Fat necrosis

pesky904

for anyone who has ever had fat necrosis, does it get progressively bigger over a very short period of time? And can it feel like a small cluster of multiple peas?

rachelcarter35

I'm waiting to get an MRI this next week for some small bumps forming right under the skin. I'm hoping it's a cyst or fat necrosis and not a reccurance.

pesky904

I also have a very tiny bump on my sternum. But this cluster of peas in my armpit is also concerning.

Denise-G

I've been dealing with fat necrosis on my MX scar since 6 months after surgery 7 years ago. It felt like a cluster of peas and showed up what felt like overnight during radiation.

My MO immediately said it felt like fat necrosis to him and we would watch it which we have. Recently, it changed a little

and I was sent for an MRI and ultrasound immediately. Thankfully, it was still fat necrosis. They told me it can change for many years

post surgery.

pesky904

thanks for the response. My radiation was over a year ago and I never had a problem with anything like this. I also don’t have anything really going on anywhere near my scars. These lumps are in my armpit and the lone one is where my initial biopsy was. And then the teeny bump on my sternum closer to the non cancer side.

pesky904

The other thing is, I don’t want to have to go and have it checked every single time it changes or gets bigger or more shows up. That was the whole reason I had a double mx to begin with. I don’t have time to be going to the doctor and having scans every time a lump shows up. I am dealing with trying to divorce a husband who has disappeared, a mother who just suddenly died, trying to find a new place to live and needing to find a new job ASAP. I can’t be having all of these appointments now or in the future. It’s making me wonder if I should have the implants removed, have a capsulotomy to remove the scar tissue and just not even think about reconstruction until I am a few years down the road and looking more in the clear for no recurrence. I am triple negative and now they are saying that after five years the risk of recurrence for triple negative is as close to zero as one can get.

NotVeryBrave

Wow - that is too much going on! You must be so stressed. I'm sorry.

I think that you will have to have this assessed. Yes, it's a pain. But it's a pain to be worrying and wondering all the time, too.

I had an area show up under the nipple on the cancer side about three months after my BMX. It felt firm and a little irregular. My MO wasn't concerned, but my PS sent me back to my BS early. Neither of them sent me for any imaging. My BS sent me for US and they followed that with a mammogram (gentle). They felt pretty confidently that it was fat necrosis.

I had follow up US every three months - mostly because what showed on US didn't seem to correlate with what was palpable. I know that it was getting bigger. My nipple looked different. Even though I knew it was unlikely to be a recurrence with my chemo response and surgery - it's hard to shake the worry.

In the end, my BS offered to just remove it with a lumpectomy. She felt it would be too difficult to biopsy it due to the position with the nipple and the implant there. I requested an MRI to be sure that there wasn't anything else if I was going to have surgery. That was clear.

I was very torn about what to do. And it made me feel sick with worry to see and feel this lump that was growing. But I worried about more surgery and scars and time off and possible complications. And then it started to shrink!

I became aware of it around August of 2017 and it seemed to get worse for about a year. It hasn't disappeared but is definitely smaller and softer now. So if it was fat necrosis - it can change.

pesky904

that’s the thing, I am very high risk for recurrence. I was triple negative, stage III with a 6 cm tumor. I started chemo with Taxol and the tumor grew to 10 cm. So then I was put on AC and the tumor shrunk but only to about 3 cm. So I failed the first chemo and only had a partial response to the second. And then at surgery they were only able to get a less than 1 mm margin. The surgeon told my family right before he started surgery that he was actually very concerned that he would not be able to get a negative margin. He ended up being able to, but again, it was less than a millimeter. My residual cancer burden after surgery was 2 on a scale of 1 to 3. But they told me that even though it wasn’t a three, I am still extremely high-risk. So the idea of having any lumps is disconcerting. The idea of having any lumps and not doing anything about it is disconcerting. The idea of having a lump exactly where my original cancer was that seems to have gotten bigger is disconcerting. The idea of having a lump that didn’t show up at all on MRI or ultrasound is disconcerting. The idea of new lamps popping up in my armpit a week after I had an MRI and ultrasound is disconcerting. The idea of having any lumps and having them say they are “pretty sure” they are fat necrosis is disconcerting. The idea of feeling a tiny tiny tiny spot on my sternum is disconcerting. The idea of having to go to the doctor every single time I feel even the tiniest change is disconcerting. The idea of applying for, interviewing for and finding a new job while not knowing if I already have or am going to have a recurrence that is going to blow my life up again is disconcerting. There is really no good scenario.

NotVeryBrave

I didn't realize that you had already had imaging done.

Except for the first mammogram that showed fat necrosis - none of the imaging that I had showed anything. It was frustrating and perplexing. Everyone could feel the area. That's why my BS ended up offering to remove it.

I know how it feels to have this anxiety about stuff that you see and feel daily and have no answers. And we all have read about people who had imaging that showed nothing and yet had a recurrence.

If the lumps under your arm are new - you do need to get those checked out.

pesky904

I just hate how the way the first alarm showed up feels exactly the way my cancer started. And the spot on my sternum has that internal itch that I had with my original tumor. I don’t really have another way to describe it except an internal “itch but hopefully some of you know the feeling that I’m talking about. I have an appointment on Tuesday with the plastic surgeon. But he is not a cancer doctor and I just know he’s going to tell me that it is common and it is fat necrosis or scar tissue. And then I will have to go back to my oncologist yet again for another appointment, where she will now be in a bad position because she has already sent me for imaging just recently and now I have new lumps. Who knows if my insurance will even cover more imaging this quickly. I just wonder if having the implants removed Will help with some of this, because if this is fat or scar tissue forming in response to the implant, meaning I will have less lumps if I just go flat, it might be best to just do that.

NotVeryBrave

My surgeon was my best help. She followed up on me. She ordered all of the various scans. She had two radiologists that specialize in breast imaging review my info. And went to bat with my insurance to get the MRI covered.

pesky904

Are you talking about your breast surgeon or the plastic surgeon? I have two different surgeons. The breast surgeon who did my mastectomy is out on medical leave. The plastic surgeon who did my exchange surgery is who I am seeing on Tuesday. The reason I am seeing him is because the breast surgeons nurse practitioner told me to go check with him to see if the lump I am feeling is anywhere near where he may have placed a suture or something.

pesky904

The plastic surgeon also is prone to blaming anything that happens in the cancer side breast on the fact that I had radiation last year. He says that radiation is so extremely tough on the breast and causes all kinds of problems with reconstruction. So he will most certainly blame these new lamps on the fact that the breast had radiation a year ago.

NotVeryBrave

I was talking about the breast surgeon. My PS refers any possible cancer concerns to her. As a matter of fact - when I asked him if he could fix my implant during the lumpectomy surgery that I was planning at the time, he wanted to wait until that was resolved.

pesky904

Yeah, I feel like this appointment with the plastic surgeon on Tuesday is going to be a complete waste of time. The breast surgeon’s NP suggested I go see him so he could tell me whether or not he had placed a suture or something in the area where we felt the original one. because it didn’t show up on imaging and they couldn’t figure out what it was and she thought maybe it was a suture. I can tell you right now it’s not a suture because it’s gotten bigger since I saw her almost 3 weeks ago. Andsince that time I now have the lumps in the armpit and a little teeny nodule or something on the sternum. I almost feel like I should just cancel my appointment with him and go back to my oncologist.

pesky904

Going back to my initial question, can anyone tell me if fat necrosis gets bigger over a relatively short period of time? Or if you feel a pea-size lump of fat necrosis, does it remain pea size?