Breast Biopsy: Core Needle vs. Fine Needle Biopsy

Welcome to connect @swal1234 - this is a great site as you can see from all the comments. We all have your back. What is important is exactly what you are doing - ask lots of questions. Or as they say, "Trust but verify". Do not worry that you are located in a smaller area - the beauty of blog sites like here is that you can Connect. So, ask why they only do Core Biopsy and not a fine needle. Ask about the procedure and what you can expect. Do they leave anything for later identification etc. What are the positives and negatives?

I am approaching 5 years of a quite arduous MBC process BUT I am here and enjoying my life. I am learning to live with not just MBC but now Ovarian with a successful tumor removed from my brain. But I remember like yesterday that we did a core biopsy because the doctors felt the results would be more conclusive and I had fibrous dense breasts, not a little spot. I will say that the doctor nicked a closely located vein that started bleeding. Pressure and a gauze bandage stopped the bleeding, until we were out to dinner that night - I was quite the sight with blood soaking my outfit. Pressure and not running around helped! So... your journey has started. Every "body" is different - you have got this! Keep living your life. Good luck!!

I have had 2 biopsies and averted a 3rd on Valentine's Day (2023) because I flat-out refused to go through with another one of these things IF they could, instead, gather my yearly mammograms and check to see if the calcification that is present had changed in any way. My first biopsy on the right breast was in 2018. I was called back after my yearly mammogram for what I thought was a re-do involving the mammogram machine. I did not know they were going to ask me to strip to the waist, lay flat with my breasts dangling down through what looked like a Medievel torture machine, and approach me with a needle that easily was as long as the distance between my elbow and my wrist. I had stripped to the waist and "dangled," but when I saw that needle, I sat up abruptly and said, "Wait a minute! I want to talk to a doctor." The woman (Jane) who had put me in at 7 a.m. (just shoot me now) began bullying me further, suggesting that if I was too frightened to have the procedure done, I should just sit up and put my clothes back on, I wish I had,. Instead, they rounded up a radiologist, who agreed, after looking at the large blow up of the mammogram on the big screen, that I could probably just come back in 6 months and see if there had been any change in the calcification in that time. I WISH I HAD. Instead, since Jane was such a harridan, I said, "Let's just get it over with" and let them plunge this really long (and painful) needle into my right breast. The results of this were benign. However, in 3 years, that breast (right) was the one on which I had the lumpectomy, after a second biopsy--done a totally different way---was performed in Davenport, Iowa, at Genesus Hospital. The first 2018 biopsy did not heal for literally months and, when I asked her for a second thing to put in my freezer for when the first one had lost its iciness, she said, "You can make your own" and refused to give me a second ice pack, What a gal! I was so upset by this woman's treatment of me that I actually sat down and wrote the hospital, which never responded. Later, I found out from my surgeon that they did have a meeting about "Jane," who apparently had had other complaints of her Helga the Stomping Mare demeanor, In December of 2021 (Pearl Harbor Day) I drove all the way to Iowa (from Illinois) to have my mammogram at what used to be called St. Luke's Hospital, because I hated the first hospital that treated me so shabbily. I told the supervising radiologist, Dr. Goswami, about my horrible experience of 2018 and she said, "Oh, we don't do them THAT way any more" and showed me a needle with what looked like a pig's tail (curly-cue). She guaranteed me that, after the area was numbed, it wouldn't hurt much and would heal in record time, both of which turned out to be true. The radiologist, when asked if it couldn't simply be a cyst, replied, "No, because it's hard." She was right. It was cancerous and the 11 mm, tumor was removed on 1/27/2022. When I had an ultra sound on the one-year anniversary of surgery that showed something there, they wanted to do another stereotactic biopsy, which would be an instant replay of 2018. By now I knew enough to ask if we couldn't simply gather all of my mammograms, faithfully taken from age 40 on, and look for changes in the calcification that shows up in both breasts. That radiologist here in Texas agreed that that was another approach and I did not have my 3rd biopsy. The mammograms---which took a while to gather---showed no changes in either breast over time. I still wonder if the stereotactic biopsy was instrumental in causing the formation of the tumor in the first place. It was very painful and didn't heal for months and I did not want to ever have to go back to Trinity Hospital in Moline, Illinois--although that is exactly where I ended up for surgery because it was the closest to my home and I was told to have 33 radiation treatment, which also seems like a lot for a 76-year-old woman. Iowa City Hospitals and Laboratories told me, THREE DAYS before the radiation was to commence, that, if I had had my surgery there instead of at Trinity Hospital in Moline, they would not have radiated me at all, because I was a woman in my 70s, (Makes you wonder,)

Also interesting to note that, about a week after they had already done the 2018 stereotactic biopsy, I got a letter from that hospital saying that my recent mammogram on my dense breasts showed some areas they would like to examine further and I should "consult with your doctor" about what to do next. Not a great line of communication in-hospital, since they had already dug in with a very large needle and caused me a great deal of pain (and possibly set the area going on forming the tumor that was found on Dec. 7, 2021.
I've written a second letter about the actual treatment of the 11 mm. tumor, mentioning all the many ways in which my treatment was irregular or not the way it usually is. (For instance, my oncologist refused to order an oncotype, dismissing my December of 2021 inquiries about getting one and saying, "You don't need one." When, 17 months later, I finally got one in Texas, my oncotype was 29 and my Texas oncologist said, had I been his patient at the outset, I would have had 3 rounds of chemo. I had no chemo and 17 months had passed. I also did not get a bone scan BEFORE putting me on Anastrozole on Feb. 1, 2022, and I was put on that A.I. drug less than a week after surgery, at a time when I had a bad seroma infection, which required 500 mg, of Cephalexan every 4 hours for literally weeks to quell. I had been in a arthritis/bad joint study from 1997 to 2020, so putting me on Anastrozole was also not a great idea. It caused my fragile left knee (injured in a bicycle accident in 1997) to blow out and I was in a wheelchair for 6 months. My bone density declined from -1.4T to -2.2T during my 7 months on Anastrozole. I also had brain fog, teariness, mood swings, joint pain that was the worst pain I've had in my life, insomnia, blurry vision and vivid violent nightmares. Had 32 ml of an anti-inflammatory injection and 6 ml of Durolane and waited to heal up from the results of taking Anastrozole for 7 months, which were similar to a meniscus tear. Off everything for 9 months. Had an ultra sound in Feb., 2023. They wanted to do a third stereotactic biopsy, but looking at old mammograms (which I had faithfully had annually for 46 years) showed no change in the calcification present in both breasts. I was talked into taking Tamoxifen. I began that on April 23, 2023 taking 10 mg., but was told to take 20 mg. on June 23 and continued taking 20 mg. daily until Aug. 30, 2023. By then, I was suffering from extreme fatigue, non-stop UTIs and a constant urge to urinate. My bloodwork had gone wacko, with 10 things abnormal when it had been fine on March 7, 2023. I quit taking Tamoxifen on Aug. 30 and had a pelvic ultrasound to make sure that I had not developed endometrial cancer during my 5 months on Tamoxifen. I am now 2 years and 2 months past my surgery of 1/27/2022 and hoping that the 33 radiation treatments I had in 2022 will protect me from a recurrence.

I had a core needle biopsy which resulted in negative for breast cancer. My dr suspected something was not right so she proceeded with the core biopsy which resulted in ER/PR positive invasive ductal carcinoma. My cancer was in the nipple area so in September of 2023 I had a partial mastectomy. I went through 4 weeks of radiation, and I am now taking Anastrozole which is awful. My cancer did not show up on a mammogram, ultrasound, fine needle biopsy but did on a core biopsy. Out of the two for me core was the best choice. I wish all of you the best and if anyone can give me suggestions on Anastrozole I would appreciate it.

Stay strong !!

To Traci in regards to Anastrozole: Anastrozole and Laetrozole are "Kissing Cousins" according to my oncologist in Illinois, who never would admit that there were bad side effects from taking them, but told me, via the patient portal (since he, personally, only saw ne 2x in 8 months): "The only side effect from taking Anastrozole is a little stiffness in your hands and fingers when you wake up, and it goes away when you quit taking it." That, as anyone who has had side effects knows, is b.s. My own side effects were many and numerous, including the worst joint pain---or pain of any kind---that I had ever had in 76 years of life. Also, dry skin, dry eyes to the point of blurry vision, teariness, brain fog, mood swings, insomnia and vivid violent nightmares. And then my left knee blew out and semi-crippled me, which is a fairly permanent thing, as I have to brace my left knee to walk now. If I had it to do over again, I would ask for Exemestane, which is pricier, but is different from the other two, And, if that was also bad, Tamoxifen is easier to tolerate and will not attack your bone density, which A.I pills routinely do. My bone density on Anastrozole declined from -1.4T to -2.2T, where osteoporosis begins at about -2.4T. I will have another bone scan in May, as Medicare will only pay for bone scans done every 2 years.

I got my biopsy results and now it is a radial scar and surgeon wants to do surgery and I am wondering why they never ever mentioned that this could be a possibility. I have had lots of scans, ultrasounds and did have my core biopsy. Nothing was ever mentioned about it being a radial scar before. I have been reading the comments and I thank everyone for their sharing. I am going to get a second opinion because no doctor, through all of this, has yet to speak to me.
All this information has been told to me by the nurse and where I live we don't even have a surgeon and 100 miles away there is no surgeon who specializes in any breast surgery at all. I remember my mother suffering through three different cancers and I can't bear to bring up all those memories again. If anyone has any information on radial scars, please could you let me know. Thank you and Hugs to everyone!