I had a stereotactic biopsy in 2/08 for calcifications. I had a severe hematoma from the procedure, which necessitated a trip to the emergency room shortly after I got home from the procedure--I lost a lot of blood from the incision site and had incredible pain. Two days later, my pain and the bleeding resumed and I had to go back to the ER. I had a blackened breast engorged with blood for two months, and the wound refused to heal. I oozed blood from the incision and the nipple for six weeks. The end result was a permanently extremely tender area that has been variously described by disparaging surgeons and radiologists as a chronic hematoma, a fat necrosis, fibrocystic disease, or even possibly a damaged nerve surrounded by scar tissue.
Since that time, I have severe pain whenever clothing, especially a bra, touches the site. It's in the front of the breast, so just lifting my arm slightly increases the pain as my clothes pull against it. I finally found a bra that I could tolerate for short periods about a year later ("Assets" Body Shaper by Target--almost like a camisole that spreads the support over your whole torso, so you have support without compression on your breasts). My pain increases with physical activity, especially if I'm using my arms. I randomly have incredibly strong pain in that area, shooting up my arm, which is possibly weather-related. I have several large cysts nearby--if they are acting up as well, I can't do anything other than lie on the couch with ice packs. I have given myself "freezer burn" from over-icing numerous times, since, when I'm really suffering, I am icing almost constantly. I've tried moist heat as well. It seems to help while the heat is applied, but afterwards the area is swollen and tender. When I ice, I am more likely to get symptomatic relief for a longer period.
I started asking for help with the biopsy the week after the procedure. No one would do anything except tell me, "Wow, that's a massive hematoma." After my second ER visit (when they gave me 20 vicodin to take home), I have not received any painkillers until recently. I have survived the last two years by taking dangerous amounts of OTC painkillers, approximately 8 Tylenol and 10 Aleve every day, plus Vitamin E and evening primrose oil (large quantities), supplemented by icing. When I leave for work, I pack several icepacks in a cooler to stuff in my bra during the day. I also have instant icepacks in my car (ACE brand is the best and available by the dozen at Amazon). Exercise is out of the question for me now; I was formerly very active. I have had to cut my hours at work in order to get through the day.
For almost two years, I have been arguing with surgeons (7 so far) that this was a botched biopsy and the affected tissue along with the clip needed to be removed, and/or I needed a chronic pain referral. I finally found a surgeon who put me on tamoxifen for breast pain, which helped my cyst pain quite a lot. Good luck to you if you want to try to get that medication—it took a lot of fast persuasive talking on my part, and I had to put up with a lot of eye-rolling.
When this surgeon wanted to do two more stereotactic biopsies on me, I went to Mass General and got a second opinion out of pocket. At Mass General, they nixed the biopsies as unnecessary and found a local breast surgeon at a major hospital closer to me (who takes my insurance). She was caring and sympathetic, agreed to continue the tamoxifen Rx which appeared to be helping with my cyst and fibrocystic pain fairly quickly, and recommended a trial of acupuncture to see if we could avoid surgery. The tamoxifen also was able to eliminate hormonal variations as the source of pain at the biopsy site, since almost all of my other breast pain diminished greatly with the addition of tamoxifen. The acupuncture was not effective for my pain. However, I have not been helped by acupuncture in the past; you might have better luck than I did.
Today I saw my newest surgeon for the second time. We have scheduled an excision of this scar tissue (with needle localization, which is frankly terrifying) for two weeks from now. I am hopeful that this will be an end to my nightmare. I am of course worried that the excision might make me worse, but I have been so angry and frustrated about this that I don't think I have a choice.
Some advice: if they say it's hormonal, ask for a trial of tamoxifen (or danazol if you think you can live with the side-effects--I couldn't take the chance of a permanent voice-change because it would have ruined my career). If it's hormonal, tamoxifen might help, and you will avoid unnecessary surgery. But...doctors in the US are incredibly reluctant to prescribe tamoxifen for this purpose, even though it's been proven over and over again to be effective for breast pain, and is the standard-of-care in other countries. There is a side-benefit to tamoxifen that it reduces your risk of cancer, which I was happy to get, since I will always be reluctant to do a biopsy from this point forward. There are serious risks to tamoxifen use, although your risk of the most serious (deep vein thrombosis) is only increased from 1% to 2%, assuming you have no other risk factors. Look it up for yourself before you ask for it and see if the risks are acceptable to you.
If you aren't getting answers or help from your surgeon, you probably need to go to a major hospital, in a big city, especially a teaching hospital. I do think it makes a difference to go to a woman doctor if you are talking about breast pain. I doubt a man would ever take a problem with a marker seriously.
At Mass General, they told me that severe hematomas like this are quite common, and that many woman opt to do an old-fashioned excisional biopsy instead of risking a repeat hematoma if they ever need another one. I can't find the study off-hand to cite the statistics on hematoma formation after stereotactic biopsy, but it's significant, and I think that there are also problems with the markers that have been pooh-poohed by the medical establishment.
The conspiracy theorist in me says that stereotactic biopsies cost less than an excisional biopsy, and is thus being pushed by our insurance companies. We are being sold on this procedure by the doctors telling us that it will leave a smaller scar...however, the exterior result of mine (probably because of all the blood oozing) is a pencil-eraser sized, raised keloid scar, not what I call an acceptable cosmetic result for a "needle" biopsy (my newest surgeon offered to fix that scar at the same time without my asking...she really is a prize).
If she hadn't agreed to excise this tissue, I was prepared to start going to plastic surgeons, or even a medical travel company where the doctors work for you, instead of an insurance company. I've done tons of research on this, and I believe there are many more problems with stereotactic biopsies and their markers than we have been told. There's certainly no long-term studies on what a titanium marker in your breast for 30 or 40 years is going to do to you. And I think it's egregiously insulting to tell us that they need that marker for subsequent scans: this is for their convenience, not necessarily for our health.
Do not accept pain. Fight back and demand help. I have almost given up on living so many times since this nightmare started, but I think I finally found a surgeon who cares about breast pain enough to help me get my life back.
I might consult a lawyer, although I'm not sure liability is clear in my case. I do think there needs to be more scrutiny of these biopsies. Almost all my friends have had one (we are in our mid-40s). None of us had cancer. I know in my case, I felt coerced into having that biopsy. There was actual pressure, specifically designed to frighten me into having this procedure. I know some women are very upset about the new guidelines for mammography, but an earnest discussion of risks, benefits, and limitations of our current cancer diagnosis practices is long overdue. There needs to be more transparency of what the statistics actually mean. We are biopsy- and scan-crazy in this country, and chronic pain is criminally undertreated.