Breast lump and possible swollen lymph node

leger

Hi All,

It has been one year and a few days since I had surgery for Breast ca. I had my first mammo and US in Feb 2015 (six months after I finished radiation) In may I noticed a lump just above my incision that was not there at the time of the mammo. Went to my surgeon in June, she did an US and said we would look again in two months. I have an appt in a week. About a month ago (as I was drying from the shower) I felt what I think is a swollen lymph node under my arm, fairly close to the sentinel lymph node incision. Now my mind is running wild.  Anyone else have anything similar? And on top of that I have started having occasional sharp pains in my left hip.

I will post again so info will show.

Thanks

Donna-Dew

Hi Leger,

I am kinda in the same waiting stance as you are. A few weeks ago I discovered a pea-sized lump next to my sternum on the recent mastectomy side. I had an ultrasound yesterday and will have results next week, hoping for the best since this is only 4 months post-op. However if it turns out to be a swollen node I might be a little more concerned. I have also started experiencing pain and swelling now in front of my shoulder/armpit area, I am guessing that this is related to the sentinel node biopsy but not sure why it is just starting now. Not a fan of this waiting game!! After doing a little more research my mind is running wild too - I'm riding along here with you!!

Donna

vlnrph

I have read about recurrence showing up along the incision but sometimes it can be scar tissue. Maybe leger can call and get her appointment moved up due to the new development. It would be good to have a chance to get a biopsy done & pathology report completed soon instead of having another long wait next weekend

Many of us use a "14 day" rule for various concerns: allow that period of time in order to see if the issue changes or resolves. A principle like that could apply to the sporadic hip discomfort...

It occurs to me that Donna might want to ask about lymphedema regarding her armpit/shoulder pain and swelling. LE has an opportunity to develop whenever there is trauma to an area, even after sentinel node removal. It doesn't always show up as measurable increase in extremity girth. Not a fun diagnosis but better than more cancer!

Hopefully these are false alarms. Let us know what you find out and decide to do for follow-up.

leger

Hi Donna- Dew,

Keep us posted on your ultrasound results.

Hopefully everything will be OK for both of us. However, there is that nagging feeling in the back of my mind. I have already moved my apt up one week.

I think I'm just going to ask my surgeon to biopsy areas for my peace of mind.

Donna-Dew

Thanks vlnrph for the note about lymphedema. A while back I was called by a lymphedema clinic in our area, checking in to see if I had any further problems after my first mastectomy. I told them that I had no problems but that I recently had a second mastectomy and that maybe I could get back to them at some point if I develop any symptoms.Guess that was foreshadowing. I'm going to be proactive and call them this week to schedule an appointment. But I will talk to the doctor first about my ultrasound results and let her know about this new pain/swelling in the sentinel node area. I won't proceed to lymphedema therapy until she gives me the go-ahead. I am definitely thinking that she will want a biopsy excision or aspiration pathology on this new little lump. If not I will definitely ask for one, just for peace of mind, I cannot imagine it is possible to get a definitive diagnosis from an ultrasound.

Hi Leger, well the weekend is almost over! Glad you were able to move up your appointment. That was a no-go for me unfortunately. Will be sure to keep you posted and I need to hear from you too! ) I totally understand wanting more testing, my gut feeling is that getting into that lump is the only way to know for sure, I will not be able to live in peace with a "it looks like a ..." type of result. However I have read that in some instances this is not always possible (ie. if the lump turns out to be swollen lymph node lodged in between veins/arteries or somethings like that) I sure hope that is not the case for us. We would like peace of mind please! Let's keep in touch!

zayb

Good luck, Donna-Dew and Leger. I hope you get your biopsies and that everything turns out well. There are definitely limits to imaging/ultrasounds and a biopsy seems like a safer bet especially for people who already have some kind of diagnosis. I keep thinking about the interventional radiation doctor saying my lymph node wasn't 100% normal. No big wonder now since most of what they were seeing on ultrasound wasn't the lymph node at all. They saw one isolated thing on ultrasound, but it was a lymph node with a lot of scar tissue in the area. It was only after an excisional biopsy that they could actually see there were different things in the one spot.

Donna-Dew

Zayb, that's exactly what I thought about ultrasound, it is only the first step towards diagnosis. I am waiting patiently to hear the ultrasound results on Thursday and preparing myself for a much longer wait to get a biopsy. With my last 2 biopsies (prior to mastectomies) there was a 3 week wait between mammogram result date and biopsy date. And a further 3 week wait for pathology results. As you can probably tell from those wait times I'm in Canada. On another post I wrote, I mentioned requesting an anti-depressant at my appointment this week but I think what I really need is an anti-anxiety med. I've never taken one before but what can happen. I'm hearing good things about zanax. Just needing something to take the edge off as I try to concentrate on work. My mind is working overtime, worrying a little (ok maybe alot) but more so planning out all the what-ifs. If this lump is found to be cancerous after excision, then I'm thinking that the treatments available to me will be radiation and/or chemotherapy. We live 3 hours away from the city so it goes without saying that we would experience a major lifestyle upheavel for a while. Thankfully by then our harvest time will be over (husband and I are farm partners). Guess I'm getting way too far ahead of myself... pass the zanax please!!

Leger, hope you can post soon!

leger

Hi Donna-Dew

I have an apt w/ gyn dr. on wed. (for us on ovarian cysts) and to the breast surgeon on Friday. I am hoping she will want a biopsy. No telling how long until I will be able to get an apt for that. I have been off work all summer and I go back on the 17th. I was hoping to get anything that needed doing, done over the summer.

I have taken an anti-anxiety medication from time to time. I take lorazepam. Low dose and it works great.

Hope all goes well for you on Thursday.

Keep the faith.

leger

Hi Donna Dew,

Did you get your ultrasound results?

I saw the breast surgeon today. She did a physical exam, felt everything was fine. Thought what I was feeling is just scar tissue and radiation results. I asked for a repeat ultrasound. She said the lymph node looked fine but that there was one area (close to previous incision) that concerned her. She said we could watch it for 6 months or just biopsy it now. I told her I would be crazy in 6 months. We will biopsy the area on the 24th.

We have to fight like girls.

Donna-Dew

Hi Leger,

Yes I finally got the results at the end of the day. Apparently the pea-sized mass that is palpable near the sternum is a fluid filled cyst. But the ultrasound picked up something else - the radiologist described it as an "oblong lesion" and then questioned if it was a lymph node. Well my GP wasn't very impressed with the radiologist leaving an inconclusive result with no recommendation for follow-up, so she will be requesting a second radiologist's opinion. She said we cannot afford to be fooling around with inconclusive results with someone like me with my BC history. She is also forwarding results to my BS, and told me to expect to be getting another ultrasound soon. The swelling in my shoulder/armpit area was described as a seroma on the report so will be interesting to see what BS thinks. Since my GP couldn't palpate any mass and nothing else was detected there on the ultrasound, she is thinking lymphedema. I will be booking an LT consultation early next week but I don't want to start any therapy until I am sure it is lymphedema.

Well it looks like you and I are still in the waiting room Leger! No doubt you opted for biopsy now, no question in my books, six months I don't think so. I will be giving it a week and then following up with GP and BS offices for any updates. I cannot imagine an oblong lymph node, unless there's something wrong with it. Definitely going to keep on top of this and will do so weekly. Yes we have to fight like girls!

Donna

vlnrph

Glad to hear both of you being assertive and pushing to obtain a definitive diagnosis...

I think pathology samples and radiologic imaging should always be reviewed independently by a second physician. Even with digital/computer assisted analyses, another pair of eyes can often provide a fresh perspective and perhaps pick up something that might have been missed otherwise. Doctors may get tired or slightly bored looking at films or through microscopes all day which could allow mistakes to occur. Hopefully errors are few & far between with minimal impact on outcomes for patients. Get copies of your reports when they become available.

Take the weekend off and relax a little. You deserve it!

Morwenna

I had the same cr*p last year, twice! The first was a pea sized lump along my mastectomy scar. The radiologist felt that it was probably benign, but elected to biopsy to be sure. Pathology came back as scar tissue.

Later last year, I felt a new little lump, which I assumed was scar tissue again, but this time my oncologist got excited and sent me for an ultrasound, which apparently showed nothing!

Now *I* was rattled so requested an MRI, which was approved. Came back no evidence of disease, neither my mastectomy side nor my other side, so big relief!

I went on to have prophylactic right mastectomy and bilateral recon this year, and all the pathology came back clear, so I'm finally believing that I might be "cancer free"!!

Donna-Dew

Thanks for your encouragement vlnrph!

Morwenna sorry you had to go through this too, but it sounds like you are finally having some peace now )

Leger how did your biopsy go on the 24th? Any news yet? I'm guessing results might take a little longer. Isn't this wait just awful!

My breast surgeon's office called last week to schedule a consult appointment for me on September 8th. I checked with GP yesterday and no word back yet about the second radiologist's opinion. In the meantime I have discovered a second much smaller lump about an inch away from the supposed breast cyst. I am just hoping these are as a result of the trauma from mastectomy. Regardless I really want a definitive diagnosis, and these lumps to be excised if possible. I'm reading about fat necrosis too and I guess that's a probability, can't wait to talk to BS.

Donna

leger

Hi Donna,

My doctor called last night and the biopsy was indeed scar tissue ! A huge relief. I am going to try very hard not to give my boobs another thought until February when my next mammogram and ultrasound are scheduled !

Please let us know what your docs say. Will be keeping you and all the others in my prayers.

Morwenna

Great to hear, Leger!

For some reason I've been flipping out this week, "feeling supraclavicular nodes" on my left side. Reason I put in "" is that part of me thinks I'm just imagining it, but I can't stop thinking about it and feeling for them. I have an occasional cough (lung mets??), and a sore spot in my upper lumbar vertebral area (bone mets??). I can't really say what sparked all this off, but I seem to be in an escalating spiral of anxiety at present.

There's so much cancer sh*t in my life just now, inner and outer circle, and I'm feeling a bit overwhelmed by it all.

I'm trying to make myself stop prodding for a week or two, then check again and see if there are really any changes, .... trying!

Donna-Dew

Oh Leger that's great news! Now you can finally relax and put your breasts out of your mind for a while. I don't understand doctors giving the option for a 6 month wait-and-watch. I am sure you will enjoy the next 6 months a lot better now that you opted for the biopsy and know the results. Will post here again when I get some news!

Morwenna, wondering if maybe it would help your anxiety if you made an appointment with your GP to have a quick check-up. My GP was able to tell me that my supraclavicular nodes were fine. My husband went to his doctor for his annual exam and he mentioned to the doctor an occasional cough that started this summer. The doctor told him that he had seen many similar complaints this year that turned out to be nothing, he believes these annoying coughs are related to continual exposure to air conditioning (for a while we had weeks of extremely hot weather). Hubby's cough resolved after a couple of weeks. The anxiety is not worth it, get it checked out and know for sure what it is. That's going to be my plan of action from now on, I just want to get on with life. But I know what you mean about hearing so much about cancer these days. And I think that once we have a cancer diagnosis it makes us extra-vigilant for more symptoms. Don't think we can change that, it's smart to keep in touch with our bodies and be aware. It's harder to keep going to the doctor and getting these things checked out, because if you're like me, I am soooooo tired of doctor's appointments and tests.

Donna

leger

Hi Morwenna,

I understand the worry. I also agree with Donnadew, a trip to your GP might alleviate some of your worries. The anxiety we sometimes feel can be very crippling and needs to be dealt with. For me that means a support group, anti depressant and an occasional anti-anxiety med. It has really helped me keep a little balance in my life.

Cancer sucks and it's not for sissies !

Hang in there and hugs.

Morwenna

Hmmm ...... I don't find my GP very helpful tI be honest. He can be a bit dismissive. I did ask for something when I was in a high anxiety state about 3 weeks before my last surgery and having trouble sleeping.

He listened to my concerns, and then said, well come back if it's really bothering you!

So I left, thinking: ok, I guess I just have to tough this out! He might have given me something if I'd collapsed in a blubbering heap.

I know from experience that my anxiety/depression is cyclical, and if I wait I will probably start to feel better. It would just be nice to have something to help me through the low points.

I'm seeing my hematologist at the cancer centre in November. I usually get a good going-over at those appointments, so I'm going to wait and see what he says. By then I guess I'll know if I've really got something growing in my neck!

Donna-Dew

Sorry Morwenna that your GP wasn't that helpful. If he had said that to me, to come back if it's really bothering you, I would have made another appointment to show him that I'm serious. Actually I have become so assertive after what I have been through that I probably would have said "No it's really bothering me now." I was so exhausted with all the appointments - I didn't need any more appointments if things could be dealt with right away. Like you, I was toughing it out for a long while with the anxiety. Then I thought, this is taking up way too much energy that I just don't have anymore. So I asked for an anti-anxiety med and was prescribed .5mg Ativan. It has made all the difference in the world. It does not make me feel drugged, just calmer and able to think more clearly instead of obsessing. Then I am able to get on with my day. November seems like a long time to be waiting with anxiety. Maybe consider making the move to get another appointment with your GP. He should be able to do a preliminary check on your neck, and he should be more understanding of how obviously this makes you anxious. If he is dismissive again I would get another GP. You deserve to be treated better!!

zayb

Good news, Leger!

Morwenna

I have made an appointment to see my GP on Friday. He may or may not feel I need anti-anxiety/depression meds, but at least he can check my supraclavicular nodes, and if he is not worried at least he will have a baseline if I go back later thinking they are changing ....

Morwenna

So upshot of seeing GP: He has prescribed Citalopram 20 mg, and to go for "talk therapy". He didn't feel any enlarged nodes in my supraclavicular area, although agreed there was "a fullness", possibly as a result of the radiation therapy to that area.

I am satisfied with all of that. Hubby is a bit aeriated about me being on meds, as it is "all in my mind", but he can go take a hike!

He wanted to know what I was having for supper tonight as he was working late, and I told him: chicken wings. He didn't like that either!

Donna-Dew

Morwenna you sound more relieved and that's great! My hubby is not a fan of meds either but he can tell a positive difference in my anxiety since I started with Ativan. Our emotions, feelings and anxiety are "all in our mind" but the mind is a powerful thing and when it spins with worrying thoughts that are out of control it can exhaust us and cause other physiological symptoms that alarm us and so we continue spiraling into even more anxiety. I hope that the talk therapy will help too. I have a counselor and I find that some appointments help me tremendously while some are just ok. But I keep going because she is definitely helping me to keep on an even keel. My hubby would have loved those chicken wings! I couldn't cook tonite, just too tired, and when my hubby got home I had chinese take-out waiting for him - too bad, so sad that's what was in the ol' feed bag for tonight, it was good )

Donna-Dew

Hello Leger,

I saw my BS and he was full of reassurance that all is fine with the ultrasound findings. The breast cyst was aspirated, and as he expected just yellow fluid. I asked if pathology would be done but he said no, that with a breast cyst it is not necessary. He was very understanding of my concern though with the other findings on the ultrasound. I will be having a followup ultrasound at his clinic in 3 months where he can see results right away and compare to the August ultrasound. He said he is doing that solely for my peace of mind since he is convinced all is good. He explained it this way, I had DCIS and LCIS a non-invasive cancer which a mastectomy removed and results included nice big clear margins. Sentinel node was clear. He explained that even though there is a very small chance or recurrence, he does not see those until 2-15 yrs after treatment, not 5 months post-op. I really do have alot of faith in this experienced doctor, though I wished I had asked about what is the earliest you could see a new cancer? Also I didn't get a copy of my ultrasound result, sigh! Will request one. Never did hear a second opinion on the ultrasound from the other radiologist that my GP uses. Should probably follow up with her too. So bottom line, I have a better sense of relief, just not 100% happy about not knowing what those other ultrasound findings are. BS felt again that this soon after surgery it could be a slightly enlarged node as a result of all the trauma to my chest area, or scar tissue. Will keep posting here as things unravel leading up to my next ultrasound. Just wanting to be done!!

Donna