It was scar tissue, but now what?

PurpleCat

I posted in an earlier thread about a scare that turned out to be scar tissue. This was great news, relatively speaking, but after consulting with the PA at my breast surgeon’s office I have a new set of unknowns. I’d really just intended to ask about how to manage/treat scar tissue and maybe prevent more from happening, but the conversation took some turns I hadn’t anticipated. Now I’m starting a new thread to process it all in a place where others with similar experiences might have words of wisdom.

They biopsied the area with the hardening and reddened skin, and that’s definitely scar tissue, so yay. HOWEVER … there’s always a however, it seems … there are also some rim/eggshell calcifications in the lumpectomy area. They didn’t biopsy these for two reasons: they are fairly certain it’s fat necrosis, and it would have required a stereotactic procedure in addition to the ultrasonic one. So, basically I am now a Birads 3, looking at six-month followups for at least 2 years, and as much as I hope to escape additional biopsies, it seems unlikely. Obviously this is the spot where cancer originally occurred, so the PA wanted to keep a very close eye on it. ctmbsikia, you cautioned me on the other thread that I might be in for six-months checks for a while. Knowing that in advance helped me not to feel less upset about it, so thanks!

It does seem most likely that any cancer discovered during this period of intense surveillance would be caught small and early, like the first one. However (again!) as my PA pointed out, I have extremely dense tissue, so maybe not. On the other hand, my original cancer was caught at just 7mm after a mammogram did manage to spot a cluster of microcalcifications despite my dense tissue, so I wouldn’t exactly say that mammograms have failed me in the past.

I was so pleased to be able to keep my breast 4 years ago, getting by with a lumpectomy and radiation. My surgeon did a marvelous job, and until this red spot appeared there was almost no visual or palpable difference between the two sides except in certain positions. I don’t think I appreciated how easily I’d gotten off until now. It’s not terrible looking, but I don’t know if it’s going to get worse. It feels weird and gross, and I’m having little shooting pains in the area.

For the first time at a medical appointment I was presented with the reminder that some women choose to get a prophylactic mastectomy rather than deal with the constant anxiety. This was kind of a jolt, as I’d never considered this before, and had actually been patting myself on the back a bit for the progress I’d made in being able to cope with my anxiety over the past few years. My attitude had been that scar tissue is a fairly common thing that was bound to catch up to me eventually, and I’d gotten through it OK, and could do so again if necessary. As long as it only ever turns out to be scar tissue, of course.

I don’t want to permanently alter my body over anxiety of something that might never happen. But I also really, really don’t want to get cancer again. And even short of that, I don’t want to spend any more beautiful May afternoons at the cancer center investigating stupid lumps of stupid dead fat. I’ve been looking at before/after shots on some breast reconstruction sites, and they look a lot better than I would have guessed. So, maybe it’s time to start thinking about this.

My next appointment is in August, so I have plenty of time to gather information and compile a list of questions. Just not sure where to start.

Salamandra

Aw Purplecat, sorry you're dealing with this!

Based on my reading, this is a hard call because no decision is clearly better. The upside of that is that neither decision is clearly worse. In effect that means, you can't go wrong with the actual decision, the only thing that can go wrong is how you feel about the decision.

FWIW I would say that if you decided to get a prophylactic mastectomy, I don't think it would be altering your body out of fear of something terrible that might happen (cancer recurrence) but to avoid something really aggravating that you can be reasonably sure will happen (ongoing imaging and biopsies).

I think you can keep patting yourself on the back for dealing with your anxiety. It seems totally normal to me that it would come rearing back after this experience. That doesn't indicate a failure of the past, just that you are only human! I think you will be able to get it to subside again.

For me, the experience of the find and the biopsy really racheted up my adrenaline. It took a while for that all to calm down. Not on a conscious intellectual level, but on the subconscious emotional level. To be honest, I don't think it fully calmed down until about a year later, when I had my *next* annual MRI and it didn't find anything unusual and I didn't need another biopsy.

So I guess I kind of think you don't need to pressure yourself to make a decision now at all, when things are all stirred up. It's different for everybody, but based on what you wrote, about not wanting to act out of fear, my guess is that whichever decision you make, you will feel better about it if you can feel it came from a place of knowledge and equilibrium. Based on my experience, that could mean giving yourself a whole year before focusing on the decision.

I don't think that's wasted time at all. You'll essentially be collecting more data on your own subjective experience that will help you make a more informed decision about the long term - in addition to whatever additional data you collect about the surgical options/outcomes, etc.

Hopefully some of this is relevant/helpful. Thinking of you!!

cathy67

Purplecat,

I have same thinking now, and my previous lumpectomy also did very well that I usually don't need wear bra unless for exercises. I marked this thread.

PurpleCat

Salamandra, thank you for such a thoughtful response! It helped to hear your experience. I think you’re right: it’s not that I know cancer will happen again, it’s that I seem likely to be spending a lot more hours of my life at the cancer center getting things checked out than I’d like, and and even if it always turns out to be scar tissue, it’s not how I want to spend my time. My next visit to the surgeon’s office is less than 3 months away. That will be followed by my annual MRI a few weeks later and then the six-month mammogram followup. If cancer is found at any point int his process the decision will be made for me. Assuming things look OK I think I will seek out a second opinion. I like and trust my current team, but I want to make sureI have a good medical consensus before proceeding with such a big decision.