Biopsy or excision?

[keeva1215]

I have recently been diagnosed with a abnormal breast lump.  I've had an ultrasound already, and am supposed to get a mammogram next.  The doctor said that the I can either get a biopsy, or have the lump/tumor removed altogether in surgery.  He said that the needle that they would use for the biopsy would be very large in order to get enough tissue to examine, and that it would be extremely painful.  However, I don't know if immediately going into surgery is a good option either.  I received a BIRAD 4a result after the ultrasound.  I am wondering if anyone can help me decide which option would be better for me.  A painful biopsy, or having the entire lump removed to be tested?

[japdip]

A biopsy could be done in the OR under a light IV sedation; you would be asleep as far as knowing or feeling anything. If the area were very small or there was some doubt about exactly where the specimen was to be taken from then a tiny wire (placed thru a small needle) might be inserted in the X-ray Dept. and then you would be taken to the OR and once again the same type of sedation (IV medication) would be administered so that you would not be aware at all of anything and a sample of lump/area would be taken. All these are Outpatient procedures and you would go home in a couple of hours.  Take care .....

[keeva1215]

Thank you very much for these helpful words.  

Japdip-- if the biopsy does not need to be the kind where they use a needle to obtain a sample as you said, what other kinds are there?  
Thanks again.

[ncmichigan]

If your surgeon is offering you options ir's always your choice. What's right for someone else may not be right for you. I've had three excisional biopsies of five areas and this choice was right for me. My thinking was that if something was going to be found on biopsy, it would have to be removed anyway, so why go through two procedures instead of just one? Two masses were fibroadenomas, which are usually recommened to be removed, so I was glad I had the excision. I was sedated so none of them was bad and recovery was relatively quick. I am one of those people who can take a lot of pain AFTER a procedure, but I am "wuss" when it comes to pain DURING a procedure. In fact, prior to one biopsy I had to have two needle locs and I almost passed out during that! We are who we are and just have to do what's best for us, so follow japdip's advice and explore your options.
I wishing you all the best and hoping for benign results for you!
Sending you a big hug (     ),
nc

[japdip]

I disagree in that the biopsy need not be so terribly painful. A local anesthetic is used and although it is not a comfortable procedure most of the women here have had this done and survived very well. If the lump is quite large and will need to be removed regardless of it's cause then complete excision would be fine. You can also have an excisional biopsy where you are given an IV sedation and a portion of the lump is removed for Pathologic examination. With a BIRADS 4 score a biopsy is indicated so I would advise you to see a Breast Surgeon for his/her opinion as to the proper path to take next. The biopsy does NOT need to be the type using a needle to obtain a sample of tissue. Explore all your options ... Regards ....