Several weeks after surgical excision biopsy

Anonymous

On March 2, about five weeks ago, I underwent a surgical excision for a biopsy (benign result - yay!) The paperwork called it a lumpectomy (though no lymph nodes were removed and she tried not to take much other tissue, though the lump was pretty large) The procedure itself and immediate post-op was pretty easy, not even much bruising or swelling immediately after and I only needed pain meds for one day. One week follow up appointment everything looked good and she told me to come back for follow up in six months. But now, at the about five week mark, I am starting to have more swelling and now significant pain, and have even found new lumps

I called the doctor's office and she is going to see me in a couple of days, but I'm just wondering if others have had something like this, where the post-op seemed to go very well until several weeks passed? I'm wondering if I should be doing anything different to care for myself. (I've been careful with the area, not doing any heavy lifting, and wearing a sports bra most days. I sleep without a bra and have resumed all of my other normal activities)

There isn't really a sign of infection that I can tell (no redness or swelling or discharge), there isn't any problem that I can see at the incision site. But my breast has a fullness on that side, the whole left side of the left breast (the same side where the lump was removed) is just larger and has an uncomfortable full feeling. I have pain if I am not wearing a sports bra or very supportive bra, and I found two new lumps in the same breast. One is right under the nipple, about an inch over from where the other lump was removed. The other is higher in the breast, maybe three inches above the old area. (These are new, weren't there before, though I am prone to breast cysts, which the one under the nipple does feel like to me.)

This was a fairly large lump removed and left quite and indention. She removed the entire thing and her nurse practitioner who I was chatting with at one point while the doc was out of the room mentioned that she does usually attempt to kind of bring in some of the surrounding tissue to fill it out - so like a minor reconstruction thing was done?

She said at my post op appointment a month ago that it might fill with fluid, that I may have nerve tinges, that there may even feel like a lump under the incision as the tissue fills in and heals and scars up. But what I'm experiencing now seems different or more than what she described

hawkeyeworried

EpicSquirrel:

Did you end up seeing your breast surgeon? I had my surgery 3/21, and I'm still experiencing pain. I'm contemplating returning but I have the feeling it just needs to heal more. Mine is sore, bruised lightly, and uncomfortable. I only take my sports bra off to shower quickly then put it back on or else it hurts more.

Anonymous

I see her tomorrow afternoon. Well, her nurse practiononer actually, which should be fine. I will ask a ton of questions and let you know what she says. I'm in more pain every day this week and haven't been able to sleep without my sports bra this week either :

Anonymous

They did an ultrasound but aren't sure what it is. took a fine needle biopsy, tried to evacuate all the fluid. The radiologist *thinks* its a seroma that is starting to get infected. Sent the fluid to a lab for analysis. Anyway it is good I went in.

She said I have small cysts in the breast and a solid nodule they will look at more closely later. This seroma or cyst has a "thick, very vascular wall" which concerns her. The fluid was mostly clear but near the end had a possibly puslike look and some blood. It is close enough to the surgery area that she thinks it's related.

Anonymous

Now that I have the report from the radiologist, I wanted to post some of the text from the report here and ask for any advice. The nurse practitioner at the surgeon's office (the bs was in surgery that day) sent me immediately to get an ultrasound and aspiration because I was in so much pain and had so much swelling right under the nipple, which is just a couple of centimeters away from the incision where the previous mass was taken out. (The excised mass was benign intraductal mostly infarcted tissue with reactive inflammatory and fibrocystic cells, fat, and periphery microcalcifications. Whew!)

On Thursday last week the radiologist did an aspiration on the spot to both relieve the pressure/pain and also to biopsy the fluid. She was concerned from looking at it and, as she said, how it has presented, that none of this was showing up on the ultrasounds from February 1 that preceded my surgery, that perhaps this is related to the surgery and might be an infection. So I have been calling my doctors office every weekday since then and they keep saying they don't have the results back. I don't *think* it is a major infection from how I feel -- there is no redness, the "swelling" has gone down *a bit* since the aspiration, but I do have a headache and sometimes feel like I"m running a low grade fever on and off throughout the day (though when I get home and take my temperature it is normal)

Is it normal to not put me on antibiotics (she said they need to know what they are dealing with) and to wait this long for results?

I logged into my patient portal and was at least able to see the text from the radiologist report from the day of the imagine and aspiration. (I wasn't able to copy & paste with their system so I am typing this from transcription, will try to get it all right):

2 cm from nipple is a thick walled cyst overall measures 2.5 x 1.9 cm and the central cystic portion measures 2.2 x 1.7 x 1.7 cm. The wall is at least 5 mm in thickness and is hypervascular.

Numerous additional simple cysts are present. There is an oval hypoechoic nodule at 12 oclock located 6 cm from the nipple measuring 11x9x6 mm. This demonstrates smooth margins but was not documented on the outside ultrasound 2-1-2017.

Real time ultrasound guided into the complicated cyst at 12-2 oclock - Fluid complement was completely evacuated yielding 5cc of turbid, partly pussy fluid which was sent for Gram stain, culture and sensitivit. The thickened cyst wall remains in place.

(I am adding a note here: After the aspirated this she said she was sorry but it seemed to be immediately refilling.. she and her assistant applied a lot of pressure to try to get it to stop, and put me in a pressure bandage for 24 hours. It does seem to be smaller than it was - and no pain now - but I can tell it isn't totally gone. Now back to her report...)

The 11mm oval solid nodule features most consistent with fibroadenoma, considered probably benign.

Recommendation is pending analysis of the fluid.

Ok that's what I know. Other than the fact that my breast is now bruised from this experience, has a large scar from the removal of the 4 o'clock mass, is still full of cysts, has a possibly fibroadenoma, and I KNOW from my breasts that I will be in pain in a short time again if this one fills up or the others grow. I am so thankful that I have not been diagnosed with bc, and I know this is a bc forum, but I just CANNOT BELIEVE that no one really seems to know what causes all of this, that there aren't any real treatments or help for benign but PAINFUL and INTERFERING WITH LIFE conditions like this. I feel like whenever I visit someone they are like OMG Maybe it is cancer we have to find out, and then Oh whew it wasn't cancer, go on about your business, and I'm like but I'm still in pain (sometimes literally in tears from the pain), I still have issues

I am editing to add: the 11mm likely fobroadenoma I found myself this week. No one seems to have seen it on the February mammo or subsequent ultrasounds. Indeed when I was having the US the tech hadn't touched that area and saidshe was done. I said to the tech: We also noticed a lump here, and showed her. Then she took the images there. Makes me wonder what else is in my breasts that no one has noticed. They are always so lumpy I feel like if I brought every lump/cyst/whatever to a doc's attention I'd need an Ultrasound Unlimited Season pass lol. But seriously, with all of the above, should I be worried that things are being missed? Can this and a 5mm cyst wall thing underneath my nipple, 2cm from a surgery done six weeks ago really be brand new

MTwoman

this looks like a good one for DJMammo!

Anonymous

[edited to delete the image of the report since it may have identifying info on it -- anyway a more recent update is nowbelow]

Anonymous

Just a small update to keep this accurate. The RN practitioner at the breast surgeon's office called. She said that the first test (posted in my message above, it said Gram Stain shows few white blood cells but no microorganisms present) doesnt show any infection, but they are doing more tests to be sure. She said the surgeon wants to see me herself, once more data is in. They are also re-looking at my biopsy slides from the excision. She said not because they expect cancer, but to try and get a better idea of what's going on, if that sample showed inflammation or infection or something else. I'll get a call for that appt in a few days

I'm so happy and grateful they are taking this seriosuly and trying to get to the bottom of it. Feel like I'm in good hands.

Curious if revisiting previous biopsy slides is common -- what additional info could they yield?

Anonymous

Did a core needle biopsy of the 11mm solid lump -- it is invasive ductal carcinoma. The doc thinks this is probably stage 1. Having me get an MRI to find out more.

MTwoman

Oh EpicSquirrel, I am so sorry! You've kept at them to get answers, but this is certainly not the one anybody wanted for you. Hoping your mri is scheduled soon! What can we do to help?