Mammogram and CRT pacemaker.

Recently found a lump under one nipple and of course, its on the same side as my bivent pacemaker.

 

I'm wondering if it wouldnt be better to have an ultrasound but it wont be me making the decision, it will be a breast clinician.  Am quite concerned about the mammogram, as there is not much flesh there and the pacemaker itself, flops about in the pocket.  Also, that they might pull on the third wire, which is keeping me alive.  If they disrupt that, I'm a goner.

 

Then, there's the damned lump.  Hoping for a cyst but it doesnt sound good so far. 


11 Comments

Idea

by Pacemaker_Sally - 2019-11-30 00:14:06

I totally understand and share your concerns. Fortunately pacemakers are really common and they will know what to do and not do. 
Can you call the mammography clinic before your appointment and talk to them? Make a written list of questions before the call and write down their answers. 

MAMMOGRAM

by Gemita - 2019-11-30 06:03:22

I recently tried to ask for an ultrasound because I had two devices left chest (pacemaker and Reveal Linq implanted monitor - latter now removed).  I am in the UK.  I have very dense breasts and an ultrasound I believe would be more sensitive at picking up abnormalities for me personally.  However, my clinic didnt agree and only offered a mammogram which I failed to take up as part of my regular screening programme.  A mammogam for me is extremely uncomfortable and I was also fearful of damaging my pacemaker too. 

They reassured me that they successfully and safely do many many mammograms on pacemaker patients and that a breast mammogram is the best initial screening tool to detect early breast cancer.  A follow up ultrasound and/or MRI may then be used for further information, if abnormalities are found.

I do hope all goes well for you and that you will have benign disease.  Have confidence in your doctors, they will do what is best for you.

screening

by Tracey_E - 2019-11-30 11:13:01

I am on my 5th pacer and have an extra lead (dead, capped off), the first 4 were placed under the breast so I've got all sorts of scar tissue and my xray resembles a bow of spaghetti. I usually end up with both mammo and ultrasound. Just make sure the tech knows the pacer is there before they start, they do this all day long. The first time I had one they did one very gentle scan to see where the hardware is, then the full scan. I always go back to the same place so they have the previous ones to compare.

If you need a biopsy, have it done at a breast surgeon rather than a radiologist. They are better at working around obstacles. I had a biopsy last year and that's what my ep suggested. I did a remote pacer report before and after the biopsy just to make sure the leads weren't affected. The surgeon knew exactly where my leads were and he went in so that he didn't get close to them. 

Good luck!!!

Third wire and mammogram

by Gotrhythm - 2019-11-30 19:06:53

I double checked before writing this reply.

According to your bio, your pacemaker/CRT was implanted in 2016.

At this point, the "wire" is going nowhere. It is embedded to such an extent it would take laser surgery to dislodge it. Nothing is going to accidentally pull it out.

I know you're concerned about the lump--who wouldn't be--but don't waste anymore precious emotional energy worrying that the mamogram could dislodge a lead.

Thank you

by Bionic Beat - 2019-12-01 21:47:03

Thank you for the replies.

 

I am much more concerned about the third wire and their ability to dislodge it than the lump.

The wires can be dislodged, that's why you have limitations on what you can do with CRT.

I am, obviously, hoping the lump is benign but it is what it is.....being paced 100% of the time, its crucial that no one dislodges that wire.

Shall give my cardiologist office a call tomorrow and see what he says about it all.

He might prefer the ultrasound and they'll listen to him.   

Thank you again.

 

Bionic Beat

 

Mammograms/ultrasounds

by Bionic Beat - 2019-12-01 21:53:00

Gemita, I also asked to have an ultrasound instead of a mammogram due to other issues and long before I had a pacemaker.

The answer I got was 'the gold standard of care is a mammogram followed by ultrasound if needed'.  

I had had a dreadful experience and purple breasts with welts but the head doctor was not about to make an exception.  I stopped going for screening, even though I had spent years at the high risk clinic and knew the doctor reasonably well.  

That was in Toronto.  I guess Gold (standard) and purple (breasts) are royal colours, eh??  lol

 

ROYAL COLOURS

by Gemita - 2019-12-02 09:43:34

Hi Bionic Beat,

Ha ha, I love the colour purple, but not when it is forced upon me from metal plates !!  I bruise all too easily these days from even the slightest bit of pressure.  (I am on anticoagulants).

I am holding out until I can get the imaging of my choice too.  Because of your lump I would think you are in a much better position to demand what you want, especially if you refuse to go ahead with any investigation that involves a mammogram.  Good luck

Hi Gemita

by Bionic Beat - 2019-12-02 16:08:31

Just left a message with my Cardiologists office.  

Said if he preferred the ultrasound, that would be wonderful.   lol

The breast doc will stick to her guns re: mammogram, unless he says otherwise. 

Fingers crossed.

I will be quite nervous if they want to do the mammogram.

Have thought about having my GP order an ultrasound outside of the hospital setting but it may be a waste of time.  Might ask though.

 

Hi Bionic Beat

by Gemita - 2019-12-02 17:49:57

Oh please let us all know how you get on.  I hope your cardiologist is intelligent enough to realise that you would prefer the ultrasound.  Let us hope for a positive outcome xx

Qualified Mammographer

by Marmite - 2019-12-03 09:14:55

I've had two mammograms since having a PM. The second time I was provided with an apology that I hadn't been given the ' pacemaker qualified mammographer'. Didn't know such a person existed, but she was very careful and knowledgeable.  Would your clinic have anyone who has specialist knowledge?

A friend of mine had an ultrasound to guide a fine needle biopsy of a similarly located lump behind her nipple. Admittedly, she doesn't have a PM, but given that benign cysts are the most common finding this procedure would help rule out a common cause of breast lumps. 

If you had that first you would also have had the opportunity to discuss your concerns if a mammogram was suggested afterwards.

the Mammogram is a 'Go'..

by Bionic Beat - 2019-12-04 15:58:43

Cardiologist says mammogram is the way to go.   bah!   lol

marmite, very good to know, will ask in advance.  Thank you for the information.

I've had lumps for years and have had biopsies galore but this one is 'different' in that it is attached to the nipple tissue or something nearby.

Its also been a long time since I've had one, they were during my fertile years.

As long as it doesnt bother the wires, I'm fine with it, just not looking forward to it at all.

Fingers crossed its benign.

 

Bionic Beat

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