Recurrence following PBMs?

amythol

Since I had no responce to my previous post and I am really feeling anxious, I wanted to try again and beg for your mercy. If you can answer any of my questions at all, I would be so grateful.

I found a lump two years ago and had a core needle biopsy. I was told I should just leave the mass in my breast, that it was not likely to be malignant. I opted to have a lumpectomy anyways and LCIS was found in the surrounding tissue. I am the mother of three children with a rare, terminal genetic disorder and their primary caretaker, so I opted for prophylactic bilateral mastectomies, with DIEP even though friends and family thought I was crazy to do so.

I lost my son six months after my PBMs and things have been bad since then. A few weeks ago, I found a lump in my new breast tissue and saw my oncologist who then referred me to a surgical breast oncologist. She ordered an ultrasound and a breast MRI to see how much breast tissue is remaining in my reconstructed breasts and to check out the lump I felt.

I recieved a phone call the day after my breast MRI telling me I needed to come back for more tests. The MRI detected a 1 cm mas near or as a part of a lymph node. Please tell me what you think.

Amy 

Anonymous

I honestly do not know what to tell you to think.  I am sure you are of course thinking the worst since that is how most of us do.  What does the onco say?  Obviously you are going to have to find out what it is and should do that ASAP.  I once had lumps all along my incision line and they had to reopen my insicion and find out what was going on.  I had an allergic reaction to the the ployeurythane coating on the implant which was supposed to disolve, but did not.  I always find the fear of the unknown to be worse than knowing since imagination combined with worry can lead us to all sorts of horrible worst case scenerios.  I wish you the very best and will say my prayers for you and your children.  Sorry about the cange in type here...have no idea why it changed midpost. 

NativeMainer

Mastectomy removes close to but not 100% of breast tissue, so there is a very, very small chance of recurrence after mastectomy.  Since you've had a flap reconstruction there is a very good chance that the lump is fat necrosis.  This happens when part of the transplanted fat dies and then hardens.  This is more common shortly after reconstruction but can occur later.  I'm not sure how well MRI or CT or Ultrasound can tell fat necrosis from cancer.  Everything that cannot be positively identified on a scan is called a mass, so try not to let the terminolgy freak you out more than necessary. The location of the mass near a lymph node does add to the concern, but the odds are still very, very low that this lump is a rucrrence of bc.  I would recommend that you also contact your plastic surgeon about the lump--he or she will have info on file aobut your surgery that can shed light on what it happening now. 

Mykidsmom

(((Amy))) I don't know what to tell you, I know tht recurrence is possible but relatively unusual after a PBM. but I am sending healthy thoughts your way!! Hugs.

amythol

I went back to my oncologist's office last week for another ultrasound.The nurse who greeted me hugged me and told me she was sorry. I got really scared, wondering why she would tell me she was sorry. Then my oncologist told me my MRI was worrisome.

When I got to the ultrasound room, there were some observers in the room. After all my terror,the radiologist found a lymph node within my new breast tissue.He called this a "floater" and said that my plastic surgeon must have accidentally transferred it from my abdominal tissue when doing my DIEP procedure following mastectomy. He said that it had a viable blood vessel and lit up on my breast MRI two weeks ago, causing a lot of concern at the office.

The radiologist said I will need close observation for a couple of years to watch the lymph node. I was so relieved it wasn't a tumor, I didn't ask my normal barrage of questions. Has anyone else ever heard of a rogue lymph node before?

NativeMainer

I hadn't heard of a lymph node being transfered during recon, but when I think about it I can see how it could happen.  The lymphatic system is very variable from individual to individual.  Lymphatic vessels and nodes tend to form along side blood vessels.  So it's logical that, from time to time, a lymph node gets transferred along with abdominal fat and other tissue.  I have no idea how such an occurance affects recurrance risk, but keeping an eye on it seems like a good idea.  Thanks for sharing the results!