More skin thickening while on chemo!

Options
AnnAlive
AnnAlive Member Posts: 450
edited June 2014 in Stage III Breast Cancer

I'm in neoadjuvant chemo, having completed 4 DD A/C and 7 of 12 weekly Taxol/Herceptin. So far it seems the chemo has been working because the tumor in the left breast is no longer palpable and the axillary lymph node tumor that was extracapsular has become tiny. At this week's onco appointment, she noted that the thickened breast skin (malignant in punch biopsies) has gradually cleared on the inner side of the breast (mainly during A/C I think), but the thickened skin on the outer side and near areola is not clearing, and is now thicker. She looked displeased or concerned, but before I could think to ask what that means for me, she was on to checking the lymph nodes.

I usually have a number of questions I want to ask at these appointments, and if there is something unexpected (while DH is busy taking notes), I lose my presence of mind to follow up what was just said! I couldn't find any other discussion on this specific topic--What does it mean if the skin starts to further thicken? Is it no longer responding to chemo and is there more cancer growth, or can it change while healing? (I realize the goal is not to make the skin beautiful - ha - but to observe that neoadjuvant chemo is reducing the evidence. I'll have a BMX in a few weeks, so that skin will be gone, but meanwhile is the tumor trying to metastasize?)

I may be obsessing a little too much on this because of steroid episodes. On Decadron pre-med, I have been flying high with energy initially, and then toward the next treatment, I have been a mess of tears, anger, and depression -- worsening for the last few Taxol cycles. My onco agreed to reduce Decadron from 10mg to 4mg, and started me on daily Ativan, which I resisted (yet another drug) but she said it was necessary if I was to have less steroids. Well, I didn't have energy after this IV Decadron at 4mg and I'm feeling kind of lethargic and achy, so I'll see how I adjust to this. I see that others have posted about steroid psychosis. I didn't expect to become so emotional about just about anything.

· Share on FacebookShare on Twitter

Comments

  • clariceak
    clariceak Member Posts: 752
    edited August 2011

    Sorry, I'm not familar with skin thickening but I can certainly identify with all the carefully planned questions evaporating once something unexpected happens,

    I'm glad you were able to reduce your Decadron.  It's awful stuff and I don't understand why the oncs don't warn of the emotional side effects. It's certainly enough to be dealing with a cancer dx, without feeling crazy and despondent from the drugs,

    Hope someone comes along soon to answer your initial question,

    · Share on FacebookShare on Twitter
  • AnacortesGirl
    AnacortesGirl Member Posts: 1,758
    edited August 2011

    AnnAlive -

    I was never given a punch biopsy even though I had significant thickening and redness.  In my case the thickening had to do with the nature of invasive lobular cancer.  I made the skin very thick and the overall breast felt very hard.  The redness would wax and wane.  The response from my oncs was that edema (swelling) is not unusual during chemo so that was why I would see a change in the skin color.  It was about 4 months into chemo before my breast finally softemed amd the redness went away.

    It could be that you also have lobular cancer.  It is not unusual to have both.  And they are treated the same.  Another possibility is that your tissue's fluid pathways have changed due to the reduction in the tumor and they can't drain as readily. 

    Surgery will be the answer to your questions.  I wish you the best!

    · Share on FacebookShare on Twitter
  • AnnAlive
    AnnAlive Member Posts: 450
    edited August 2011

    AnacortesGirl: My first visible symptoms that sent me to the doctor were edema in one breast and mild redness that would come & go, plus blotchiness and thickened skin. That was before any chemo, and I asked more than once if it was IBC and the onco said no.After over 3 months of chemo, I still have edema, but the other discoloration and part of the thickening has disappeared. Nobody mentioned the possibility of ILC (since the pathology report said IDC), but it is a curious thing why the remaining thickened skin (located closer to the tumor) seems to be getting worse -- thicker -- while on chemo. True that surgery should answer my questions! 

    clariceak: You are right about Decadron, confirmed on other threads and also one of my chemo nurses said it leads some to steroid psychosis while they are taking it. I felt like I was on my way there, and now, almost a week later on less Decadron and with Ativan added, I am feeling more "even-tempered" -- less crazy. Wink

    · Share on FacebookShare on Twitter
  • TooManyCocktails
    TooManyCocktails Member Posts: 182
    edited August 2011

    They told me that I had mastitis for about 7 months. I, finally, got the BS to do a biopsy, which said adenocarcinoma.  She assured me that I did not have IBC.  So, I had a BMX.  It showed 18 small tumors in the breast and a 3 cm axillary tumor and 41/41 positive lymph nodes.  The pathology report said that it was IDC.  I didn't like my first onc; so I changed onc's and she says that I have IBC.  She said IBC can be diagnosed clinically and pathologically.

    On my mammogram, I had skin thickening and edema, which they all said was mastitis.

    I think you should get another opinion.

    · Share on FacebookShare on Twitter
  • AnnAlive
    AnnAlive Member Posts: 450
    edited August 2011

    TooManyCocktails: That's perplexing to me that your pathology report said IDC, yet your new onc calls it IBC anyway. Did she have the specimens reevaluated? In what way would treatment for IBC differ from IDC? I'm already getting the works: almost through chemo AC -TH (proceeding to at least a year of H), followed by BMX & axillary node dissection, then 6-7 wks rads. I'm unclear on whether it is possible to know, after neoadjuvant chemo, how many nodes had been positive (in addition to any that are still positive at surgery). My scans showed many enlarged axillary nodes, but only one was biopsied and was positive, with extracapsular extension. Will I know what the "real" positive node count is from before chemo?

    Seems like no one has mentioned having an issue with skin involvment that may be thickening/growing during chemo. I wonder if it is an ominous sign, or has been IBC all along, ominous enough, but not sure what would be done differently for it with another opinion.

    · Share on FacebookShare on Twitter
  • adgirl5
    adgirl5 Member Posts: 81
    edited October 2011

    I wish I knew the answer.  I HAVE heard of skin thickening from the TripleNegativeBreastCancer forum.  Right now I'm battling chemo not working and shrinking this tumor in my right breast.  I'm surprised they didn't do all the testing to find out if there were positive nodes before treatment.  I guess it would be hard to detect as micro cells aren't visible to even the most sensitive diagnostics.

    Good luck my dear!  I'll pray this goes in your favor.

    · Share on FacebookShare on Twitter
  • Kay_G
    Kay_G Member Posts: 3,345
    edited October 2011

    I had skin thickening with IDC.  I think I was told it was caused because of inflamation.  Cancer causes inflamation, and someone above mentioned that chemo causes inflamation.  I would think it could be from the chemo.  I was never told the thickening got worse during chemo, not sure if it did or not.  I do remember BS saying when she was feeling something she thought it was scar tissue, not sure if that would have been increased thickening or not.  I had neoadjuvant chemo, so I will never know how many positive nodes I really had.  Not sure if any of this helps you or not, but I know how you feel.

    · Share on FacebookShare on Twitter

Categories