Stereotactic biopsy

I had a stereotactic biopsy today on my left breast. What is a difference between stereotactic biopsy and core biopsy. Why do they do the stereotactic biopsy rather than core biopsy.

Thank you Maggie.

I had my stereotactic biopsy on Wednesday on left breast and everything seems to be fine except I have pain on rib by left side when I breathe, cough and move a certain way is that normal? Did anybody have that discomfort after the biopsy?

The biopsy showed micro-invasive lobular carcinoma, classic type, intermediate nuclei. Going to surgeon tomorrow. This is a real bummer.

doing lumpectomy on 4/17 hopefully there is no node involvement so I won’t need chemo. I had bc on right side 10 years ago now it’s on left side. I really never thought I would get it back I guess I was wrong.

Hi @dpako, Whether to do a SNB after 70 depends on the pathology and circumstances. In the case of microinvasion and no palpable or US node involvement it might not be necessary. The fact that you had bc before might be a reason why it should be done. You will have to decide whether to do radiation, hormone therapy or both and knowing the SNB status would make that decision easier. SNB is less invasive than the ALND done in the past and currently for some stage III patients. Statistically SNB causes lymphedema in 3.7 to 17% of women while ALND causes LE in 20 to 50% of patients. Did you discuss this at the appointment with your surgeon?

Hi @dpako, I think that you are leaning toward the right decision. Since you had IDC before with two positive nodes checking would give you peace of mind. My nodes looked OK on ultrasound but one of them was positive. With a microinvasive tumor at your age you may not need radiation but it would be something to ask about. I didn’t need chemo since my Oncotype was 24 but I had axillary radiation added because of that node. I ended up with breast (not arm) LE but it was due to radiation, not surgery. Good luck getting your treatment plan finalized.

The pathologist usually gives the grade on the biopsy pathology report. Sometimes it is given as separate Nottingham scores (tubules, nuclear grade, mitotic activity) which can be added together to get the grade. My first pathologist at a small hospital just saw DCIS on the slide and gave it a grade of 3. The second pathologist who viewed the slide noticed microinvasion but gave no grade or Nottingham scores. The surgical pathologist who specializes in breast cancer determined my actual tumor was IDC with adjacent DCIS grade 3. She then revisited the biopsy slide where she found 2 cm of IDC and was able to determine the grade. I guess there is no knowing exactly what is there until after surgery.

If the ILC is too small for an oncotype you most likely won't have chemo. My oncotype was two points below the score where chemo is recommended for older women so my RO just added axillary radiation because of the positive node. A week of radiation sounds not too bad. I hope it all goes well.

I have a math/science background and was a teacher (everything from preschool through college.) In the summers I worked analyzing veterinary research for a drug company which manufactures many meds for people so while human medicine isn't my field it's related. Some of the human research originates with animals since it's cheaper and if something works for one group of mammals it just might work for humans.

As far as I know LCIS is not usually given a Nottingham grade. While my DCIS got a grade the second read of DCIS with microinvasion did not. The pathologists have rules to follow about how each breast cancer subtype should be reported and there are differences. Your doctor is probably telling you the scores aren't important because a biopsy is just a tiny sample. After surgery when they have the entire tumor the real pathology is done.

You should ask your doctor about the rationale for the radiation decision but whole breast radiation covers a much larger area than the lumpectomy spot and would get any cells that might be outside the tumor bed.

Exbrnxgrl, I have taught every level from preschool through grad school and I think first grade is by far the most challenging. Kudos to you since reading is such an important skill. I’ve seen the consequences later on for those who fell through the cracks and weren’t rescued along the way.

I moved about quite a bit because of my husband’s job and had to be adaptable to find employment. I had coached and taught swimming so was used to dealing with all age groups which was a help. The one constant was the multinational pharmaceutical company which had field trials or branches everywhere I lived until online work became possible. While covering for employees I never knew what I was jumping into the middle of and had to get up to speed quickly. My academic background in math, chemistry and physics was strong but I learned biology working with experts in the field.

I’m not a medical professional so I don’t offer medical advice but as a teacher I try to help people understand what they have been told by a medical provider or read on the internet. Doctors often can’t explain things at the level of their patient’s knowledge. As you know, an essential part of teaching is defusing social situations and calming students so they can learn. People first come to this website scared, upset and confused. You are an expert at alleviating their fears and putting things in perspective for them.

Microinvasion means the cancer has invaded the breast tissue by less than a millimeter, a tiny amount. DCIS and LCIS are not invasive since they remain in the ducts or lobules (milk producing glands.) Even though it is very small your doctor’s treatment plan sounds like she wants to ensure that any cancer cells are destroyed.

Maybe your original doctors are more cautious since they treated you for IDC before. They are separate primary cancers but being the second one it makes sense to be extra careful.

Don't beat yourself up over the red wine. They now have evidence that drinking increases the risk of breast cancer but it does not cause it. It does increase the risk of ER+ breast cancer more than other types, The figures are statistical and don't take into consideration your personal biology and health so it can't predict how it will affect you. An association was seen in the late 1980s but it wasn't until fairly recently that it was strongly recommended to reduce or eliminate drinking.

Drinking will not cause breast cancer and not drinking doesn't prevent it. When I was much younger I drank socially but quit totally at age 28 since alcohol of any type started causing migraines. In spite of that I got breast caner 40 years later so I'm proof that you can't prevent bc by not drinking.

yes they treated me for IDC and it worked for 10 years so I am hoping for another 10 years and hopefully more. I am 77 now.