My Breast Cancer and its History: Summary

 
 

 

 

 

 

 

 

 

 

last update Nov. 29, 2016

Copyright © Nov. 2004

Erika Rusterholz

Medical Support:

PD Dr. Mathias Fehr

PD Dr. Christoph Rageth

 

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CLARIFICATIONS

 

 

 

What has to be done before surgery when there is suspicion of breast cancer?

 

The early case history shows that errors had been made:

waiting to long for a clarification of the microcalcifications - postponing too long to get an appropriate mammogram of the hardening - a biopsy with tissue sample from outside the lump and therefore a false diagnosis. I then decided to find on my own a better address for further examinations. A breast center seemed to be the right place.

Which services should be offered by a breast center? (Descriptions in German)

 

January 5th, 2004: I brought the mammograms including diagnosis of November 11th, 2003 (no proof of a carcinoma), to the breast-center and asked, if it would be possible to remove the same day the lump in the gland tissue. In the meantime I had therefore gotten a bad feeling, the lump had become larger again. Perhaps it was not so good-natured as I had assumed according to the available diagnosis.

 

The physician thought that in my case and in view of the mammography pictures, he would prefer a usual tissue sample/biopsy, but I insisted on a complete excision of the lump due to the presented "good" diagnosis.

 

 

The lump was removed under local anesthesia on an outpatient basis and to about 80 %.

 

Four ultrasound images represent the vacuum biopsy

with VacuFlash® (lumpectomy with a large needle).

 

four PICTURES

 

A compression bandage during 48 hours around the torso within the chest range should prevent blood from accumulating in the cave which had resulted from the lump excision. Unfortunately already during the first night the bandage slipped down, so an effusion of blood could form around the place of the former lump. This was worse looking (see picture), as it was.

 

The different colored spots became lighter, between the incision part and nipple, however, a swelling (hematoma) occured.

 

The mammograms of November 11th, 2003,

were examined again by a further radiologist:

 

 

SECONDARY EVALUATION  (in German)

 

Diagnosis 8 days after re-biopsy of the lump:

 

new DIAGNOSIS LUMP  (in German)

The lump in the left breast was in fact a cancer.

 

Now the microcalcifications in the right breast were examined again more exactly, tissue samples should give information. This happened outpatient under local anesthesia.

 

(see the two pictures at the left)

 

 

DIAGNOSIS TISSUE SAMPLES (in German):

 

the core biopsy (Trucut®) of the microcalcifications

in the right breast and

the core biopsy (Trucut®) of the axillary lymphnode

at the left side

 

 

Also of an enlarged lymphnode in the left axilla a tissue sample had to be taken, also outpatient and under local anesthesia.

 

Here it is important to know, whether the axillary lymphnodes are already cancerous. If yes, these would have to be removed also during the surgery.

 

If without metastases, a Sentinel Node Biopsy could be made during surgery so that the side effects can be avoided, which mostly arise after the usual dissection of the axillary lymphnodes.

More on the sentinel lymph node biopsy: (in German)

 

 

 

 

The Hematoma

Three weeks after the removal of the lump the skin over the hematoma (a localized swelling filled with blood resulting from a break in a blood vessel) had become very firm.

It felt, as if under it a half cooked egg was stored. The blood in the cavity of the wound had thickened (dark encircled).

 

My desire to get the whole lump removed, instead of just a tissue sample, was therefore not very good.

   

The diagnosis of the microcalcifications at the right was not completely clear,

 

a new mammogram on January 21st, 2004...

 

...and a Mammotome® biopsy of the microcalcifications at the right should give clarity here.

 

Under x-ray control the stereotactic vacuum-assisted biopsy (removal of the microcalcifications, see accompanying drawing) was made outpatient and under local anesthesia.

 

six PICTURES of the stereotactic Mammotome® vacuum biopsy

 

One week later: The resulting diagnosis of the microcalcifications in the right breast also was cancer:

 

(Anamnesis see "Doctor's Info")

final

DIAGNOSIS MICROCALCIFICATIONS  (in German)

 

Animation STEREOTACTIC VACUUM-BIOPSY (2.6 MB):

Why and when a breast biopsy?

(Explained process "MAMMOTOME® VACUUM BIOPSY" in German)

depending on

your browser:

.mpg

.mpeg

 

BI-RADS®Classification

BI-RADS®= "Breast Imaging Report and Data System", American College of Radiology - www.acr.org

Original-pdf-files in English language:

 

 

ACR BI-RADS ATLAS Mammography 2013

see table on page 135

 

ACR BI-RADS ATLAS Breast Ultrasound 2013

see table on page 128

 

ACR BI-RADS ATLAS Breast MRI 2013

see table on page 137

 

How will, as next question, the surgery be carried out?

 

Neu und hilfreich - in German language:

Der Verein, der bei Verdacht oder Diagnose Brustkrebs weiterhilft

mit Kurzbeschreibungen wichtiger Themen und eigenen Erfahrungen, mit Links zu medizinischen Informationen und Wissenswertem aus dem Internet. Ergänzt mit e-mail-Beratung und unterstützt von einem Ärzte-Beirat - alles an einem Ort:

www.wissen-hilft-weiter.info/diagnosen.htm