atypical ovarian cysts after bc treatment

Hi mmm5, thanks for finding me again!  You really have had just about everything, haven't you?

Gosh, I am sooooo upset over all of this.  I posted on another thread about how I had just recently finished chemo, am finishing up radiation (in 2 weeks) and really starting to get the pieces of myself back togehter (both physically and mentally.)  I made (what I thought) were routine appts with my regular primary doc and my ob-gyn just to do all the normal, "stay-healthy" things that haven't gotten done because of all the bc treatments and appts.  I have had the pelvic ultrasounds in the past (because of my mom's history of uterine sarcoma) so I really didn't think much of it.  Boy was I surprised when my ob-gyn called me with this new news.

He referred me to the gyn onc because he told me with my history and since we had already discussed the possibiltiy of getting my ovaries out already (because of the whole estrogen positive, tamox, AI issue that you already know about) that he was not recommending the "wait and watch" approach which is still pretty standard in the size of mine.  He said why wait if we were already thinking about the surgery already. But the gyn onc made the decision not to see me until I finish rads.  I finish rads on Thurs, March 4th and my appt with the gyn onc is on Wed, march 10th. I tried to plead with the receptionist to schedule me the week of my last treatment just to get the ball rolling, but she said the doc had already reviewed my files and wants to see me AFTER rads.  (I know he did review my case with my ob-gyn already b/c of a mix-up with the referral that my Ob-gyn had just cleared up with him.)  So I don't really know how to get in earlier.  DARN rads!

You asked about the nodule--I have a typo in my post above--the report should read, "cyst has a mural nodule."  My obgyn says this means there is something solid in the fluid filled cyst.  I think the mural part means there is blood flow (yippee)  to that area.  I keep telling myself all the things that you said and that I have read from these other posts--rationally, this is probably nothing.  But you know that "rationally" really isn't a word in our lives anymore because "rationally" I shouldn't have had breast cancer in the first place.  My original mammogram/ultrasound impression read, "LOW suspicion of malignancy.  Most likely a fibroadenoma."  So. . .  there goes rational thinking out the window in my view from now on.

 I asked my ob-gyn about the possibility of it being breast cancer mets.  He said possible, but rare.  Most likely, if it is a malignant finding, it would be a second primary cancer.  But being found so close to the end of my chemo makes me think it is more likely to be a met than a brand new cancer.  I'm so nervous.  Would a MRI be able to tell the difference between a cyst with solid benign contents or a cyst with malignant solid contents?  I doubt if my onc would order one anyways before I would see the gyn onc.  She seems really adamant about not doing anything else at the same time as rads.  She even had me postpone my herceptin for these 6 weeks (I know anxiety, anxiety, anxiety, but I did get 2 opinions from the rad oncs and one said it wouldn't matter, the other said she tended to agree with my onc based on the fact that I was being radiated on the left side with a mastectomy.  I guess it has something to do with the whole heart damage possiblity again.  Anyways, I got my treatment right before rads and I'm scheduled for one 4 days after finishing, so really I'm only missing one treatment in the middle and late for one by just a week.)

I went yesterday to have my CA 125 blood test as well as the CA 27.29.  I (of course) will be by bright and early on Monday morning to pick up those results, rather than waiting for appts. 

Hello! 

 My mother was diagnosed with breast cancer in 2008. She had a lumpectomy, (3 lymph nodes were taken out, but only one of them were positive) chemotherapy and then radiation. The tumor had both estrogen and progesteron receptors, but no HER2 receptors. Therefore, she gets hormone treatment. She started to take tamoxifen in last September. (The US before the treatment didn't show anything in the ovaries.) At the end of September, she had other examinations (as tamoxifen reduce the risk of breast cancer, but it increases the risk of uterine cancer and so forth..) The US examination showed something in her right ovary. Then there was an MR examination. The result was: Atypical ovarian cyst, it is needed to be controlled. The cyst mainly contains fluid, but it has a soft / semi-solid part. Since September, she has had more examinations in order to monitor the cyst and make sure that nothing has changed. Fortunately, nothing has changed since September, so it didn't get larger, it didn't change in look, it didn't grow, it's the same. However, my mum's oncologyst still worries, because of the semi-solid part. A very experinced gyncologist examined my mum, he took a look on the cyst, but he couldn't decide wether it is malignant or benign. He told my mum that only surgery and biopsy can decide it. Nobody had ovarian cancer in our family, even not breast cancer. We are still worried. My mother'll have a surgery in April. (Her ovaries will be taken out)
Is an atypical ovarian cyst malignant (if it didn't change)? Can it be benign (if if didn't grow) ? Can tamoxifen cause such a cyst?

Just wanted to add, that most ovarian cysts, even ones that are atypical and complex with solid tissue pieces, are still benign. My gyn keeps reminding me of this.  That's why they usually try to watch them for a bit before they decide to do anything.

Weety, I've read your posts. My mum's surgery will be on 7th April (laparoscopically). I've also read articles about ovarian cancer. Most of them say that 95% of ovarian cysts are benign and ovarian cancer is considered to be rare.

septated means it has "divisions" growing in the cyst.  Instead of being one open cyst, it has divisions that are like multiple compartments inside of the cyst.  Mine doesn't have that.  Septations are not a good thing, but again, even benign cysts have them sometimes.

Weety. I know the actual size of my mum's ovarian cyst. It's 18 milimetres in diameter and the semi-solid part is 10 milimetres. I think it's a small one. Could you tell me what the difference is between a complex and a septated ovarian cyst?

"Report just said it is on the cyst wall". Does it mean that the solid tissue is not inside the cyst? Or what does that mean?

I see what you mean! Don't worry! Everything'll be fine! My mother hates cancer as well. Her surgery will be next week. I hope she's gonna be fine! I don't know how much time the biopsy will take, but I'll tell you the results. Best wishes!

Hello Weety!

 My mum's surgery was yesterday and fortunately everything is fine. The cyst turned out to be a dermoid cyst which contained hair. Even the doctor who performed the operation had no clue how the hell the cyst developed. The other interesting thing is that dermoid cysts tend to be much larger and my mum's cyst was tiny.(That's why my mum's gyncologist didn't know whether the cyst was benign or malignant.) The MR examination showed an atypical cyst in September (atypical cells are also dangerous, because they can transform to cancerous cells.), so it was wrong. You can never know it.  Only biopsy and operation are sure (in my opinion). As for my mother's condition, she is well, actually. She can walk now, of course she feels a lil' pain, but that's natural. Don't worry! I agree with the statment: "95 % of ovarian cysts are benign". Everything'll be fine! Best of luck and please update me after your surgery and tell me your results. Good luck!

I just want to add that it's not probable that your cyst is malignant, because you are young! You are not after menopausa. (I wrote to a doctor and he said that ovarian cyst are likely to be malignant over the age of 60.) Did anybody have ovarian cancer in your family? Have you been tested for BRCA gene mutation (familial mammary-ovary syndrome)? Did anybody have cysts in your family? Have you been tested for CA-125 tumor marker? Did anybody have colon cancer in your family?

BRCA negative.  No ovarian cancer (or breast cancer) on either side of family.  Colon cancer, yes, but genetics doctor did not seem to think I fit the criteria for familial lynch syndrome.

 I am curious as to what kind of surgery your mom ended up having.  Did they remove everything laparascopically since the cyst was small?  Or did she have the traditional, open surgery?

Weety!

 She had to go into the hospital the day before yesterday. She got laxatives and enema. The surgery started yesterday between 11 and 12 o'clock in the morning. She was put to sleep. The operation took about 30 minutes. Everything was removed laparoscopically (both ovaries and both fallopian tubes.) The surgeon cleaned her abdomen with a kind of fluid during the surgery (I don't know too much about that.) First a small insection was made under her navel in order to examine the cyst with an instrument and a microscope. The doctor said my mum that if the cyst is benign, they would remove everything laparoscopically (that happened luckily). If the cyst would have been malignant, a total hysterectomy had been carried out which requires a much longer insection. (if a cyst is malignant, laparoscopy is no good, because there's chance that the cyst spreads to other parts: uterus, cervix).

If you have further question, just ask and I'll tell you what I know. 

Hello Weety!

Please update me about your surgery as soon as you can!
Dorothy

logged on just to check on you weety...of course I just knew it would be b9

Hi Weety,

What great preliminary news on your surgery!  Happy, happy b9 day!!

Be sure to make rest and recovery a priority, and let everyone wait on you and treat you like a princess. 

Gentle Hugs,

MM