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There are many publications and sites that write about cancer. We want you to know we don’t produce the news items you can read in this section, they belong to the MD Anderson Cancer Center. This section only intents to inform you about what is out there.

However, we are working on the first edition of the Pink Ribbon Magazine as well as in the production of featured articles that will be published here.

 

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8 breast biopsy questions, answered

Getting a breast biopsy? You might be wondering what it is and how it works.

A breast biopsy is a diagnostic procedure in which a doctor removes a small amount of breast tissue to examine under a microscope. If the tissue sample shows cancer, the physician can have it analyzed further to provide the most accurate diagnosis — a critical first step in getting patients the best treatment possible for their particular type of breast cancer.

A biopsy may be ordered when a mammogram or other breast imaging (such as an ultrasound) reveals an abnormality or you feel a lump in your breast, or when a physician notices something suspicious (such as dimpling or a change in skin texture) during a clinical exam.

We spoke with Marion Scoggins, M.D., to learn more. Here’s what she had to say.

What are the types of breast biopsies, and how are they different?

There are two basic types of breast biopsy: surgical and needle. A breast biopsy done surgically through an incision in the skin is called a surgical breast biopsy. A breast biopsy done by inserting a needle through the skin is called a breast needle biopsy.

There are two main types of breast needle biopsy: 

  • fine needle aspiration, which uses a thin, hollow needle attached to a syringe, and
  • core needle biopsy, which uses a larger needle that removes a small, tube-shaped piece of tissue with a spring-loaded device or a vacuum-assisted device.

Because it’s important to pinpoint areas of concern and pull tissue from those exact spots, doctors typically use an ultrasound — or a mammogram or MRI, in some cases — to guide a breast needle biopsy. A mammogram-guided biopsy is also called a stereotactic biopsy.

At MD Anderson, we place small metallic markers called “clips” in the breast at the time of a breast needle biopsy and leave them there. This allows our radiologists and surgeons to know the exact location of the biopsy, in case we need to remove something else from the area where a tissue sample was taken.

How painful is each kind of biopsy, and how long does it take to recover?

Local anesthesia is given for breast needle biopsies, which makes them tolerable and comfortable for most patients.

The recovery time is typically very short, but may vary depending on the amount of bleeding and/or bruising. A core needle biopsy is more likely to result in bruising than a breast fine needle biopsy. Bruising from a breast biopsy may take several weeks to completely resolve. Your doctor can discuss expected recovery times and what to do to take care of the area that’s been biopsied.

Do any breast biopsies require general anesthesia or an overnight stay in the hospital?

A breast needle biopsy is done with local anesthesia, so it does not require general anesthesia.

A surgical breast biopsy may require general anesthesia, but typically won’t require an overnight hospital stay.

How do doctors determine which biopsy is best for a particular patient?

If there’s an abnormal finding on your mammogram or breast ultrasound that we need to biopsy, a radiologist will determine the most appropriate type of biopsy, based on how much tissue is needed to get an accurate diagnosis and the question doctors seek to answer with the biopsy.

Is there ever a time when a patient should ask their doctor for a biopsy (or for a specific type)?

A biopsy is only recommended if there’s a suspicious finding on a mammogram, ultrasound or MRI, or a concerning clinical finding. If a scan is normal and there are no worrisome symptoms, there’s no need for a biopsy.

If you do need a biopsy, your doctor should discuss which type of biopsy is needed and why. Your doctor can answer any questions you have and explain the procedure and its purpose, as well as its benefits, risks and alternatives.

What are the potential risks of a breast needle biopsy?

As with any medical procedure, there are known risks and benefits with a breast needle biopsy. It is possible that patients may have pain, bleeding or infection. So, be aware of these potential complications and discuss them with your doctor before the procedure.

Some patients express concerns about whether a breast needle biopsy might cause cancer to spread. But there’s no evidence of a negative long-term effect from a breast needle biopsy. And the benefits of a breast needle biopsy — as opposed to a surgical biopsy or no biopsy at all — outweigh the risks.

Why should you have your biopsy done at MD Anderson?

All MD Anderson does is cancer and our doctors perform all different types of breast biopsies on a daily basis. Each year, our breast radiologists perform more than 2,000 ultrasound-guided biopsies, 750 stereotactic biopsies and 250 MRI-guided breast biopsies, on average. Our radiologists are fellowship-trained breast-imaging specialists, which means they’ve received additional sub-specialty training after completing residency. And our biopsies are interpreted by pathologists who specialize in breast cancer.

If a biopsy reveals cancer, our team of oncologists, radiologists, surgeons and pathologists work together to develop individualized treatment plans for the patient. This approach ensures that patients have access to any additional support services they might need, such as physical therapists, dietitians and social work counselors.

Anything else readers should know about breast biopsies?

Just because you need a breast biopsy doesn’t mean you have cancer. In fact, most breast biopsies turn out to be benign (not cancerous). So don’t worry if it takes several days to receive the results of your breast biopsy. This is typical, and it simply means we are doing our job and ensuring you get the most accurate results.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Acinic cell carcinoma survivor grateful for clinical trial

Keith Taggart noticed a lump the size of a pea in his left cheek in October 2014. He was also experiencing fatigue, weight loss, nausea and incontinence. His primary care physician wasn’t too concerned about the lump but referred him to an oral surgeon to have it removed and biopsied.

Keith was diagnosed with acinic cell carcinoma of the salivary gland 10 days later. But he wasn’t especially worried. “I believed that any future tumors could be easily treated by extraction with local anesthesia, the same way they’d removed the lump for the biopsy,” Keith recalls. An oncologist near his home in  Oklahoma City scheduled him for oral surgery and seven weeks of radiation therapy.

Coming to MD Anderson for acinic cell carcinoma treatment

After his tumors came back four separate times,  Keith sought a second opinion at MD Anderson in January 2016. 

“MD Anderson has an impeccable reputation for cancer treatment,” Keith says of his decision to travel here. “It’s light years ahead of everything in my state in terms of treatment and success rate.”

Facing metastatic acinic cell carcinoma

At MD Anderson, Keith met with head and neck surgeon Neil Gross, M.D., who was concerned with how quickly the cancer seemed to be spreading. Keith underwent a full-body  CT scan, which showed the cancer had metastasized to his lungs, liver, kidneys and lymphatic system.

“It had grown out of control, and we needed to go in a different direction,” Keith says.

He met with head and neck medical oncologist Renata Ferrarotto, M.D., who told him that chemotherapy might prolong his life for a little while. 

“That was the first time I realized I had a terminal situation,” Keith recalls. “I thought it was simple salivary gland cancer that moved into my lymphatic system. It turned out to be much more serious than I ever thought possible. I was terrified and found myself emotionally falling deep and hard.”

Choosing a Phase I clinical trial

In addition to suggesting chemotherapy, Ferrarotto told Keith about a Phase I clinical trial that he might be a match for. Previously, doctors had biopsied a lump in Keith’s chest, which revealed a genetic fusion called NTRK III. It made him a possible candidate for the clinical trial, which was led by David Hong, M.D.

“I went home from my appointment thinking I was going to die within the next month or so, and three or four hours later I got a call from the nurse handling the clinical trial, Sandra Montez,” he says.

Keith learned from Montez that the clinical trial would put him on a daily medication called larotrectinib. He’d need to travel to Houston from Oklahoma every four weeks for physical exams and blood tests. He also needs full-body CT scans every other month. Keith decided to enroll in the clinical trial instead of undergoing chemotherapy.

“Immediately, I had hopes that I was going to make it through this,” Keith recalls of his first conversation with Montez. “She had such a positive attitude.”

The first signs of hope

After four days on the clinical trial, the lumps Keith felt on his neck, cheeks and shoulders were gone.

“Immediately I felt better,” he says. “A lot of the fatigue was gone, I was no longer losing weight and a lot of the symptoms from the cancer stopped.”

When Hong checked Keith’s first scans during the clinical trial, almost all of the tumors were gone, with the exception of two in his lungs, which had shrunk by 65%.

Cancer is no longer a constant

Keith will take larotrectinib – which was recently approved by the U.S. Food and Drug Administration – for the rest of his life to keep the tumors from growing back.

But he doesn’t worry about cancer anymore.

“Before, it was constantly on my mind. But after I knew the drug was going to keep the tumors from growing, I stopped even thinking about cancer getting me down anymore,” he says.

“I have a whole lot to be thankful for – MD Anderson saved my life and really enriched my life in so many different ways,” he says. “I can’t tell you how much I love MD Anderson for how much it has done for me.”

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Helping my husband through brain tumor surgery

My husband, Richard, likes to say, “If it’s not broke, don’t fix it!” That’s what he said to me when I first noticed the small bump on the right side of his head while we were dating.

I’m a physical therapist and have dealt with patients with musculoskeletal, orthopedic and neurological issues, so I knew to ask him about headaches and vision changes. But he didn’t have any other symptoms at that time.

Brain tumor symptoms increase

I noticed some little changes around Christmas 2016. The bump had grown bigger, he had some weakness on his left side, his smile had changed and he started to get headaches with dizziness. By then, we were engaged and busy preparing for our wedding. We got married on March 11, 2017, in Magnolia, Texas. Richard had short-term memory loss at that point and can barely remember the events of our wedding. But he knew he married me!

Richard saw his primary care physician the week after our wedding and was immediately referred to a neurologist. By then, Richard had started vomiting and had terrible headaches.

I was at work when Richard called and told me the neurologist had confirmed what I’d already begun to fear: Richard had a brain tumor. I cried in my car and prayed, “We just got married and have so many plans together; please don’t take him away from me now.”

Brain tumor surgery at MD Anderson

Richard’s neurologist recommended we go to MD Anderson and see Dr. Sherise Ferguson, a neurosurgeon in the Brain and Spine Center. Soon after, Dr. Ferguson performed a craniotomy to remove Richard’s tumor, which turned out to be a baseball-sized grade II meningioma, a benign brain tumor.

Because it all happened so quickly after our wedding, we didn’t get to go on our honeymoon. We stayed five days in the ICU and teased the nurses that we were having our honeymoon at MD Anderson.

We snuggled in the hospital bed together, took a trip up to the MD Anderson observation deck to see the city and just appreciated that his surgery was successful.

Our belated honeymoon

In September 2017, we were able to finally go on our honeymoon in Hawaii. Before our trip, we asked Dr. Ferguson’s advanced practice provider, Ufuoma Avbovbo, what Richard could and couldn’t do after surgery. She told us, “Live your life like this surgery never happened.”

So we did. We snorkeled, parasailed and even swam with sharks. We had a blast!

A brain tumor strengthened our marriage

After Richard’s meningioma surgery, most of his symptoms improved remarkably. Since it was a benign tumor, he didn’t have to go through any further treatment. He still has issues with short-term memory loss and sometimes loses his patience. Being a physical therapist, I had the advantage of being exposed to brain tumor patients before, but it’s different when it’s your own husband.

Richard is a fighter – that’s why I fell in love with him. He survived childhood leukemia and still hasn’t given up. He may fall and stumble, but will always stand tall.

Although I can’t understand exactly what he’s going through, I’ll always be here to ease his burden and help him. I’m his wife and his motivator. If we’ve survived a brain tumor and all the physical, emotional, social and financial consequences, then there’s nothing we can’t surpass, as long as we do it together.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Stage IV melanoma survivor: Immunotherapy clinical trial gave me my life back

I was diagnosed with stage IV melanoma in December 2014, a year after I had a cancerous mole removed from my left calf. I thought I was done with it.

Then I felt a lump in my groin while shaving my legs when I was 20 weeks pregnant with my second child. A lymph node biopsy revealed the melanoma was back, but it appeared to be confined to that one area. Not wanting to hurt the baby, I deferred any additional scans or treatment until after I delivered. A PET scan taken the day my son was born showed the cancer was also in my liver, spine and other places. When I heard the results, my daughter was two and my newborn was only a week old.

I went to one of the larger hospital systems for treatment, but the chemotherapy they recommended didn’t work. All of my tumors were still growing. The doctors there told me to enjoy what time I had left. But having such a young family, I couldn’t accept that prognosis.

Instead, I found a clinical trial at MD Anderson that combined targeted therapy and immunotherapy. It saved my life.

Why I chose a clinical trial for my melanoma treatment

I knew I was in the right place at MD Anderson when I first met with my oncologist, Dr. Isabella Glitza. She started my appointment by simply listening. Then, she sketched out a list of all my options and explained each one, as well as its risks and benefits. My husband and I picked the one we thought was best: a clinical trial yielding tremendous results for people with my exact type of cancer.

Fortunately, I qualified to participate, so I enrolled in the clinical trial in March 2015. But I only made it through three of my four scheduled IV infusions of ipilimumab and nivolumab. My doctors thought the severe diarrhea I developed might be colitis, a known side effect of those drugs, so they took me off the trial.

I was devastated. I thought for sure I hadn’t received enough of the drugs for them to make a difference. But my first scans in May 2015 showed a 95% reduction in my tumors. And by November 2015, I showed no evidence of disease at all.

Cherishing the time I never thought I’d get

I’m not sure I can adequately express my reaction to finding out my cancer was gone. It’s hard to explain how grateful I feel just to be alive. I literally fell asleep smiling that night.

I didn’t go into the clinical trial hoping for a cure. I thought if I could just stretch out my time with my husband and children a little, that would be enough. So, when I was told I was essentially cancer-free, I couldn’t believe it. It wasn’t even a possibility that had crossed my mind.

Since then, I’ve finished grad school, celebrated birthdays and holidays, and watched both of my kids perform in plays and gymnastics. Those are all things I never thought I’d have a chance to do. So the last four years have been amazing.

Could I be teaching the next Nobel Prize winner?

I’ve since learned that Nobel Prize winner and MD Anderson immunotherapy researcher Dr. Jim Allison is responsible (at least in part) for my survival. It was his research that led to the development of ipilimumab, which was approved by the U.S. Food and Drug Administration for the treatment of my cancer just a few months after I left the clinical trial.

I like Dr. Allison’s story because he seems like such a normal guy. And anyone who comes from a small town and plays in a band can’t be bad, right? Sometimes, I look around my own small-town classroom and think, “Could one of you be the next Dr. Allison?”

That’s why I’ve started sharing his story with my students. I think it’s one that young people can really learn from: it’s about not giving up and believing in yourself. Dr. Allison trusted his gut with his research, and because of that, he’s saved many lives — including mine.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

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