lump after flap reconstruction. freaked out.

CandDsMom

Sooo, I am trying to stay from the "bad place" but went in today to get lump checked out. I noticed it over the last few months but put it out of my mind - there has been so much going on at home and at work, and I have been recovering from my 5th surgery in the last year so I think mentally I just shut it down.  Anyway, when I was showering last week I noticed it again, and it feels bigger, and harder.

It is an area that sits under the skin, not mobile, the surface of it feels smooth but it seems to either be adherent to my flap (had a free TRAM done) or is a part of my flap.  The edges feel a bit irregular.  I have also been having some achiness and itching in that area of my recon breast (could just be nerves regenerating I guess, but why all of the sudden now?) as well as a feeling of fullness in my right axilla (I do have some minor LE which I guess could account for this).

The rational part of my brain says "flap tissue can't grow breast cancer since it is transplanted stomach fat". The irrational part of my brain says "well, it could be a recurrence in the skin on top of the flap"

Either way, I am freaked out.  I know rationally it is probably an oil cyst or area of fat necrosis, but I just want all this to stop!  I am over a year out from diagnosis, but today going to my onc's office I felt like I was having flashbacks to last year.  My Onc is proactive and great, but she does feel it needs to be imaged and probably biopsied.  And I know I am at a higher risk of local recurrence given that I had multifocal/multicentric disease to begin with. 

So the waiting begins again I guess...this sucks.

lovetosail

Hi - I'm sorry to hear that you're having to go through all this again.  I recently had some similar symptoms and had a mammo and U/S on my flap.  I was fat necrosis.  The good thing about this is that the radiologist can tell that right away, without a biopsy, and that's nice in that we get to avoid the waiting game.  I am keeping my fingers crossed for you that you'll find that this is something benign and get to put all this behind you after your imaging!

dlb823

I also had a lump that turned out to be fat necrosis.  Your PS and/or BS should be able to feel it and reassure you, but it's best to have it removed and biopsied, as your onc is suggesting, just to be on the safe side.  

So sorry you're going through this, but hopefully, it's similar to what lovetosail and I both had.  Also, the achiness and itching sounds pretty normal if you're still recovering from a recent surgery.  I had some persistent, stabbing pain that freaked me out around a year post-surgery, and I was told it was nerve regeneration, and that it can happen up to 18 mos. out.  It eventually went away.     Deanna 

CandDsMom

Thanks so much. I am just waiting to hear if next step will be mammo with US or MRI. Am not too excited about squishing my flaps after I had to have 5 surgeries in the last year to fix up the nightmare my idiot first PS left me with.

Thanks for talking me down. Fingers crossed!!

Shrek4

I had the same thing, twice, and freaked out like you do now (esp because I had skin-sparing MX). Breast surgeon and PS told me that it was just scar tissue, but did a biopsy of the area and ordered a pathology at the time of my next revision. And it was like they said: scar tissue. The flap forms scars as well, that is, the muscle tissue underneath the skin. Slowly one of them disappeared (did a lot of massaging) and the second one is about half the size it was.

Btw, I don't know how your BS is, but mine told me "no more mammograms for you" so I'd think it will be an MRI.

CandDsMom

So, not totally the news I was looking for. It does not look like an oil cyst/fat necrosis based on ultrasound and spot mammogram. The radiologists at my NCI center are adamantly against MRI but I finagled an order for one out of an internist friend.



In the meantime, my onc recommended that i follow up in the breast surgery clinic for discussion of core biopsy vs excisional biopsy. I think I will try to schedule the MRI first. If it looks like fat necrosis on MRI then maybe I can avoid someone sticking needles into my flap.



The good news was that the axillary nodes (have been having a lot of achiness and some swelling there) look fine.



Thanks for your responses...

nikola

Ask for MRI. I just got my results and it showed fat necrosis.