Thickened breast tissue - Opinions pleaseee.. Thank you!!

renny85

I am going nuts everyday thinking about my sister. She is very calm and doesn't seem to care about the lumps on her left breast. She is 28 years old. She found a little grape sized lump on her left breast about 2 years ago. The doctor said it is a benign. And about a month ago, we noticed an thickened area on her left breast in the upper area. I took her to a breast specialist. They did an ultrasound and mammogram. They could see the little grape size lump but not the thickened area. They did an ultrasound guided core biopsy on the little grape size lump and it is fibroadenoma. The breast specialist wanted to do an open surgery biopsy on the thickened area as that area is not showing on both the ultrasound and mammogram. The radiologist seemed to think that it is part of her breast tissue. My sister said she felt pain on her left breast at times and a little breathing difficulties at times. And she said the thickened area seemed to decrease in size a little but no change as of right now. She does not want to do another biopsy as she thinks that it okay and biopsies are painful. I am going back to Indonesia in January. And i want her to do the biopsy before i go back to make sure that she is okay because i worry a lot. I read online and it might be part of her fibrocystic breast but it is only in one breast? And she just got her insurance about 4 months ago from Anthem Blue Cross. Will they deny an open surgery biopsy? I really appreciate any thoughts and opinions. Thank you so much!

Shirlann

Hi renny, I don't know what the insurance will do, but usually, when it is a cancer (possible) issue, they will do whatever the doctor wants.

An open biopsy is nothing.  Let me back up a little, it was nothing for ME.  I had a small cancer, close to the surface and he just injected a little novocaine, and did the biopsy, I got up and walked out of the outpatient clinic.  It was truly nothing.  But I have to add, of course, if she were to get an infection, if the lump were large and hard to find, or near the chest wall, of course, many things can go wrong.

If she is worried about this procedure, have her hop over to the metastasis thread and see what happens if you don't get on this thing when you have the option to do so.  It is not pretty.

I don't know truly, how you can jar loose her thinking, but this is such an easy thing for most of us, it is very stupid not to get this settled, once and for all.

She is quite young and the chances of having BC are very small.  In fact at any age, 80% of these "thingys" are benign.  But still.  To not do this because of fear of pain is just plain silly.

You can tell her all this, or just print off the page.

Gentle hugs, Shirlann 

 

renny85

Shirlann,

Thanks for the quick prompt reply. She does not want to do it as she feels it is unnecessary as the ultrasound and mammogram showed nothing. But i still want her to do it to make sure it is really okay. I have read that fibrocystic breast usually happens on both breast. But hers is only on one and on the same breast as her fibroadenoma. I really hope she is okay. Thank you!

nash

A thickening can indicate invasive lobular breast cancer, which is best seen on breast MRI, especially in younger patients with dense breasts. I would push for her to have an MRI to rule out ILC.

leaf

Thickened breast tissue may be a sign of an uncommon breast cancer called invasive lobular carcinoma.  It is also known as 'The Sneaky One' because it often does not show up in imaging.  It often does not present as lumps, but as thickenings. 

Breast cancer doesn't read our textbooks, so sometimes it can do unexpected things. 

I agree so much with Shirlann!  Your sister is quite young and her chances of getting breast cancer are small.  

The only way she will know for sure is to get the biopsy!! 

renny85

Is there a possibility that a thickening is a benign? Because i know it wouldn't be a fibroadenoma. I really hope she is okay. The thickening decreased in size a little. Is that a good sign? I will still push my sister to have the biopsy done. Thanks for all the inputs.

leaf

Decreased thickening is good, and is often hard to feel.  Cancer by definition means uncontrolled GROWTH, and shrinking isn't growth.  But I would still urge her to get it biopsied, especially if that's what the breast surgeon recommended!

lilsunshine

Pardon my ignorance but what is or how would you know if you had thickened breast tissue? Just asking.

I have one inverted nipple and pain in my left breast and underarm but I am not sure about anything anymore?

Bonnie

renny85

The thickened area could be felt in the upper area of the left breast. Yes i will definitely get her to do the biopsy. When i do a search on the internet, most of the topics are on breast lumps and not thickening. The breast surgeon called it the large mass instead of thickening. But my question is is there a possibility that a benign presents itself in a thickening instead of a lump? Because from what i read mostly are lumps and not thickenings. Thank you again!

Shirlann

Oh and to add to your worries about your sister, remember, mammograms are about 70% accurate, meaning, they find a whole lot of things, but they miss some too.

A lot of women's BC's were not found on a mammo.

Hugs, Shirlann

renny85

Yes i am aware that it is not 100% accurate. I just can hope and pray that everything is going to be alright. And is there a possibility if benign presents itself as a thickening /  large mass instead of a lump?

renny85

i was talking to my aunt and my aunt suggested that she waits to see if the thickening increased in size or not. She does not recommend biopsies as there are a lot of effects from any surgeries such as taking a piece of something out of your body. And since the thickening decreased in size, the biopsy is not necessary. My aunt is a nurse. I am co confused now. Does ILC grow in size? And again to my previous question, could a benign presents itself as a thickening or large mass instead of a lump? I am so sorry for my questions but i just don't know where to search anymore online. Thanks again everyone.

nash

Yes, ILC grows. It is invasive cancer. Fibrocystic changes can also present as a thickening. Please refer to my previous post where I recommend that your sister have an MRI, which is the best imaging procedure to rule out or diagnosis ILC. And your aunt is misinformed in suggesting that biopsies cause further damage or spreading of cancer.

renny85

And can fibrocystic changes appear in one breast instead of both? So should she go ahead and do the biopsy or mri? I think she should do the biopsy just to be 100% sure. And yes my aunt is a little paranoid about surgeries. Thanks again Nash!

leaf

Yes, fibrocystic changes can appear in one or both breasts.

Encourage her to get the MRI or biopsy done.  I'm a health professional too (a hospital pharmacist) and before my diagnosis, I thought all breast cancer was because women ignored their lumps.  I didn't know....

Most likely it is benign.  But go further with an MRI or biopsy to get it checked out.

There are a few instances of *possible* seeding with breast cancer in the literature. These women may not have had standard breast cancer treatment. This is a  POSSIBLE handful out of several MILLIONS of women who have been diagnosed with breast cancer.  After a biopsy of a cancerous breast tissue, probably some cancer cells are dislodged.  But most of these breast cancer cells seem to die on their own, and the others would be killed by radiation or chemo or mastectomy (the usual treatments for invasive breast cancers.) Seeding probably does occur with some OTHER cancers, but it does NOT seem to be a worry for breast cancer.

 So the moral of the story is that *if* she is diagnosed with invasive breast cancer, and that's a big IF, then get standard treatment.

Beesie

Thickened breast tissue is very common for those of us who have fibrocystic breasts.  And it's not unusual to have different amounts or different areas of thickening in each of the breasts.  If the thickened area is your sister's breast is painful - and particularly, if it is more painful prior to her period and less painful afterwards - and if the thickened area changes in how it feels (i.e. more 'solid' feeling or a larger area before her period and a less solid feel and/or a smaller area after her period) then it's most likely simply a symptom of having fibrocystic breasts.  If that's the case, then it's benign and totally harmless.

While some of us (lucky me, for example) have thickness and other symptoms of fibrocystic breast condition from the time we are teenagers, most women with this condition aren't affected until they are around 30.  So with your sister being 28, it makes sense that this condition might just be showing up now. 

Because this is a breast cancer website, when someone shows up here with any strange symptoms, we automatically think "breast cancer".  And certainly, thickened breast tissue can be a sign of ILC.  But ILC is unusual in younger women (it's most common in women in their mid-50s and older), whereas thickened breast tissue that is a symptom of having fibrocystic breasts is very common.  Additionally, as others have said, breast cancer grows - the nature of cancer is that it is an uncontrolled growth - whereas the symptoms associated with having fibrocystic breasts tend to come and go, or at least, sharpen and lessen over the month.  So it certainly seems a lot more likely that your sister's condition is related to having fibrocystic breasts, and that is a benign condition.

Personally, if I was in your sister's shoes, I would not want an open biopsy either.  I agree with the suggestions about getting an MRI.   If the MRI shows an area of concern, then a biopsy probably is necessary.  But if the MRI comes back clean, then personally I would wait another few months to see if the area of thickness changed with my menstrual cycle.  I'd also ask for a 6 month follow-up ultrasound and doctor's assessment.  If all the tests are clear, if the thickness varies over the course of a month or two, and if the 6 month follow-up shows no changes, then I think the doctor would probably be quite comfortable giving a diagnosis of "fibrocystic breast condition".

Here are a couple of articles about fibrocystic breast condition.  You can see if the symptoms mentioned here match your sister's symptoms:

http://www.medicinenet.com/fibrocystic_breast_condition/article.htm

http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/000912.htm

And for your information, here is a website link with a full description of ILC:  http://www.mayoclinic.com/health/invasive-lobular-carcinoma/DS01063

renny85

Leaf and Beesie, thank you so much for your clarification. I really appreciate it very very much. Yes the thickening is a little smaller compared to two months ago when we see the breast surgeon. Yes i think i will make an appointment for her to get an MRI done. Is MRI 100% accurate? Because i think an MRI is far less invasive compared to an incisional biopsy and i am sure my sister will be far more comfortable. Thank you again!

renny85

And the breast surgeon called it a "large mass" instead of thickening. But i felt it as a thickening.

Beesie

Renny,

No, an MRI isn't 100% accurate - nothing is except a full surgical biopsy.  But MRIs do tend to be the most sensitive of all the non-surgical diagnostic tests.  And it's particularly good for dense breasts, which most young women and those with fibrocystic breast condition tend to have.  And yes, an MRI is completely non-invasive.  I've had a couple - in mine, I had to lie on my stomach with my breasts positioned in special holders and then I was slid into the MRI machine feet first.  I'm claustrophic but because I was on my stomach and my head was at the front of the MRI tube, I was able to rest my chin on my arms and look out, so I never had a problem being in that tight space.  The MRI took about 45 minutes, is very noisy and you have to stay perfectly still while it's being done.  Part way through you are injected with a dye.  Not the most fun way to spend an hour, but totally manageable.  

vhqh

I had no palpable lump, what I did have was skin fixation, an inverted nipple and a thickening that only I could feel, neither my PCP nor the surgeon could feel it.  Please urge your sister to follow up with at the very lease a MRI. 

nash

And as far as age and ILC, I was 38 at diagnosis, and based on tumor size, it had probably been growing since I was about 30.

It's good that your sister's thickening has decreased--it most likely is fibrocystic changes--but nothing in breast cancer is absolute, and it's better to rule things out than to ignore them. You're a very good sister to be advocating for her. Keep us posted.

renny85

Thank you everyone for your inputs. I will for sure get her to do either an mri or surgical biopsy. I am going to call the surgeon tomorrow to see what she suggests. Thank you again!

nash

One other thing, renny--if the MRI shows an area of suspicion, your sister should be able to have the area biopsied via core needle biopsy, rather than surgical excision.

renny85

Okay thanks. Could the MRI differentiate if a mass is benign or cancerous? And how long does it take to know the results? Because with the ultrasound and mammogram, we can know the results right away. Thank you!

nash

Renny, the MRI can give the docs a good idea of if an area is suspicious for malignancy or not. MRI's do give a lot of false positives, though, which is partly why they are not used for regular screening. Here's info on breast MRI from this site (sorry I can't post a live link with my browser):

http://www.breastcancer.org/symptoms/testing/mri.jsp

I doubt you would have MRI results right away, but it depends on the imaging center. I had to wait a couple of days for my MRI results (I already knew I had bc off of ultrasound and core biopsy, though). But I've always had to wait for mammo and u/s results, so maybe your imaging center is different than mine and can give the MRI results right away.  

renny85

Nash, thanks so much for your help. I really appreciate it. How is yourself doing right now? I hope and pray that everything is okay for all you ladies here too.

dryan

I have had a problem with fibrocystic breasts for ever.  A couple years ago I noticed a spot on my left breast and we've been watching it.  Extra mamograms and such.  This year I noticed a difference and when I went in for my mamo so did they and they took a LOT of extra shots.  When the radiologist came in and said she'd highly recommend a breast MRI I was totally freaked.  Any way I did have one and it showed nothing on my right side where I've had the issues but it showed 3 other spots that they felt were benign and should just do a follow-up with then in 6 months.  Thus no answer to what I'm feeling on the right side.  So my doctor referred me to a surgeon and he couldn't believe that what I was feeling wouldn't be showing up on the MRI when it was on the mamo and he definately could feel it so we did a biopsy.  Diagnosis was just thickened tissue - after reading all this I'm even more nervous to get the biopsy results back.

nash

Dryan, odds are in your favor that your thickened area really is just a thickened area of fibrocystic changes. ILC tends to show up very well on MRI and not so well on mammo, so it's fairly unlikely that you've got ILC if your MRI was OK. Of course, biopsy is the only was to tell for sure, so it's good that you've had that done. Keep us posted on the results.

Renny, you're welcome. I hope I've been able to give you and your sister some direction. I feel like if nothing else, my experience with bc allows me to help others navigate through the medical mazes one is up against. My late Stage IV bc mom just passed away in February after 5 1/2 years of active treatment, so between her situation and mine, I know more about than the disease than I really care to. Physically I'm doing better than six months ago--I finished chemo last December and radiation last February, and now I'm on Tamoxifen. Overall I'm doing fine.

conniehar

Another vote here for an MRI.  I was dx'd in Mar 07 with ILC after finding a thickening myself.  The mammogram and ultrasound showed nothing.  I had three radiologist techs looking at me and the main radiologist told me she could not see anything but that she definitely felt what I felt.  She sent me to a breast surgeon who sent me for an MRI.  The MRI could see the mass and I had a core biopsy to confirm.  I was 39 at the time.

Chances are it's nothing, but I wouldn't let it rest without an MRI.  Best wishes for your sister. 

LUVmy2girlZ

I too had "thickening" and pain...I didn't feel a lump.  I later had discharge and a "suspicious" lymph node that ended up being reactive in nature.

MRI and later a biopsy confirmed it was DCIS as well as the final pathology. 

I have a dear friend that has a breast abscess and has to have hers aspirated or "drained" a non-cancer related symptom that she has on an occasional basis. She too experiences thickening and discharge.

This could be a number of reasons why the thickening is present...as everyone suggested. Be your best advocate.

BEST of Luck and do keep us posted !

Much LUV 

renny85

Nash, I am so sorry to hear about your Mom. I am glad you are alright.

Dryan, does your result show thickened breast tissue due to fibrocystic condition? I hope you are okay too.

Conniehar and Luvmy2girlz, I hope you guys are okay too.