipple area and how long does that take until it takes effect? How much Emla cream is needed to insure it works? Then the Lidocaine shot is given to numb the nipple area? After that the shot with the dye is given to locate lymph nodes? Do I have that right?
Lastly, is this what you had done and did you feel anything? Was it any worse than the biopsy Lidocaine shot? I just feel that since its near the nipple or in the nipple?.....that sounds horribly painful.
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This is very interesting - I didn't have any of this done. Just the lumpectomy alone. Wondering if I should have?
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Hi; getting ready for a Lumpectomy; saw your note about the nipple shots feeling like bee stings. Stressing out over those nipple shots!!! Can Dr give you something to alleviate the nipple pain prior to the shots? Is it really that painful? Just diagnosed last week and can't sleep.....so overwhelmed with all of this.
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Liz1985, they did my injection in 4 places around my areola the afternoon before my surgery in order to give the radioactive dye time to travel to the sentinel node. (12, 3, 6 and 9 0"clock positions) The injections were with a tiny needle and felt exactly like a lidocaine injection - a little bee-sting type burning for a few seconds, and that was it. It was actually less painful than I thought it was going to be. A lidocaine injection hurts worse.
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Liz1985: I had one radiative injection a few hours before surgery. The shot was uncomfortable but nothing outrageously painful. They did not give me lidocaine beforehand. The blue injections were done during the surgery. Expect to have blue urine for a few days. I wa very nervous about it but it really wasn't that big a deal. And I hate needles
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VL22: I had the same bumps around my incision after I started radiation. I actually saw small amounts of the incisions poking thru. They eve went away as my body obsorbed them.
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Liz, I also had DCIS stage 0 diagnosed in May. Partial mastectomy in June. I knew that I would have the needles with the blue dye and the wire localization ahead of time prior to the surgery- but had no idea how it all worked. I have to say that the cream that I was given as soon as I went into the hospital helped tremendously. There is still a pin prick for each one but it is quick. Wire localization was harder for me but honestly- the fear ahead of time is worse than any of these procedures. I had brachytherapy also and when I had to have the device taken out I was sick with fear all day.....but I was surprised how quick and pain free it was...the fear is really the worst. You will get through it.
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thank you for responding. I am feeling much better about this now. This is all new to me...just diagnosed last week and I feel like I’m in a bad dream. But I can do this because all of you are giving me such great support and it really does help. May God bless you
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barb, thank you for that reassurance. I am so stressing right now but I’m beginning to feel better as more women are relating their experiences. I have a few questions for you..when they put each of the 4 shots around the aerial, are they injecting the dye at same time? Are they that quick? Like seconds for each? And what is the wire insertion thing? Does everyone have that? Meeting with Dr on Monday when the whole plan will be laid out. Just nervous as heck about all of this and just anticipating pain. Thank you for your support and I wish you well as you continue thru your healing. WE CAN DO THIS!!!
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Liz, the four needles seemed pretty quick. I had to lie there for a while and rub breast to get the dye moving. They do a scan to make sure that the dye has moved before they let you go. The wire localization: I was in a mammography room; seated; breast is in the machine pretty squeezed. They are taking film to locate the marker which was placed when the biopsy was done. Doctor (radiologist I believe) inserted needle type thing which places the wire and wire sticks out of breast- then I went to surgery. I have to say I kept eyes closed and tried to go to my happy place. Mammography technicians were very compassionate- holding hand etc. When I started this journey just the thought of anything going into my breast brought fear...now I know that it's not as bad as I had thought. You can absolutely do this! Keep us posted.
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Did you ladies have your breast frozen for the areola needles? The needle pricks didn't hurt me, but whatever was injected hurt like a son of a gun!
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Hi Barb. When they did the wire, did they numb your breast before they inserted wire?
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Liz, yes they numbed my breast before doing the wire locator. Thank heavens. About 7-10 years prior I had one done by a man who had no compassion and no numbing. I swore I'd never have another it was so awful. Of course, I didn't have a choice and it was a vastly better experience this time. It is all doable. Just keep that in mind.
HUGS!
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Liz- I'm pretty sure no numbing....other than what I got with the cream prior to the 4 needles in areola.
Barbara
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Liz, our minds can be our worst enemy. I too was scared and anticipated pain and discomfort. Four shots that lasted about two seconds each for the blue dye. You may pee blue later so don't be surprised. What my mind really was freaking out about was the wire locator because my tumor was up against my chest wall and I am large breasted. My surgeon is a block from the hospital and she said they would put the wire in and tape it down and then I would drive over to the hospital. REALLY?!!! Well the wire is about the size of a strand of hair. The mammogram they use to locate the spot was all I felt. Again my mind had anticipated much worse. Best wishes for an easy time of it like mine.
Jo
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Jo, thank you for responding. Yes, you are so right... my mind is overthinking and it’s causing anxiety and tears and stress. Meeting with Dr is tomorrow to discuss the plan. I am not a big baby...I’m a very strong woman but you would never know it this last week since the diagnosis. How could I let this knock me down? I have to get up and be strong and get healed. I’m so afraid of pain regardless of strength so I worry about these procedures. Thank you everyone for being here to help me thru this. Your response and honesty is extremely supportive and I am keeping all of you in my daily prayers for healing. I’ll let you all know the plan tomorrow after my Dr meeting
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I had numbing prior to the wire insertion, which was done by the same Dr that did biopsy, with breast in mammo machine. Recall initial pain when they started the wire (or maybe it was the dye?) & then numbing increased & kicked in. I was very emotional going into this part, so my recollection is somewhat unclear. The "wires sticking out" description is also what I experienced. Surgery was scheduled for 2 pm, but I was last surgery of the day, so not taken in until almost 4 pm. By that time, where the wires were inserted was hurting and the blue "smurf pee" started in.
Liz - make sure you ask about the wire & dye injections - these were not explained to me very well & calls to the nurse navigator prior to "the day" for information went unanswered, which led to my fragile emotions on "the day". My responses were very similar to yours when confronted with all this - many of us were where you are and you are not alone on this journey. Please continue to ask questions. Best wishes and gentle hugs.
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