New lumps 2 months after exchange surgery

pesky904

Hi! I originally posted in the recurrence forum. I'm very high risk for recurrence and the tumor was 10cm at its largest, less than a 1mm margin after mastectomy. I was stage 3 triple negative, diagnosed June 2017. Had 4 months of chemo, then double mastectomy November 2017. Then 6 weeks of radiation and then oral chemo (Xeloda). Just had exchange surgery at the end of November 2018.

They felt okay at first. The cancer side felt a bit firmer, as I was warned it would due to having had radiation.

Within a month of the exchange surgery I felt a small lump and luckily already had a follow up appointment with my oncologist. The lump felt exactly the way my original tumor felt, and my cancer grew FAST, from pea sized to 6cm in just under 4 months. My oncologist felt it too and noted it as a small palpable lump of several millimeters between the rib and the rim of the implant, in the same spot as my original tumor.

She sent me for an MRI and to see the breast surgeon (I actually saw his nurse). The nurse also felt the lump and sent me for an ultrasound. She said if it was fat necrosis, ultrasound would be able to definitively say so. None of the imaging saw the lump at all. The radiologist told me “There's nothing there."

That was just over 2 weeks ago.

I asked how we can all feel the lump but imaging didn't see anything at all. I was told it may be a suture from surgery and I should check with the plastic surgeon. So I call and the PS is out on medical leave. His PA checked his notes from my surgery and said no suture is noted in the area in question and they'd have to see me to be sure. So I have an appointment next week. (But I don't really feel the plastic surgeon will take it as seriously since they're not cancer doctors.)

NOW that lump feels bigger. I also now have either two small lumps or one large lump (hard to tell) in my lower armpit right where the breast meets the armpit. This was NOT there at all when I had the MRI/ultrasound.

There just seems to be an awful lot of lumpy areas for a “breast” that had a mastectomy and should have very very little actual tissue left behind

The whole breast also appears to be retaining fluid or something because yesterday morning I woke up and had “pillow creases" on it, just like you sometimes get pillow creases on your face when you sleep.

Dealing with unknown lumps after having a mastectomy is frustrating. Especially when imaging showed nothing and now just two weeks later, the first lump is bigger and there's lumpiness in the lower armpit now too.The BS's nurse told me fat necrosis or scar tissue would show up on imaging and wouldn't grow. But is she right? Can scar tissue or fat necrosis get bigger over a few weeks and start popping up in the armpit area also a few months after surgery?

Dm39

Hi pesky904. I just had similar situation. I had a double mastectomy with implant exchange surgery. A couple months later I found another lump. They did a biopsy and it was cancer. Then when I went to have a further margin surgery, we found another tumor in the original needle biopsy location in the skin. Now I am a stage 3 because it is in the skin. None of my tumors have shown on the imaging. Not even the pet scan. Please for the love of God! Have them remove the tumor and have the pathologist examine it!! Do not rely on imaging. Also, I am concerned with your doctor's and why they did not recommend to do a lumpectomy on the tumors. Please get a second opinion if you need to. Let me know how it goes. Praying for you!

pesky904

Dm39, did you have radiation, and if so, was it before or after implants?

My right (cancer) breast has radiation 9 months before the implants were placed. Tissue expanders were in during radiation.

When the implants were placed, he did a capsulotomy to remove the existing scar tissue. So right after the exchange surgery everything felt fine. It was not until a month later but my oncologist and I found this pea size lump right between my rib and the rim of the implant.

That lump now feels bigger and now there’s a lumpy feeling in my lower armpit right where the breast meets the armpit. I’m sure there was some breast tissue left behind in that area because I have read that it is very hard to remove all the tissue from the axilla. So I can’t tell if it is lumps or lymph nodes that I am feeling in that area.

Now my breast bone has one little spot on it near the rim of the implant on the non cancer side that has a kind of deep internal itch and is sore to the touch.