Cancer found during breast reduction surgery

Digezy

hi. New here. I had a Brest reduction on April 28, 2021. Out of the blue May 2 I got a call from my surgeon saying I had breast cancer! What?! The removed tissue sent to the lab has cancer. I went in for a breast reduction. There is no history of cancer in our family. 1.4 cm tumor. Now I guess I work backwards from here. Need some type of scan to look for growths. There is no way I can have a mammogram, my incisions are still healing. I guess I’ll have another surgery for removing my lymph nodes? This was so unexpected. I didn’t have any symptoms. You could knock me over with a feather right now!

-Kelly

moth

Hi Kelly, wow, that is an awful surprise. I mean I'm glad they caught it but still. You'll have a crash course in breast cancer now. The pathology report should tell you about grade and hormone receptor status. That info plus the results of your scans will guide your oncologist in making treatment recommendations.

Btw, most breast cancer pts have no family history of cancer. It's just a random crapshoot However, if you're young & depending on your hormone receptors, you might consider genetic testing.

let us know what is next in the process for you. Have you been referred to an oncologist?

Digezy

hi. I have been referred to a breast surgeon who does biopsies, lumpectomies, mastectomies, etc. I go on Tuesday. I think he will determine if the cancer has spread to my lymph nodes and/or if there are more tumors. Based on his findings I would go to an oncologist and get a treatment plan started. I was wondering if I needed to see an oncologist yet, but this is who I got referred to. The dr. that did the reduction said I would need more surgery. I’m really lost here since, like I said earlier, I’m kind of doing this process in reverse. -Kell

moth

That makes sense as usually cancer surgeries are handled by a general surgeon or an oncology surgery fellow, not by plastics/cosmetics surgeons. One thing I'd suggest you start now is figuring out how to access all your lab & dr reports. You should be able to see the pathology report and it would give you a lot of the info about the type of breast cancer you're dealing with --- but yes, knowing about the lymph nodes etc is going to be key as well.

2019whatayear

man does that stink I’m sorry this happened

Aram

I am sorry this is how you found out but on the bright sight they found it. I had a breast reduction surgery scheduled but the docotor cancelled it, and the Covid hit, and about a year later I found the tumor myself. I wish the surgon wouldn't have cancelled on me a year ago.

I hope you get answers soon, and start your treatment.

Ashlyn525

Wow, how scary. Prayers for you. The surgeon you see Tuesday should give you a lot of information. Did they give you any idea of type, etc.?

LivinLife

Sorry you find yourself here Digezy! I agree with the others about the good fortune of finding that early though it still stinks big time! Often times people are not meeting with an oncologist right away - often surgeon first.... I agree with moth about gathering the information related to your specific cancer. You will learn more about what all that means over the near future - it's a crash course unfortunately while there is a lot of waiting too....

Moderators

Posting in case anyone is interested:

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May 10, 2021 12:00 PM Eastern Time (US and Canada)

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ShetlandPony

Digezy, I see you have noted Her2 positive. In this case I would want to see a medical oncologist before further surgery. With Her2 positive, neoadjuvant (before surgery) chemo may be recommended and that is the oncologist's call, not the surgeon's.

RebzAmy

Digezy, something similar happened to me, except the tissue wasn't tested when I had the reduction. Had it been, it would have been caught so much sooner. I'm fine now, but back then I was only 37, and was so happy with the reduction and the shape. Fast forward a year or so and I found a huge lump in my armpit, followed by another one my breast (found by my GP). I was referred urgently and the diagnosis was HER2+ IDC (invasive ductal carcinoma) and also widespread DCIS (ductal carcinoma in situ). Had I had a mamogram prior to the reduction or had they tested the tissue after surgery, the DCIS would certainly have been found. My consultant who treated me was so so frustrated that the tissue removed wasn't examined at the time. Anyway, the main thing is all is okay now. I know what a shock this will be to you. The. main thing is you found it. I'm thinking of you.

Very best wishes

RebzAmy

Digezy

I saw the surgeon yesterday. He wants to doa mastectomy on my right breast. Because the margins were positive there is no way to guarantee it is all gone. Is this how this works? I don’t go see an oncologist about treatment like radiation or something? He just says take the whole breast and the lymph nodes. My reduction was 2 weeks ago. I’m just starting to heal and sleep better. I really don’t want to go through a reduction, then a mastectomy, then several months later a third surgery for reconstruction. I want someone to tell me there is an alternative. All I was supposed to do was get a reduction. Now I’m on a whole different path I never imagined I’d walk.

moth

Digezy, it's not unusual to have surgery first and then consult the oncologist. Your cancer samples will be sent for oncotype testing which will help your oncologist with recommendations regarding chemo. The MO also recommends and prescribes hormonal therapy. During the mastectomy you'll likely have sentinel lymph node taken for biopsy. If they're negative you wouldn't need radiation.

This is a lot to take in. You must be reeling. Hang in there.

SummerAngel

I would recommend seeing an MO first to get his/her opinion about treatment, and maybe get another surgical opinion as well if you're interested in trying to avoid a mastectomy. There's nothing wrong with surgery first, but you're not in as much of a hurry as you may think. You want to make sure you choose the treatment plan that's right for you.

BtwnStars

Digzey, so sorry you find yourself here. My breast surgeon actually spoke of this happening, in which she was called into a reduction surgery bcz cancer was found. I am curious if they offered any sort of diagnostic tests to determine more about it? If it is 1 cm, is a lumpectomy possible? It may be bcz it's both DCIS and IDC that they recommend mastectomy. I would definitely seek a second opinion at a cancer center if you can. I did and it made me feel better about my decision.

Also can you ask the doctor for percentages? My breast surgeon laid all the options out with the percentages for different surgeries, treatments, etc. Is there a nurse navigator you can talk to? Sometimes they are more helpful.

And just to clarify, yes, depending on cancer type, which yours seems early stage, it goes surgery then possibly chemo depending on oncotype score, then radiation or just skip to radiation if chemo not needed. Then hormonal therapy via medicine.

I know you are scared but you will be ok, you can get through it. I hope you can find some support, maybe seek out therapy. Hoping for the best for you.

ShetlandPony

Here are some questions I would want answered:

So it sounds like you did not have a mammogram before your reduction surgery. Since you just had breast surgery and cannot have a mammogram right now, would they recommend a breast MRI to make sure there are no other areas of concern?

Exactly what is the surgeon proposing about the lymph nodes? Is it possible to do a sentinel node biopsy (remove one to three nodes that are closest to the cancer, so to speak) after the reduction surgery, or will that reduction surgery interfere with the tracer finding the sentinel node(s)? Is he proposing to remove ALL your axillary nodes (ALND, axillary lymph node dissection) if he cannot find the sentinel node? Consider this carefully and determine if it is really necessary, as it raises lymphedema risk, and lymphedema is a serious condition. More and more we are moving away from ALND in favor of radiation and systemic therapy.

Why is mastectomy recommended? Is it because the DCIS extensive? Or can you try a re-excision and then go to mastectomy if the margins are still not clear?

I would definitely want more explanations and a second opinion from a major cancer center tumor board, especially since your situation is a bit different.

You ask if there is an alternative to mastectomy and reconstruction. Yes. There is mastectomy without reconstruction. Look up "going flat" and "aesthetic flat closure" here on BCO. I have read here that not all surgeons respect a woman choosing this option, and not all of them know how to make a smooth flat chest as opposed to lumps and extra skin. Research carefully all your options for reconstruction and no reconstruction to find what is right for you.

P.S. I see that you have filled in your "stats" and it is not Her2 positive after all.

Primavera304856

When I got diagnosed, I was also confused why I was being sent to an oncologist. I thought I would have surgery first, then chemo.

I saw that surgeon only that day. I was sent to the oncologist. She already had a plan for me. Chemo first: 4 rounds of Adriamycin, every two weeks, then 12 consecutive weeks of Taxol, mixed with Perjeta and Herceptin every 3 weeks (every 3 weeks I would have a very long day).

That was August last year to March this year. I saw surgeon again to prepare for surgery. Treatment worked. I had a left breast mastectomy and the margins were clear and the lymph nodes came clear too (there was one they were tracing where the cancer had already spread).

So maybe because you have a "fresh" surgery, they'll send you to chemo first. They sent me to chemo to reduce the size of the tumor and because I had two cancers, the tumor plus a "bed" of another cancer in a different quadrant.

All I wanted to avoid was radiation, and at this time, oncologist said I don't need it. I'll continue with Perjeta/Herceptin every three weeks and then I'll go to Arimidex. Afraid of Arimidex, too, but I don't think I can avoid it.

P.S.: I just read your other posts. There is a lot that's been left unanswered. You might want a second opinion. You could have an MRI of the breast to find out where you stand.