Pain is one of those things we all fear, isn’t it? Whether it’s a sharp jab or a dull ache, the idea of something hurting can often feel worse than the reality. Anxiety feeds into it, making the unknown even scarier. I’ve learned that over the last few years of navigating breast cancer.
Today, I want to share my experience with a needle biopsy done a few days ago—not to dwell on the pain, but to help others face it with less fear. Because here’s the truth: while medical procedures can intimidate, they’re not always as painful as we imagine. And understanding what to expect can make a world of difference.
I began this online journal a few months after I was diagnosed with stage 1 breast cancer and shortly after my lumpectomy in 2021. That is, after the biopsy of the mass showed that it was triple positive and the treatment regime would be a lot tougher than I had anticipated (explained in Why this Journal?). Hence, I did not write about the first time a needle biopsy was done, and frankly, it was a nothing-burger in the big scheme of life.
But today I’ll share the process and my experience of it, intended for those following my health journey and others who may face this procedure and are wondering what to expect. And if you have any fear of needles or medical procedures, I hope this post will allay it and boost your courage.
Courage is resistance to fear, mastery of fear, not absence of fear.
Mark Twain
For this night owl and her honey, getting up before 6 am to drive into the city for the early morning appointment was perhaps the hardest part of the day. LOL.
Preparation
The procedure was done at the BC Cancer Agency in Vancouver. Knowing the steps helped me feel more in control, and I hope it does the same for you.
The technician asked me to remove all clothing from the waist up (in a private cubicle) and put on an all-cotton light blue hospital gown with the opening at the back.
In the ultrasound room, he asked me to lie down on a surgical bed and open the gown to expose only the affected breast. My arm was raised over my head and made to rest on a pillow. He cleaned the breast with an antiseptic solution to prevent infection, then covered it in gel to start the imaging. He spent about 7 minutes scanning to locate the suspicious area. Then he called in the doctor.
The doctor lifted the right side of my body up slightly with a pillow, so I was not lying flat nor fully on my side. She injected local anesthesia into my breast to numb the area. The injection stung just a little, but I won’t call it pain.
Procedure: ultrasound-guided core needle biopsy
The doctor used ultrasound imaging to guide the needle into the right spot for the abnormal area. It was shown to me on the screen.
(Other guide procedures doctors can use to do a breast biopsy are a special mammogram or an MRI.)
In my case, the core needle biopsy process involved the use of a spring-loaded tool attached to a hollow needle to cut and collect tissue samples. (Alternatively, in a vacuum-assisted core biopsy, the needle is attached to a suction device that helps pull tissue into the needle.)
The needle was inserted six times, all at the same entry point. The moment it cut a tiny specimen (core) of the suspicious mass or breast tissue, I heard a loud “clack,” and she warned me each time. But I felt absolutely no pain. I only felt the light pressure of the ultrasound scanner against my breast.
Pain nourishes your courage…[]… You can’t be brave if you’ve only had wonderful things happen to you.
Mary Tyler Moore
The next step in this part of the process was to insert a small metallic marker (clip) at the biopsy site to help locate the area in the future if needed. I asked whether this would hamper future scans (when they always inquire whether you have any metal in your body) and no, she said, it doesn’t interfere with either scans or metal detectors.
Since I am allergic to the usual transparent medical tape and I don’t tend to bleed, the doctor covered the entry point with a simple Band-Aid.
The technician then led me (and carried my bag and clothes) to the mammogram room, where a low-pressure mammogram was done to confirm the marker was in the right place. It was.
This all took no more than an hour and a half.
A note about pain
Knowing the technical side of things in advance can bolster our confidence. But I suspect most women want to know more about how much does it actually hurt?
I am thankful my body has tolerated well just about every test and treatment of the last three years. Some discomfort felt; some adjustments to our life plan made.
But no unbearable pain—not physical, mental, or emotional.
And thus it was with this needle biopsy. No pain. This puts me in the 39.7% of women who in one study reported no pain. 48.5% experienced mild pain (1-3 out of 10), and 11.8% reported moderate-to-severe pain (≥4 out of 10).
I feel a minor discomfort in my right breast, but not enough to take a pain-killer, as suggested by the doctor who did the procedure. She rattled off a list of names of what not to take, but the only one I remember is the one prescribed: over-the-counter Tylenol, a brand of acetaminophen.
It’s interesting to note that besides younger age, a significant predictor of greater biopsy pain was higher anticipated pain before the procedure. My guess was that when a person goes into a procedure with anxiety, the body is tense and adds physical resistance to the process, causing increased pain or perception of pain.
I then found several medical studies that highlight the influence of fear of pain on pain perception. They concluded that high levels of pre-procedure anxiety can increase perceived pain intensity, contribute to discomfort during medical procedures, and affect postoperative recovery and pain.
‘Anticipation of pain leads to fear, and fear amplifies pain,’ he says. ‘Expectation of relief from pain increases the opioids in the brain, makes the hurting stop. How your mind reacts to pain determines how much pain you actually feel.’
Gregg Hurwitz, Orphan X
Managing anxiety
There are many simple, no- or low-cost ways to reduce pre-procedure anxiety. Or any anxiety, for that matter. Let me list just a few, but they all boil down to taking your mind off your fear or anxiety, distracting you from stress, and helping you to relax.
- Do something creative: make collages, draw, paint, color adult coloring books
- Motion is lotion: yoga, walking, stretching, swimming
- Enjoy the outdoors: take nature walks or garden
- Practice mindfulness or meditate
- Write about it: journal, use a worry or gratitude box/jar
- Engage socially: play games, visit a good friend
If you want to learn more about pain, a good place to start is the TEDxAdelaide Talk (2011) about why things hurt by Dr Lorimer Moseley, neuroscientist and pain expert. He says—and explains:
Pain is a construct of the brain—100% of the time.
And Lauren Cannell offers a new way to think about pain in her recent TEDxHobart Talk (2023).
Why did I need a biopsy?
It’s been three and a half years since I was first diagnosed with a malignant tumor in my right breast. It was palpable; I could feel it with my hand. And it’s been just over two years since the tumor in my eye was discovered.
Over that time, I’ve undergone four PET and/or CT scans, three MRIs, and various other diagnostic tests, all recorded in this journal.
Why so many tests? Because, being triple positive and having had two cancer sites, I’m at a high risk of a recurrence. I’m grateful to be living in a country with universal healthcare and where the follow-up care is excellent.
I wrote in my previous post that I was waiting to hear the results of a contrast-enhanced mammogram I had undergone to follow up on the earlier PET scan with a nonpalpable abnormal finding on my right breast. Those results, too, were vague, but suspicious enough to warrant the needle biopsy.
The lab result may lead to another cancer diagnosis. Or it may lead to a diagnosis of a benign mass or microcalcification from radiation treatment. I’m rooting for the latter. And I’ll find out in about two weeks when I meet with my oncologist.
Everything is okay in the end. And if it’s not okay, then it’s not the end.
Domingos Sabino
Having gone through this procedure before, I had no concerns or anxiety going in. But if you have more questions, ask your doctor, or ask me in the comments below.
A brief comment about the tumor in my eye. I met with my ocular oncologist two weeks ago. I underwent all the same diagnostic tests as before. The tumor has flattened out some more. When asked whether it’s still malignant, she said, “By definition, cancer is the uncontrolled proliferation of cells. That’s not what’s happening in your eye now.” Hurrah for my eye.
I end this post with one more quote:
One isn’t necessarily born with courage, but one is born with potential. Without courage, we cannot practice any other virtue with consistency. We can’t be kind, true, merciful, generous, or honest.
Maya Angelou
Whatever procedures we must face, let’s be brave and make this our best year ever!

Francisca, thanks so much for keeping us all updated here.
Thanks for walking your talk even when there is uncertainty – not easy to do, but you are our shining example that it is possible. Making the best of even the most distressing circumstances is not easy but you are definitely doing it! Carry on!
Much love to you and Lordson, and yes, let’s hope for all that is good in the New Year and the courage to walk through all that is not.
Thank you, Seema. There are many ways life challenges us, aren’t there? And having courage, not catastrophizing, and handling any anxiety that does arise, makes the journey easier. Much love back to you. 🌸💜🌸
Thanks for this. Your nothing-burger mixed metaphor made me laugh, and who expects to laugh while reading this topic? Love you friend!
Hehe… we agree laughter is the best medicine. Love you back Judi. 🌸💜🌸
Hurrah for being brave – and objective, Ciscs.
Many others will doubtless benefit from your detailed documentation of your cancer treatment process.
I can only sit back and hug you in my heart.
Thanks, Gigi. Big hugs right back! 🌸💜🌸
Keep up the good spirits sweetheart and keep us posted. You are in my prayers and thoughts lots of hugs and kisses love ❤️ Rebecca
Right back at you, Rebecca. 🌸💜🌸
You are amazing and thoughtful to all to express yourself and share all of your experiences and journey with everyone. It is very helpful and encouraging and educational to all who are experiencing or are struggling with the same thing. Thank you for sharing. I know firsthand how difficult this is because of the experiences I have shared with friends and family. You are an incredible lady Love ❤️ you your cousin Rebecca.
We should talk one of these days, Rebecca. Love you back, cousin. 🌸💜🌸