Core biopsy and titanium marker
Hello!
Please stick with me as I am new to this forum and this post might be lengthy.
I am a 30 year old female who recently underwent a core biopsy for a small lump, called a nodule by my doctor, to confirm if it was a benign fibrodenoma or not. I have been an emotional wreck throughout this whole experience and my anxiety has been at an all time high. I am posting here to find comfort in others who may have gone through the same experience.
Although the core biopsy went okay I am very apprehensive knowing that a small titanium marker has been left inside me to notate this area. My anxiety about this is at an all time high. I of course have "googled" and read many stories where people have had issues with these but I have rarely came across a post where someone has had one of these where there have been no issues. I am so afraid that by leaving this foreign object in my body something bad will come from it. I'm looking for a glimmer or hope to ease my worrying that this will be okay. Is there anybody who can share a positive experience?
Comments
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The marker was left for future reference. Meaning that area has already been investigated.
Think about people who have pace makers or other medical items implanted in their bodies for years. I've been living with a LOT of metal in my neck for 15 years. Yours is the size of a seed. Don't panic
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Hi,
Probably those who did not have a problem with the surgical clip are not online relating their good experience with them. Agree with above, too, in that lots of people have titanium elsewhere. I have had it in my wrist since 2002 and have had no reaction nor issues. It does kind of creep me out now that I have a clip in my breast (three weeks ago), but from what I understand they are very tiny. I don't feel mine nor do I have any irritation. Just had a big colorful bruise, which has faded, and relatively little pain after from the stereotactic vacuum biopsy procedure.
And don't hesitate to voice your concerns to your medical provider(s). You have worries, so they are legitimate, and you deserve to be listened to and appropriately counseled. Good wishes for a B9 report coming to you!
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I have clips for gall bladder surgery in for many years. I had 4 markers in from my breast and lymph node biopsies for 6 months until my BMX removed them. I still have my port in as well and now 2 implants and Alloderm. I have not had an issue with any of them.
I think the majority of people on this forum have some foreign object in their body and are totally fine.
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Those who have had no issues with anything implanted in their body do not have any reason (or place) to go on line to relate a basically 'non-issue story'. There are,some,who choose to dwell in the negative and unfortunately they are the ones who the those looking for negativity choose to latch onto.
Oh by the way, I have a plate and screws in my wrist from fracture repairs 5÷ yrs ago - much bigger than a titanium chip. I still have my port 7 yrs 11 mths after it was implanted - no issues of any kind but of course I make. Sure it is maintained (flushed) regularly. I have a friend who was able to live an active/healthy life for over 30 yrs with a pacemaker (they were maintained/serviced as needed). There are many Veterans walking around with shrapnel in there body. There are many with artificial joints that allow them to live a great life.
And you're complaining about a less than pea size dot that was placed to mark an area that has been investigated for possible future issues?
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Kicks,
I'm am not complaining and am offended at the fact that you think that. I am simply looking for reassurance as I have never been through something like this in my life and am very apprehensive. I am very higstrong person with great anxiety which is very powerful over me at times. Please do not act as if I am being petty, I don't appreciate it. I am simply looking for some reassurance.
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AJ
I have been placing those clips in breasts since they were invented. I have never seen or heard of a problem with them in all the time that I have been placing them. They are sterile and inert. They also serve a very important function in the scheme of things. Here is a page from one of the manufacturers: http://www.bardbiopsy.com/pdf/UltraClip_Dual_Trigger_Patient_Brochure_S11697-0.pdf See the pic where they show them actual size.
If you want it removed, ask for the fibroadenoma to be removed by a surgeon, at least that way your insurance may cover its removal.
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I honestly wouldn't worry about it. I think I have at least one in there, and I worry about pretty much everything, but not my titanium marker, lol.
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I am sorry that you misinterpertated my words. You stated that "I am so afraid that by leaving this foreign object in my body something bad will come from it.". (Your words) . That is what I replied to (as did others) that many live for mega yrs with several/larger implanted
My reply was quite positive. Pointing out that there are so many of us us who do have a foreign object' for varing reasons in our bodies. I am 'offended' that you have chosen to ignore all the positive posts to you.
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i have about 30 titanium clips in my stomach and a nice new pain-free titanium knee. I had a couple of titanium markers in my breasts, but they went away with the BMX. Oh. And the titanium markers didnt cause my breast cancer--two stupid gene mutations did that.
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I have two titanium knees and a right tibia that has more titanium (plates, screws) than bone. Yeah, I set off metal detectors. But so does the underwire in my bra.
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My 'underwire bras' don't have wire any more - just some sort of 'plastic'.
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Kicks,
I have ignored none of the positive posts. I have read all of them and had a little sigh of relief. I was offended at the fact that you thought I was complaining. To state that I am worried about leaving something foreign in my body and something bad coming from it is my concern and as a human I am allowed to voice that. I came here for comfort not to be accused of complaing.
I am not here to argue.
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AJ
There is no reason for concern regarding the marker.
You can put that worry out of your mind.
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I'd like to add that when communicating through these forums, you can't see a person's face, and you cannot hear their tone of voice so it can be difficult to discern their full intent. My rule of thumb when reading and responding to posts is to always assume good intentions.
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My cousin who is a large cupsize has had many, no problem. Me, with a small B cup, took two months till I could wear a bra and I cannot wear one for more than a few hours before it hurts. was told it is titanium coated nickel, and am afraid they will do more damage trying to fish it out, so not doing that now. I am mad that this thing is in me to make a radiologist job easier and after all the stories of migrating, it was just another big pharma shoved at unsuspecting victim. No they did not find cancer. Kept me on the table trying and trying in their cancer hunt training new people on the new computer procedure that I was a "great candidate" for. Year after I found out that I was not even at level that should have been sent for biopsy. Hope no further problems. I just try not to think about it. Never had a problem with my breasts until the Breast Center got ahold of this unsuspecting victim. Right after mine was done, there was a big story on the news of how they have been over zealous in the breast cancer search and that people who died of natural causes biopsy showed small areas that they lived with fine into their 90's that they are now trying to aggressively chemo, etc., I questioned mine at the time and I went with all the swaying. My gut instinct was they were using me as a pin cushion to train and moral of my story to always trust my gut.
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I am scheduled for the same procedure next week. I was not ok with the clip being left but now after reading all the comments I have made My mind up. I am going to call My Doctor's Monday and inform them that I am not going to allow them to leave the marker. My x-rays will show where they removed the calcification. What is the real reason for leaving the marker
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Hi all. Just adding my two cents that the marker is super tiny and does serve a real purpose: it alerts all the radiologists and surgeons and MRI techs you will see in future exactly where the biopsied site is. If you think about how different your breasts look when you're standing up as opposed to lying down, you can visualize how hard it might be to find a small spot six, 12 or 24 months later. Seems to me very safe, akin to titanium knees, etc. but much smaller.
That said, everyone gets to make their own decision.
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I also had a breast biopsy and a titanium marker. However, after the biopsy I found out that I had a V shaped marker instead of just a marker that looked like a piece of rice (provider's description of the marker). I feel I should have been told there are different types of markers of different shapes.
I was told that it marked the area of the biopsy so if surgery was necessary, the surgeon cold identify the correct area especially since it was thought that the tumor was 5mm, small. The marker bothered me, it wasn't exactly a lot of pain but something wasn't right.
A month after the biopsy was my lumpectomy surgery. I had an MRI with wire localization the morning of my surgery. Guess what? The Radiology doctor identified that the marker had moved 1 cm since it was put in. No wonder I was having pain. So the marker was useless for marking the tumor for purposes of placing the wires to identify the area for the surgeon. If I hadn't had surgery, I really wouldn't want the marker to stay in so I can understand your concern.
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I had a clip placed as a marker three weeks ago when I had a core biopsy. I honestly have no idea it’s even there - no issues at all. Aren’t most hip replacements and such titanium
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Markers come in many different shapes and each company making them, have their own proprietary shapes. If you have more than one biopsy in a breast, each marker has to be a different shape so that they can be told apart. For example if you have 2 done on one day in one breast, and one turns out to be benign and one turns out to be malignant every one can tell which is which. My preference is one that has a material that absorbs water so it can be clearly seen at US to make pre-op wire localizations quicker and easier on everyone.
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DJmammo,
Thank you for sharing your expertise in a clear, calm manner. The vast majority of those who get a biopsy marker/clip have absolutely no problems. Does that mean anyone will guarantee no problem will arise? Of course not, but chances are you won’t.
Could you please address two other issues? Someone mentioned that she should have been informed of the type of marker she was getting. Is this feasible given that there are so many different types?
Another poster said that the biopsy ste would show up on an X-ray. If that were true, and I don’t think it is, why would a marker be needed? The poster asked what was the “real reason” for leaving a marker in. Can you clarify this? Many thanks
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I'll try to answer these in an organized fashion ;-)
Placement of a marker is necessary for practical reasons and also for medico-legal reasons. It confirms that the intended target seen on mammogram or US is indeed the target that was biopsied. It is proof the proper lesion was sampled. It also allows the lesion that was biopsied to be quickly and accurately identified pre-operatively so that the correct target is removed, especially if there is more than one radiologist involved.
1) Although there are never any guarantees in medicine, I have placed hundreds of markers every year for many years and have never had anyone say they had a problem from the marker.
2) I have never told anyone ahead of time what kind of marker they were getting unless they asked us and its very easy to tell them what we have picked out as the "marker du jour".
The companies that make the markers often give breast centers the little markers sealed in a plastic cube to show patients if they are curious. They are in the 2-3 mm range in size, sterile, and usually either titanium or stainless steel, the same as joint replacements.
3) There is no "duty to inform" regarding what kind of clip is being used unless during the pre-biopsy interview the patient says "I am allergic to certain metals" then a discussion follows.
4) Lets say one has a very small group of calcifications and during the stereo biopsy they are all removed. No marker is placed. The path comes back and says its DCIS. When I speak to the surgeon and they ask "what tissue should I remove?" there would be no way to accurately tell them where as these kinds of biopsies leave no scars. Lets say one has a large group of calcifications and during a stereo biopsy many are left behind and no marker is placed, they come back benign. In a few years you have a mammogram in another state and they don't have your prior films yet or they have them and there has been an increase in your benign calcifications. When they see all the calcifications with no marker, they will call you back for more views and a possible biopsy. We like to say the marker acts as a "do not disturb" sign in those cases.
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Thank You so much for Your knowledge. You have so helpful. When you use the "US" what are you referring to? Are you referring to the human body, Us meaning you are including yourself in this discussion, or something else?
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US refers to ultrasound.
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Sorry, yes US is ultrasound, which in turn is interchangeable with sonogram and sonography which I also use at times.
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They place the markers during lumpectomy too, right? In the surgical cavity? Or is it pretty obvious on mammogram/MRI that a surgical cavity is there?
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dj,
Thank you so much. I hope your clarifications help dispel fears, concerns and misinformation on biopsy markers
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@djmammo I know I am worrying Your nerves but You seem to be helping Me a lot. Why wouldn't they remove all calcification if they may pose problems. And if they are so common why remove them anyway?
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Calcifications can be associated with a wide variety of benign causes but also cancer. Some of these calcifications look different enough to predict which is which but some are in that middle grey zone. If you develop new calcifications between mammograms, we as breast imaging radiologists are obliged to prove what kind they are.
The purpose of a biopsy is not to remove all the calcs but to sample them so see if they are benign or malignant. If benign they are harmless and left in. If malignant, they will have to be removed with a 1-2 cm margin at surgery, and this cannot be done through a biopsy needle.
Also remember calcifications are not the disease, they are a finding produced by the disease. They are the smoke not the fire.
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Calcifications can be associated with a wide variety of benign causes but also cancer. Some of these calcifications look different enough to predict which is which but some are in that middle grey zone. If you develop new calcifications between mammograms, we as breast imaging radiologists are obliged to prove what kind they are.
The purpose of a biopsy is not to remove all the calcs but to sample them so see if they are benign or malignant. If benign they are harmless and left in. If malignant, they will have to be removed with a 1-2 cm margin at surgery, and this cannot be done through a biopsy needle.
Also remember calcifications are not the disease, they are a finding produced by the disease. They are the smoke not the fire.
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