Breast biopsies and metal clips / markers?

[MamaChef]

Hi Ladies,

My midwife found a lump last week and referred me out for an US.  Im 20w pregnant.  The ultrasound revealed a mass so they want to biopsy it.  It is probably a fibroadenoma but it's guilty of being cancer until proven otherwise.  That's how medicine works, right?  Im kicking myself for letting the midwife talk me into a U/S to be honest.  Now Im just a big stress ball of worry and can barely function even though I know logically this is nothing.  I hate the whole persona of diagnostic medical professionals.  No explanations, no "breast changes are normal in pregnancy but lets just take a look to be safe".. just it could be malignant until proven otherwise. 

I know that they have been using biopsy markers for many years and everyone feels they are safe, but I have read stories of them migrating, causing pain, causing allergic reaction, causing systemic reaction, etc.  And it isnt as easy to get the darn things out as it is to put them in.

I really dont feel good about having a piece of metal hanging out in my body and wanted to get feedback on how others have handled this.  I called the coordinator today to ask if I could refuse the marker or if we had any other options and she said nobody has ever refused the marker and she didnt thing the Doctor would agree to that.  Yay for having control over my medical care.  The Doctor/Radiologist is supposed to call me back this afternoon to talk to me about it.

[JayGee]

I just had a biopsy last week and they put in the marker.  It's a tiny sliver of titanium.  I agreed to have it put in, but then again, I'm not pregnant or nursing, nor do I plan to be pregnant or nursing again!  I didn't have a lump, but a cluster of microcalcifications (diagnosis ended up being benign sclerosing adenosis).  With the marker in, they will know that section of my breast has been biopsied so they won't end up having to check it again when my next mammogram shows up with microcalcifications.  I had not heard about the clips getting lost.  Best of luck with your biopsy.

[kjbrown92]

I also had a clip put in when I had my biopsy, and when they had to remove the whole mass, it helped them to be sure they got what they needed to. My brother's hip is made out of titanium (as are other artificial joints). I've never heard of the clips migrating, but as with the other poster, I wasn't pregnant or planning to breastfeed. Good luck.

[Buzzer Beater]

I got the clip. There is no way I want to go through a biopsy again, so... I researched it and thought it to be safe, hadn't heard of them migrating. Mine causes no pain and I am breastfeeding with it.

Good luck mama, I wouldn't want to make those choices while pg.

[MamaChef]

Hi Ladies,

Just talked to the radiologist.  She said that the only issues they see with migration are stereotactic guided biopsies.  They see none with the U/S guided ones.  She called it the accordian effect and said that when the breast is let out of compression that's when the migration can happen.

Since Im pregnant everything is Ultrasound, so she assured me that it wouldnt be an issue.  Now I just have to decide if I want to have the clip put in or not.  To complicate things my mom has 8 sisters and her and 6 of the other sisters have serve metal allergies. One aunt had a titanium pin that had to be removed because she was showing autoimmune reaction.

Ive never had any allergies *knock on wood*.. but since its not very easy to get them back out once you get them in I still havent made up my mind on the marker.

Thanks for shaing your experiences

[HRJ]

I was going to refuse it just b/c I had talked to some autism drs about titanium (we have 4 children w/ autism in our family).  The drs feeling was that it was usually okay but some people do have issues with and they do chelate for it.  My feeling was if I weren't pregnant (my biopsy was done around 20 weeks) and weren't planning to breastfeed, I would do it.  The surgeon at first told me that they were encapsulated with some plastic-type material that stays there forever, but the radiologist said that the plastic (it's not plastic but some sort of clear material) dissolves.  Well, when I went in for my biopsy, my radiologist said she had no problem not putting the marker in b/c the mass clearly looked like a fibroadenoma to her and it was fairly large sized.  She said the markers are typically used for smaller masses.  I know that I may end up having to have another biopsy again in the future due to my decision since the marker wasn't put in, but I didn't want it while PG.  The surgeon was on vacation when I tried to call back about my concern that the plastic dissolving (again, it isn't plastic but it's some sort of encapsulation).  The other thing to ask your radiologist is that for me, they always check after they place a marker with a mammogram to make sure that a) it was placed in the right area and b) it wasn't a blank.  Sometimes they get the encapsulations without the titanium inside.  This has to be checked with mammogram, so they told me that even if I had the marker placed, they wouldn't be able to double check it b/c I was pregnant.  Good luck to you - I know this is scary!  Mine was a fibroadenoma.  I have to go back in in January for another scan (I'm due march 2) to make sure it hasn't grown too much.  It if gets too big they want to remove it - 1 surgeon removes them when PG so you don't get a milk fistula while breastfeeding and the other surgeon removes them while breastfeeding with no issues.  My OB and a lactation consultant see no reason to remove it.  So we'll see.  Also, it may have a lot to do with the person/people that do your biospy.  My radiologist and nurses were all women that took their time.  But it didn't hurt at all.  It wasn't bad at all. 

Edited by HRJ - 12/16/10 at 11:37am

[MamaChef]

HRJ, our stories are so similar!  Im 20 weeks as well.  Im so sorry you had to go through this too, but there is comfort in knowing that others with such similar factors (pregnant, 20 weeks - thought to be a fibroadenoma) have been through it too with good results. 

Ive decided not to get the marker.  We also have 2 children with autism in our family, and the metal allergy.  I just see no reason to chance it.  My biopsy is today at 3pm and Ill be so glad to have this over with.

[HRJ]

I know you will. Report back when you get results.  Thinking of you  . . .  I just set up my followup scan for Jan 7 (the surgeon wants to make sure it doesn't get too big b/c pregnancy hormones can do that).