Does breast cancer spread more quickly in smaller breasts?

simoneg

I want to preface this by saying thank you for allowing me to be so frank and open b/c I don't have a support system.

I was recently diagnosed with ILC and it is like a weird, cruel joke b/c I have no breasts.

I am not exaggerating, being facetious or vain. It has been a very painful part of my life b/c I look like a man. I am completely flat except for nipples.

Three years ago I gained 30 lbs. in less than 6 months due to a thyroid problem and I have not been able to lose it b/c had no health insurance/could not afford the meds. It is b/c of this 30lb gain that I have even the TINIEST of breasts. It was almost impossible for them to do a mammogram, couldn't get good images so they did 2 ultrasounds on 2 different days.

My question is: since I literally have no breasts, couldn't I conclude that the cancer will spread more quickly since it has less area to invade?

I think this is a very valid question/concern and would really like to know if anyone has any info/statistics etc.

Also, I was told over the phone that I have cancer. This just seems very insensitive. Is that how others were told?

I have talked to NO ONE b/c there is no one. So I am so grateful for this board.

Thank so much.

ErenTo

Simone, I'm sorry for your diagnosis and I hope you keep coming back to this site for support. It can be a great resource and an excellent support network of people who are going through the same thing.

I don't know if what you're saying is true, cancer spreads either through blood or lymphatic vessels. Theoretically, breast size shouldn't matter. Tumour size, perhaps, but I'll leave it to more knowledgeable members. I'm curious if any research has been done in this area.

edwards750

I don't have big breasts either but not as small as you describe yours are. Dense breasts can cause difficulty for detection on mammos.

Your primary concern is your particular tumor. BC isn't one size fits all. I would concentrate on the treatment plan the doctors have outlined for you. Not trying to be flippant at all but just suggesting you shouldn't worry about it spreading. There are advantages having smaller breasts. Mammos have missed BC because the breasts were dense.

I was told over the phone too. I was prepared for it so itdidn't bother me that they called instead of scheduling an appt to tell me. There is no easy way to be told regardless.

Good luck!

Diane

Icietla

I am so sorry about your diagnosis.

I was told of mine by telephone. I appreciate their thoughtfulness in letting me know that way. They knew I was anxious to know and (figuratively) standing by for that news. If I had had to go back to the Surgeon's Office again to learn of my diagnosis, I would necessarily have had to wonder through another weekend.

It is fine not to share your news with people who do not need to know. This website is a safe place to talk about it, though. Everyone on here understands and cares.

simoneg

Thanks so much ErenTo, edwards750 and Icietla.

What you said about tumor size vs. size of breast makes sense. Being that I have no breasts and that I have the lesser common cancer (not ductal), I guess my head is just spinning...But I'm going to keep seeing if I can find any info. My tumor is/was 1.9cm but that is 1.9cm in a tiny breast so not very far away from the lymph nodes. Whereas, someone who has ILC in large breasts, regardless of tumor size, it would need travel farther to get to the lymph nodes-does that makes sense??? I'm not the most educated about biology.

*I* didn't mind that I was told over the phone, at all. For me, sooner rather than later was better. I was just thinking, if it were someone I loved would I want them to find out that way? I also think that knowing whether or not that person has any kind of support system is important in terms of how they are told.

Don't get me wrong, the nurses and doctors I saw were wonderful to me. At the same time, it almost seemed like it wasn't a big deal to them. I don't know...

Thanks so much again for allowing me to get some of my thoughts and feelings out and for your compassion and support.

Please know that I am wishing every single person on these boards the strength, love and support that you need to get through.

Icietla

We wish the same for you, simoneg. We will be glad to be your support system.

Lily55

EVen though your
breasts are small you still have breast tissue and ILC tends to spread in breast tissue more than anywhere else and also tends to be in single cell lines or single cell sheets, BUT it also tends to spread very slowly.  1.9cm is not even one inch and if it is not a solid lump either then it is not actually that big.......but cáncer does have a mind of its own so can spread in all kinds of directions and there does seem to be a connection, although it is anecdotal and not proven, between women with underactive thyroids and breast cáncer.

A good imaging for ILC is an MRI but that, as well as ultrasounds can often get size wrong and make it larger or smaller than it is in reality. If you have always wanted breasts then maybe you could ask for a doublé mastectomy and immediate reconstruction with small implants?

There is a special fórum for those of us who have or have had lobular cáncer so do look for that and come and join us

Lily55

Hi Simone - here is the fórum section for lobular cáncer

https://community.breastcancer.org/forum/71

simoneg

Kayb~~~very informative, thank you!

Lily55~~~this is the 2nd time you have responded to a post of mine-thank you for making me feel so welcome.

Lunderwood

Last November I was diagnosed with BC (IDC) after finding a lump. The lump was 2.1 cm and the doctor who did the sonogram said it was so small a lumpectomy would be all that was needed. But after consulting with a BS; I found that although the tumor was relatively small that since I am very small (4'11 100lbs and 34a bra) that proportionately the tumor was considered large for me. The only way the BS could confidently get good margins was a mastectomy. She also said that even if a lumpectomy was possible there would be virtually no tissue remaining. She did note that the size of the tumor or my physical size did not necessarily mean that it had spread elsewhere. In fact no lymph nodes were found to be involved when I did have surgery. The only other down side to being a small person with a relatively large tumor was that I was not able to have a nipple sparing mastectomy. I realize that your cancer is different and may have different characteristics but don't let your size scare you too greatly. One other note - my medical team also did MRI and Xrays as additional imaging before surgery. Hang in there!

LoveMyFamily

I, too, was told over the phone... and by a doctor filling in for my doc (so I didn't know her at all). She actually said, "The biopsy showed you do have evil lurking inside you." or something like that. It felt weird and murky, like I was hearing the words under water, unable to fully comprehend them. That being said, I didn't mind being told on the phone per se b/c I didn't want to wait any more. My stomach had been in knots for days waiting. Regarding your question about smaller breasts, I do not know. Did you get a cell grade (1, 2, 3)? This marker measures how fast the cancer cells are growing. Mine was 2, so not slow, but not aggressive.

Bock

First let me say I'm so sorry for your diagnosis. At age 48 I was told over the phone that I had rectal cancer by the Dr that performed my colonoscopy the previous week. I was at work and was not expecting that diagnosis therefore I completely lost it, had to be driven home. One year later I was told to call on a specific day (by a different doctor) for my biopsy results of my breast. I really preferred knowing the day i was gonna receive my results, at least I was able to prepare myself before the call. I think if either Dr had called and asked me to return to their office for the results then I would have assumed the very worst and been totally freaked out.

Anonymous

I've never heard a theory that smaller breasts get cancers that spread more quickly, in answer to the title of your post. I do know ILC is more difficult to detect with mammos. Here I am with 5 clear annual mammos (report noted "very dense breast tissue" but report never shared that cancer is more difficult to detect in dense breasts). And all the while I was celebrating those "clear" mammos I had an ILC growing inside.

As for being told the bad news, my surgeon told me, after my excisional biopsy, in the recovery area. I was still super groggy,flat on my back, and didn't appreciate that he told me alone, while my husband waited outside in the waiting room. We should have been together when he shared the news.

Jennie93

simone, I can relate, I'm very small too. I always joked around that if I ever found a lump, I would notice even if it was pea-sized, like, oh look, it's bigger! The joke was on me though, when I did get cancer, because there was no lump. The tumor just somehow "took over" part of the breast tissue rather than growing "in addition to" it, if that makes sense. I had a sort of hard spot that was quite painful, but no one ever seemed to think it might be cancer. Now I'm sure that if it had gone undiagnosed a few more years, it would have become a lump.

Anyway, needless to say, lumpectomy was never mentioned as a possibility. As the surgeon diplomatically put it... "Considering the size of the tumor vs. the size of the breast..." Ha. Meaning that my 1" wide tumor was practically filling up the whole thing. I would have chosen MX anyway if I had a choice. Hoping to avoid radiation.

As far as it spreading, no, there's no relationship to breast size. If it's gonna spread, it's gonna spread. The cells travel through your lymphatic system and whether it goes a little distance or a long distance, seems completely random, and unrelated to the size or location of the tumor.

JessieJake

Simoneg, you could be me. I always said I looked like a boy without some uber padded ill-fitting bra faking people out. When I was told of my first odd mammo result and that I would need further testing I got downright angry. I was angry until I decided to get my BMX. Like you, I thought it was a cruel joke. I also suffered through the humiliation of difficult and extremely painful mammos. One time the woman doing it had to get another person to help push me up to the machine. I had tears coming down my face. Not fair, not fair, not fair. I would constantly surprise myself at how angry I was at my appointments for 4 years! I just managed to be polite and it's not normally like me. I still kind of laugh because more than once they'd ask if students (residents?) could watch something being done to me and I'd just say, "No". They handled it well, but there was always a few interesting moments where they had to clear extra people out of the room.

Not that your path will follow mine, but I can completely and whole-heartedly empathize with where you are coming from. Maybe it's nice to know you are not alone with where you are starting from?

I'm having reconstruction and will get my implants next week. Whoa, I might end up at a 32B or possibly ..... a 32C! Still, tiny by real world standards but a world of difference from where I started.

Grab the bull by the horns, I say! That was probably odd, but it just came to me.

Best wishes as you deal with this.

Anonymous

As for being small, I try to be grateful that I was (36 A+). I wouldn't have found the growth if I had just a bit extra breast tissue surrounding it and would have had to wait till it was a lot bigger.

Claire

VLH

I was told by telephone as well; however, the radiologist who did my core needle biopsy had warned me that the mass definitely looked suspicious so I wasn't told everything looked normal only to be shocked by the diagnosis.

KBeee

I was also very small. A lumpectomy was not really an option and an implant would never have been able to match the other side. I would have needed implants on both sides. They made decision for BMX easy. My implants look great and I now have the cleavage I never had. There are few silver linings to this whole thing, but got me, that was one. Mine had not spread do far, though undid recursion 2 spots.... But I have a family history.

I was told over the phone too

Hopeful82014

Simone, I'm sorry you've had to join us but hope you will find plenty of support and kindness whenever you need it. It is VERY hard navigating through all this alone.

Bravemama34

i am a small girl too.  53, 105 lb, 32B.  my DCIS was 14cm.  i still cant believe that.  i had multiple areas of microinvasive cancer as well

Trvler

I was VERY small, too, but I had implants, which I think made mine harder to detect. I also had ILC and it was + in two nodes. I can't answer the question about it spreading faster. I honestly have no idea.

But I was also told over the phone. My doctor told me something like I had the 'best kind of cancer'. I know now he meant hormone +.

LovesLoons

Sorry for your diagnosis Wanted to add I hear ya about being on the small side. Normally A, maybe A.5. Thought I'd NEVER get breast cancer. Ha ha ha.

Mine was a bit strange in that it was more of a hardening/swelling and maybe a sort of lump .... but now apparently after only a few months that lump is 10 cm x 7 cm. It's ready to bust outta there, ya know?

The one thing I was MAYBE looking forward to was getting implants. But of course I can't do reconstruction now until at least a year after radiation. Ug. Whatevs. I can pick out whatever size falsies I want I guess. I was going to be limited in implant size ... Always a bright side somewhere.

Hang in there! There is great support here. I was NOT told over the phone. I don't think they would have done that even if I would have wanted them too. I told them to tell me to come in no matter what because I think they only have you come in when it's something bad. So I didn't want to know by deduction either. I think they should always be sure you WANT to be told that way. So that was kinda crappy if you didn't want to hear it like that.