fibroadenoma developed after surgery/radiation

Coco50

I am over a year out from surgery/radiation and a 3D ultrasound picked up a fibroadenoma near the surgical site.  It did not show up on my mammogram done a month prior (June 2013).  Not sure what to make of this.  Has anyone else had the same thing, and if so, what was the outcome?  i had the discussion with the radiologist Friday afternoon so I get to stew about it this whole weekend before I can reach out to my onco to discuss it.  This waiting and wondering is a killer.  Radiologist says standard of care is watch every six months for a few years but, uhm, I'm thinking bx but I'm not going to have any tissue left in my radiated breast.  Any one have same experience out there?

PS I'm fifty years old.  A bit old for fibroadenomas.

CTMOM1234

I'm approaching 4 years out from full breast rads following a lumpectomy. In that same breast I already had a fibroadenoma for many years (different quadrant), only first learned about it when I had my first screening mammogram in my early 40s about 7 years ago, but who knows how long it'd been there. So my situation is slightly different but hopefully helpful.

For the first couple of years after we knew about the fibroadenoma, I was having 6 month ultrasounds (including when I'd have my annual mammogram) but now they just look at it during my annual screening. It really doesn't even concern me anymore, it's actually gotten a little smaller, and I have to work very hard to even feel it (and when I do, it is a slippery little mobile thing). I'm pre-menopausal, have read it may further shrink as my hormone levels decrease.

It is more likely going to be a personal decision whether or not you are comfortable living with it or having it removed. Mine is in the 12 o'clock position so I'd definitely see the scar from it each time I looked down and I'm truly happy to just let sleeping dogs lie. I've read others have inner peace having them removed, and recall one post saying it was removed and grew back. A fibroadenoma is benign, and at least in my case, the characteristics are clear and the quite thorough and conservative radiology staff have never proposed removal. Mine has nothing to do with having had rads.

Coco50

Thanks CTMOM1234, since my post have had a FNA which has shown a benign fibroadenoma with atypical cells???  Have not seen my path report yet, but they are recommending removal.  Who knows what really lurks in there.  I almost wish I would have just left it alone. Since my diagnosis it seems we are chasing everything and it's exhausting.  Btw, I too have declined Tamoxifen as you have.  I'm not mentioning this to open it up for discussion because I tried it twice and nearly went crazy and almost went to jail.

So anyway, thank you for your post, I appreciate it very much.

CTMOM1234

I know, it is very very exhausting! Yesterday was my annual diagnostic mammo and ultrasound and I was there for 4 hours -- got to watch the waiting room entirely change patients, I'm truly glad they are thorough with my tests (got called back in for some additional mammo shots on my good side and then they did an ultrasound on something they thought maybe was something on my good side ... thankfully all is fine on both sides) but this heightened sensitivity due to the past is stressful!

Well you most certainly need to have the FNA pathology report before you can make an educated decision -- so do not assume anything yet! Atypical cells is too vague a label, I think.

As far as the tamoxifen debate, I, too, only quietly open that door to discussion, because my own personal decisions are based on my own stats and risk-aversion levels. I am grateful that my rad onc. treated me with respect and providing me all of the information I needed to understand the pros and cons and then make the best educated decision. I sleep really well at night with having chosen lumpectomy, SNB (well that one wasn't a choice thanks to the trace idc showing up in my path. report), prone full breast rads + boost, and no tamox, and regardless of what the future brings, I did the best I could with the information available at that time.

Please update me on the path. report when you know it, and wishing you the very best!

Coco50

CTMOM1234, this is my path report which sounds like they are not sure what they are seeing:

 The aspirate smears and cell block are mildly
cellular and show clusters of cells with nuclear enlargement,
prominent nucleoli, and smooth nuclear outlines with associated
myoepithelial cells. There are fragments of myxoid stroma. Overall,
there are features that would suggest that this lesion could
represent a fibroadenoma. However, there are atypical nuclear
features, which may be related to the history of prior radiation.
Therefore, we defer definitive classification to the anticipated
core biopsy, and think that this is best diagnosed as atypical. Dr.
Kong has reviewed this case and agrees with the above findings.

Any thoughts?

CTMOM1234

The pathology report isn't clear cut, but that is often the case. No dcis or idc was in the pathology report, so that's a very good thing. You are also only a year out of rads, so there's still healing going on. I would go someplace else for a second opinion ultrasound, you have time, before I'd agree to surgery (and yes, it is surgery even though it is not as significant as a lumpectomy).  You also need to look within youself and see how you feel about living with the fibroadenoma and having it followed in 6 month increments vs just getting it out.  There is nothing wrong with either decision, whatever you decide is right, you just want to have no regrets. Why is everything so complicated?

Coco50

Well actually I did get a second opinion.  My oncologist concurs that I should have it taken out.  I was just starting to get "right" again, now this.  Last year was hell.  I had the diagnosis, surgery, radiation, then a few months later, pneumonia, which led to a CT scan which showed some little something in my lung, so then it was lung cancer??  CT to follow up on that, then rectal bleeding (I know, TMI, sorry!) colonoscopy to follow up on that (it was "nothing"), so things were just starting to seem "new normal".  ugh.

y 50 years old!

SheaJ

Coco50 I too have been experiencing rectal bleeding had colonoscopy today said ischemic colitis that's may be caused from the femera. Did they say anything like that to you?

Coco50

SheaJ, no, I'm not taking femara or tamox, it was a mysterious inflammation from who knows what.  they thought the prep contributed but I had the bleeding before the prep, so not sure....it has gone away...wow, what do you do for ischemic colitis?  do you discontinue femara?

And ctmom1234, I had an excisional biopsy for that suspicious lesion and it was a totally benign fibroadenoma!! yay!

SheaJ

Told to wait and see if it reoccurs. That the section is healing. Have actually been bleeding on and off for several months I thought it was just bleeding hemroids from the pain meds. but had significant blood on thurs prompting me to go to my PCP and she set up an urgent colonoscopy for the following day.

The colon prep appears to have washed out the blood so far anyway. I will wait and see.

CTMOM1234

Coco50 - CONGRATULATIONS!!!!  Nothing sweeter than totally benign, and I hope you have quick healing!