Chest Wall Resection ?????????

Lena_Margaret

I am a woman who was first diagnosed in Nov 2010 at 47 with TNBC, stage IIb, 2 positive nodes. Had a lumpectomy and ALND. Had the ACT regimen with rads and a prophylactic oophorectomy after finding out I was BRCA 1 positive. Things perked along just fine until Jan 2015. Found another lump on the same breast. This cancer was ER+, PR+, and HER2 -. Had no nodes to check. And had a double mastectomy with significant problems. I am unsure of stage, but it was less than 2 cm. It was a mixed mammary carcinoma. After healing 7 months later, I had the TC chemo. Have been on Arimidex since Jan 2016.

Changed cancer facilities. And the current onc did one exam and said "You need a PET scan, those bumps are NOT scar tissue." Got the PET scan result on Tuesday, I have 3 suspicious areas on the same breast. Part of the PET scan reads " FINDINGS: 1. There is a nodule associated with the right breast tissue along the anterior right chest wall. This nodule measures 13 mm but is intensely pathologically hypermetabolic in the cutaneous area of the right breast with a maximum SUV value of 8.83. In addition, there is a second subcutaneous nodule involving the integument and the subcutaneous fat measuring 11 mm in the mid chest wall leftward of midline, contralateral side of the right breast lesion which exhibits a maximum SUV value of 4.5. 2. In addition, there is a tiny nodule within the skin itself, intrinsic to the integument which only measures 4 mm, however, it exhibits hypermetabolic characteristics with a maximum SUV value of 1.69. It is indeterminate."

The oncologist wants the surgeon to evaluate me for a chest wall resection. Does anyone have any experience with this?

KBeee

It sounds like there is suspicion of further cancer, but from the description, it sounds like it's all superficial and near or involving the skin. It sucks that the cancer may be back, but if it had to come back, better skin than bones or organs. Hoping you get firm answers and a plan of attack soon. Sorry you are dealing with this

Lena_Margaret

Thank you, KBeee. I am assuming part of the rationale for the chest wall resection is my last treatment (surgeries, chemo, and AI) are obviously indicating failure since it has been less than a year since I completed chemo. I agree, skin should be a better place for a recurrence than distant sites. One step at a time in this fight.

pajim

Lena_Margaret, when the surgeon does a mastectomy, they never get all the breast tissue. From the PET report it sounds like you have some breast fat left, and that's where the tumors are.

In the very old days of the Halsted Mastectomy, when they did the surgery they'd take out all the muscles in the chest wall. So it used to be done. I can't imagine they'll take much more than needed for clean margins, but you should ask the surgeon.

All in all this seems like a regional recurrence. Nothing in the bones or organs. . .