Concerned Husband

concernedhusband1 · June 2012

Hello all, i hope i'm not intruding as a male in this room, but I'm looking for some answers. My wife has not been diagnosed with breast cancer, however her mother had breast cancer, and she is high risk. My wife has been developing fatty necrosis for the last year in her right breast, which scared her, obviously. She had the first 2 lumps of necosis removed and others seem to keep coming in different spots. She was in a lot of pain and recovery last year. Three surgerys and recovery kept her out of work for most of the year. She has recently had another lump show up now in her left breast and it is getting bigger and bigger every day. These lumps seem to show up almost over night and grow quickly. The doc keeps telling her there is not much he can do. He doesnt want to remove anymore of this necrosis, because the surgerys can cause more. She is having trouble sleeping due to the pain and she is looking for othe options. I have found online that massaging and heat compresses would help, but she is so tender in the area, that she cannot massage

Infobabe · June 2012

concernedhusband1

I assume those lumps have been biopsied and they do not show any carcinoma. Correct me if I am wrong.

I don't know if anyone on this board can help you but perhaps there are some medical people out there who can give an opinion. What does her doctor say?

This sounds very troubling. You doctor should be giving you guidance.

Something you can do is go to every medical appointment she has. She needs you to be a second pair of ears and understand what she is going through. She should also go to a breast center in a city near you. The bigger the city the better.

dlb823 · June 2012

I'm not familiar with fat necrosis developing on its own, separate from fat transplant surgery, which is commonly done these days for breast reconstruction. However, I'm wondering if a second opinion might be in order? If she's not already being treated at an NCI-designated comprehensive cancer center, I think seeing a breast surgeon at one of them might yield some additional insight and helpful information. Most of these facilities have actual High Risk Programs that include evaluating and all sorts of extra screening, as well as teaching preventative lifestyle changes, if your wife truly is at high risk.

Here's a list of those medical facilities where you'll find the top breast surgeons/experts:

http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html

So sorry your wife is going through this, but it sounds to me like a second opinion might be in order, and hopefully a breast expert of that caliber -- one who is dedicated only to breast health 24/7 -- will have some better answers for her. Deanna

JayeGA · June 2012

I agree. Not sure if the doc is a general surgeon or breast surgeon, but a second opinion might be a good idea.

concernedhusband1 · June 2012

Yes the lumps that have been removed are benign, and i have been to every appointment with her. She has never had any other surgerys on or near her breast until these lumps "fatty necorsis" came along. The doctor is a general surgeon, he was referred by another doctor when they found an abnormality in a mamogram. I asked him if there was a specialist he would reccomend he replied with "I am the specialist" I think we need to seek a second opinion.

LISAMG · June 2012

Concernedhusband, kudos to you for being the strong advocate for your wife ))) YES, I would definitely seek a 2nd opinion with a breast surgical oncologist and preferably not a general surgeon who happens to be just that. Has your wife ever had breast MRI's, being that she is high risk with multiple biopsies??? This is standard of care for high risk women. Did the general surgeon, or anyone, ever recommend a breast MRI for your wife, other than a mammogram? Seems as though your wife may have dense breast tissue, another definite high risk factor, and painful fibrocystic breasts as well. Where are you located? Are u located near a major cancer center?

Equally important, how old was her mother at the time of her diagnosis? Is she alive or deceased? If her mom had BC on or before the age of 50, this could be suggestive of hereditary BC and a possible BRCA gene mutation. Any other women/men in your wife's family with breast or ovarian cancers? If any of the answers are yes, perhaps genetic counseling would be a good idea for your wife and/or her mom too. Keep us posted and best wishes!!

dlb823 · June 2012

Perhaps you've already done some on-line research, but here are a few articles I just pulled up that talk about fat necrosis as an ongoing condition:

http://www.livestrong.com/article/331555-breast-fat-necrosis/

http://breastcancer.about.com/od/whenitsnotcancer/tp/Breast-Fat-Necrosis.htm

http://www.riversideonline.com/health_reference/Womens-Health/BR00013.cfm

http://www.freemd.com/breast-fat-necrosis/treatment.htm

Another idea you might keep in mind ... depending on what a breast surgeon diagnoses, perhaps a highly qualified naturopathic doctor could offer suggestions for diet and/or supplements -- natural, non-pharmaceutical things to help with both the pain and future prevention. But I think a breast surgeon should be your first appointment, to be sure the diagnosis is correct, and to see if any high risk assessment or additional screening is recommended. Deanna

Infobabe · June 2012

dlb823

That was a good and well researched response, Deanna.

concernedhusband1 · June 2012

Thank you all, I looked up the Doctor that my wife has been seeing and he comes up as a general surgon, however i know that his patients are all cancer patients, from the visits i have been to. My mother in-law was diagnosed in her 30's which is what is concerning my wife because she is now 35. We are in San Antonio, TX not sure if there is a major cancer center here. I will check on it. The doctors have mentioned the "cancer gene" and wanted to wait on doing the test because they say it is pretty expensive and if the lumps that have been removed are benign that they dont want to do the test yet. I dont think they have mentioned a breast MRI, but i know her doc wouldn't send her back to get another Mamogram because she was in so much pain. Something else i forgot to mention...some of these lumps have turned into the "oily cysts" and pushed to the surface and have actually broken the skin and drained. From what I've read these are common with the fat necrosis also. She has another appointment tomorrow so we have lots to discuss and hopefully we can find another doc for a 2nd opinion, and we can get this gene test done also. Thank you all so much.

Sommer43 · June 2012

Fat necrosis of the breast can occur from surgery, or from a trauma to the breast. I have had one, that is very painful and I have been unable to massage it. What I am unsure about, is that your wife has more than one. You say that on the ones removed, there has been a final histology on these masses? Necrosis can mimic carcinomas, so it is important that they are biopsied because of the resemblance to carcinomas.

I have read a lot on fat necrosis, very much associated with large, pendulous breasts and women who smoke, are very prone to them after trauma. So, it would be prudent of you both to look to see if she has had any injury, trauma, even something as simple as a knock can kick off a necrosis. I was most disturbed to have a large one, after a small surgery. What happens with the necrosis, is that calcium soaps break away, causing oil cysts, and ultimately form calcifications, which are, from my reading up, benign. Which you have pointed out and like any other benign condition, your wife may be susceptible to fat necrosis.

If, after this investigation, your wife has a diagnosis of another fat necrosis, I would certainly be looking into why, and something as simple as a seat belt could be kicking it off.

I can sympathise with your wife, it is a painful condition and mine is being monitored, I had one cyst drained on Friday which has given me some relief, but the mass is still there, not causing me too much pain at the moment, but am hoping with time, it will filter away.

I would be interested in how this goes on!

besa · June 2012

I think that a 2nd or even 3rd opinion would be good and looking into being monitored with breast MRIs, being seen by a breast surgical oncologist --- LisaMG's recommendations. Another source of information is:

www.facingourrisk.org

http://www.facingourrisk.org/about_us/contact_force.php

This is a national organization for high risk women with family histories of breast and/ or ovarian cancer (for women with or without the BRCA mutation). There is a local chapter in San Antonio. You should be able to get names of physicians or programs that specialize in monitoring and treating high risk women through the local group -or even better yet through Sue Friedman at the main office. If there is no one you are happy with locally I would consider traveling for a 2nd opinion - this is important.

Jodycat · June 2012

MD Anderson in Houston is superb. You can simplygo to their website and follow the directions for requesting an appointment.

That said, it can be hard to get through. I'd be happy to try to help. Pm me if you want.

They think they are one of the very best in the world. They may be right.

concernedhusband1 · June 2012

Thank you all agian, we had a visit to the doc on Tuesday, which turned into a rush surgery, he was concerned with the size of the lump she had on the left breast. The right breast turned out to be more of the oily cyst junk that is resurfacing behind one of the old scars. The left side which was a large lump, about the size of a potatoe, turned out to be nothing but puss. YAY SOMETHING NEW. Great. Now the doc is really scratching his head. He says puss is usally from an infection, this one looked like staff. He said this type of infection is something you would see when a woman is breastfeeding, but its been 4 years since any of that has been going on. So now we are needing to see an infectious desease doc, and next week we will be getting appointments for a second opinion and scheduling her BRCA test. I know i have no idea what women go through, but i see what my wife is dealing with. My heart and prayers go out to all of you.

apple · June 2012

thank you for your prayers.. personally, i'd have my breasts just removed. it seems you are having so many problems.

Infobabe · June 2012

concernedhusband1

That is such good news. Very confounding but at least you are getting a handle on it. I never heard of anything like that.

I am so glad you came to this site. My husband is very supportive but if he read these pages he would have a better understanding of what a confusing problem breast disease is.

You are really to be commended for ferreting out guidance and recommendations. Though some, but few men think to do this.

jenniferjones440 · June 2012

I can understand from which situation your wife is going now, I know that Fat necrosis of the breast is very painful and in addition to that this puss problem, you should go with her to the infectious doc and be with her all the time as she needs your support very much.

Concerned Husband

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