Lump near scar after skin sparing mastectomy

Piksie

I had a unilateral skin sparing mastectomy and immediate reconstruction Jan '16; revision in Feb '16 to ensure a good margin at the incision. Multifocal IDC; Onco = 17, 8, and 3; 10cm of DCIS. no chemo or rads. I've taken Tamoxifen since Feb '16 with little to no side effects. I'd almost put the whole thing behind me; enough so that when my Tamoxifen prescription wasn't automatically refilled as usual, I didn't notice until I ran out and had to go about a week without it.

Shortly after that (July 3) I found a lump very close to the scar. My last exam was a month ago, and I check all the time. Could it possibly have been there for a long time, but just stifled by the Tamoxifen?

I am seeing MO tomorrow and trying to stay out of those dark spaces in my head.

Micmel

sounds like what I’m dealing with now. Fat Necrosis! Very common near scars. The cells die where the drain was and or scar. Because of lack of blood supply. My breast plastic surgeon Is locally taking it out July 30 in his office. Mine is the size of an acorn. I had my surgery two months ago. But they say it can be hidden very well. I have had scans the week before I found it. So it would
Have been detected. I am hoping that is what yours sounds like. ~M~. Wishes for the best

Piksie

Thank you, Micmel. My fingers are definitely crossed!

DodgersGirl

Piksie—I had 2 fat necrosis spots develop along my mastectomy scar that I found about 6 months after surgery. I had an ultra sound followed by biopsies with dx of fat necrosis. Hoping you get b9 news, too.

KBeee

It could be a lot of things, but it is good you're getting it examined. 1 week without Tamoxifen should not have affected whatever it is. Do not let your doctors feel it and send you on your way, because though it is most likely benign, that is also a common spot for recurrence. Insist on some sort of imaging. My docs dismissed my lump and said they were 99% sure it was benign. I said I wanted 100% sicne my gut told me it was malignant. They were 100% wrong. Though your lump is likely benign, do insist they be thorough. Please keep us updated.

buttonsmachine

I had a lump near my scar that my doctors dismissed as fat necrosis. My "fat necrosis," which was really cancer, was not biopsied for several months and it spread to two lymph nodes in that time. I don't want to scare you - most of the time it is just fat necrosis. But still... cancer is tricky, and better safe than sorry. I agree that some kind of imaging or biopsy would be best. Hope you have a better scenario than I did and that it's benign.

KBeee

Piksie, What did hte doctor have to say? Thinking of you.

Piksie

It didn't go as well as I had hoped. Just had a mammogram and ultrasound. The radiologist wants a biopsy of the lump, but was more concerned about a suspicious lymph node. That one threw me off a bit... So I have two biopsies tomorrow morning, but probably won't know anything until at least Monday, possibly Wednesday. Being the second time around, I feel a bit more calm than last time; sort of like I've been given a few more days to feel/act cancer-free. Although I don't expect the lymph node biopsy is going to be a walk in the park. Anyone have any insight on that one?

I'm still crossing my fingers for the surprise of my life, but I'm preparing for the worst. That way I'm relieved that it's good news rather than shocked that it's not.

Piksie

Apologies, I meant to update sooner but I've been a little distracted... The lump and lymph node were positive, also ER+/PR+, HER2-. I had an MRI yesterday, a CT scan tomorrow, and seeing Oncologist Thursday and surgeon Monday. I was feeling pretty good about it until the Oncologist moved my appointment up after the MRI because "he didn't want to wait until next week". Still hoping it's a schedule issue and not an MRI issue.

The good news: most of my left breast and armpit are numb from the mastectomy, so the biopsies were a breeze.

I hope you're all doing well!

buttonsmachine

Hi Piksie, I'm sorry to hear about your positive biopsy results. At least you'll be seeing your MO soon, and you'll have more information about the imaging results and treatment plan. I'm sending you my best wishes and please keep us posted!

KBeee

I am so sorry you are dealing with this recurrence. Hoping it is a local recurrence and has not spread. Having had a local recurrence, I know the thoughts and constantly changing emotions swirling through your head right now. (((HUGS))). Do keep us posted.

SharonS

Hello all....sorry to see recurrences. I have what feels like some fluid under the skin around my mastectomy scar. It is on my right side and there hasn't been any surgery there since 2014 when I tried to redo an implant twice but even with hyperbaric had trouble. Any one experience this so long after surgery? Wondering about lympedema, I occasionally have issues with my right arm.

KBeee

Sharon, It could be lymphedema, but any change should be checked.

I_Spy

Piksie... yuk this is awful. I had all of my treatment at UCSD Moores Cancer Center... is that where you are? I'm wondering: you mentioned you had a mammogram recently; was that on your foob? You said you had a uni MX so I was wondering if they did a mammogram on the fake one or just the real one? I'm asking because I'm getting ready to be seen to rule out a recurrence. I wish I was still at UCSD ;(

Piksie

Aw ispy! Fingers are crossed that you are clean! Yes, all my mammograms were on both breasts. Foob was limited to a couple of images, but she never escaped mammography.

I'm also at UCSD and feel very fortunate. I changed from Sharp to UCSD shortly after being diagnosed the first time, and boy! What a difference!!! I hope you find a team in LA that takes good care of you (and tells you that you're good to go!)

Edit: I read some of your other posts. I don't know anything about IBC, but I'm praying for you to get real, fast, good news.

Were you with Dr. Wallace at UCSD?

I_Spy

Piksie I forgot to add this to my favorites so I didn't get a notification! I was with Dr. Blair at UCSD, and Dr. Gosman was my plastic surgeon. I adore them. Adore them. What are the next steps for you?

So far there is no obvious recurrence for me, which is good of course, but until I figure out what is going on with my BMX scars I won't be able to relax or stop pursuing answers. I did not have a good time at my appointment this morning at Kaiser with a P.A. in the bs office. See my thread for the details. I just trust Dr. Blair and the radiologists so much and so far Kaiser has fallen short at least on the bc end of things. Even if the radiologist and the P.A. are correct ("oh I don't think this is anything") they are not delivering the information very well or giving me confidence in their opinions.

Do you have a treatment plan?

Piksie

Ispy, I'm sorry you're not getting what you need from your medical providers. That is very frustrating. I hope it's resolved to your satisfaction soon!

My plan so far is surgery 8/17 to remove the tumor at the scar line, approx 1" of skin around the scar, and Level I and Level II lymph nodes. Assuming nothing new pops up in surgery, I will get a new implant and be done with surgeries (hopefully FOREVER!) I will do radiation, but I don't know how much or how long; consultation with RO 8/22. Chemo is a maybe, I believe depending on the extent of lymph node involvement. MO says no right now, BS says don't be so sure... They were of the same inclination last time, and I went with MO. This time, Dr. Wallace gets final say. And I've dumped Tamoxifen for Zoladex and Arimidex. I've had my first Zoladex shot, and it wasn't too bad. If I handle menopause well, I'll probably ditch the ovaries in 12-18 months and skip the shots. I have a pelvic US tomorrow to confirm a mass on my ovary is benign. I will not miss them at all!!!!

I get through this one silver lining at a time. For surgery, I've lost weight since reconstruction in Oct '16 so lefty is bigger than righty. I was starting to consider when I would go back for a revision; I guess the time is now... Because of the inch of skin being removed, the nipple will be lower, but I'm the only one who sees them, so whatever!

Fingers crossed that Kaiser comes through for you!

I_Spy

Hi Piksie that sounds like a good plan! It is so good to have a plan and know where you're heading. I'm jealous of you being at Moores.... there is so much confusion in this process, it is nice when you have people you can trust and not worry about whether you should be second guessing them!

Keep us posted as you go through the process, we will be here for you!

Piksie

Thank you. I've been staying pretty calm this time around, but I'm starting to wonder about those little chest aches and pains I've been attributing to the gym. Here comes the panic I remember so well... I'll feel much better on 8/18!

I_Spy

Yes! You are in really good hands, so it is time to do my other favorite saying that got me through so many things: "Surrender to the process." If there are things to worry about, your doctors will worry about them! You just go along for the ride!

Micmel

very sorry to hear it wasn't fat necrosis. My surgeon made sure to check the lumps he removed thank god with pathology. I was really hoping it was fat necrosis or an oil cyst for you. It's such a rough thing to deal with. I hate even seeing those cancer commercials anymore, they are everywhere. I'm glad your team is on it. I will keep you in my thoughts. I am so disappointed that you have to have more surgeries. I am so sick of them also. You're in my thoughts. Hugs and support ~M~

buttonsmachine

Hi Piksie, I hope you are doing well. I'm glad you are at UCSD - you are in good hands, and it will be great to get that cancer out.

What kinds of imaging are you getting before surgery? This may not apply to your situation, but I feel like I should throw this out there in case it would help you: After my recurrence, an MRI before surgery turned out to be crucial. One surgeon I saw wanted to go in without doing an MRI first, but another surgeon ordered an MRI, which revealed more cancer than we initially knew was there. That was invaluable information! Anyway, I hope they are doing plenty of imaging on you beforehand.

Anyway, I was so relieved after my surgery, and I know you will be too. It was a big surgery, but I would do it again in a heartbeat. Hugs and best wishes.

Piksie

Buttonsmachine, fortunately, they've always been very generous with imaging. I had a bone scan in May to check out rib pain (turned out to be self-inflicted), then after the biopsy was positive, I had an MRI and a CT Scan. Tomorrow, I have a pelvic ultrasound to check out an ovarian mass. They've seen every cm of my body! I'm glad, although I know that surprises are always possible in the OR. Last time she was sure my lymph nodes were involved, but they were clean. And what they thought was two tumors turned out to be three, plus 10 cm DCIS! And I had all the same imaging last time.

I'm staying cautiously optimistic on the outside. I only freak out when I'm alone in my car.

buttonsmachine

That's great news, Piksie! I'm so glad they've done thorough imaging. It's so true that there can always be surprises, and imaging isn't perfect. I've had false positives and false negatives with imaging, but I've also had imaging show cancer we didn't previously know about - is that a true positive? ;-) Anyway, I think especially for a recurrence or higher stakes situation, the more types of imaging the better. I'm so glad you are at UCSD and they are taking good care of you.