Suspected New After Radiation!!!

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Kohinoor
Kohinoor Member Posts: 18
edited October 2014 in Radiation Therapy - Before, During, and After

I had a lumpectomy for ILC in late July followed by a 25/5 radiation course. I've been put on Tam 1.5 months ago.


I had a breast ultra sound two days ago. The radiologist noted a small lesion that she graded BIRAD 4C. She recommended an ultra sound true cut pathology. My surgeon seconded this opinion saying there is a probability this is a new malignancy. The question is how could this have gone undetected only two months ago when I had the mammogram, US and MRI? The doctor said it could have been very small to be detected and the radiation actually made it grow. Radiation treatment was supposed to destroy any rogue cells and not to activate new tumors. Am I missing something?

Does this make sense? Please help answer my questions. I'm worried sick.

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  • SmartassSmurf
    SmartassSmurf Member Posts: 157
    edited October 2014

    I have no answers,, but I am very sorry you are going through this. Good luck, I hope it is nothing. You are in my thoughts.

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  • zha-an
    zha-an Member Posts: 31
    edited October 2014

    kohinoor

    any update? Thinking of you during a scary time ... Zha-an

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  • Runnergirl36
    Runnergirl36 Member Posts: 16
    edited October 2014

    Prayers are with you. Please keep us posted.

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  • Kohinoor
    Kohinoor Member Posts: 18
    edited October 2014

    Dear ladies,

    Thank you for your concern.  The biopsy results showed this is fat necrosis resulting from the surgery and/or radiation.  My surgeon wants to have it removed as soon as possible given the fact that it's graded Birads 4C whereas my oncologist prefers we wait a couple of months to give the skin time to heal after radiation.  The surgeon sees no point in waiting since it's going to be removed anyway and if the surgery is done in three weeks' time that'll be six weeks after I've completed RT and the skin should be OK to handle a new surgery.

    At least the probability of a new malignancy has been ruled out - for now! I'll leave the surgeon and oncologist to decide on the timing of the new surgery.  I'll keep you posted.  Thanks again for your concern and support.

    xox

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  • Tomboy
    Tomboy Member Posts: 3,945
    edited October 2014

    two things: i am startled they actually gave it a birads "4C". there are only numeric assignments to birads. and i am also startled they want to "remove" fat necrosis. It is caused by radiation, and they usually leave it alone. i would listen to your rad onc, and not the surgeon. or seek a 2nd opinion elsewhere. why would they take it out, and six weeks is not a very long time at all for radiated tissue to "heal". something is sounding fishy to me...

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  • Racy
    Racy Member Posts: 2,651
    edited October 2014

    Good points, kathec! Wishing you well, Kohinoor.

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  • Kohinoor
    Kohinoor Member Posts: 18
    edited October 2014

    Dear ladies,

    Thanks for your responses.  I too am baffled by my surgeon's decision.  He says he wants the area cleared and kept "clean".  My oncologist too wants to have it removed but not so soon.  Given the choice, I would leave it in as I'm dreading the prospect of a new surgery.  However, I don't want to take risks by opting to avoid surgery.  I think I'm going to postpone having the operation for as long as possible.

    Thanks for your concern.  I'll keep you posted.

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  • Tomboy
    Tomboy Member Posts: 3,945
    edited October 2014

    Thanks, Kohinor, for checking back in. I think a "watch and wait" is a good thing. Radiated tissue is never as strong as it was before. I am still really wishing you could get a second opinion at a place that doesn't have anything to do with the first one. I have quite the area of fat necrosis myself,and they are doing nothing more than just watching it. it happens, many women have it. What is your radiation oncologist saying? Can you talk to him/her? I am not trying to upset you at all, please, I hope you aren't, I am just trying to understand. what did you mean that you were going to have the surgery anyway?  Does your place treat cancer exclusively, or is it a private practice? Do they folow NCCN guidelines? I am hoping the best for you, and just don't want to see you go through an unnecessary process, that's all.

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  • Kohinoor
    Kohinoor Member Posts: 18
    edited October 2014

    Hi Kathec,

    Thanks for reply.  I checked with another surgeon and he totally opposed the surgery option.  He said radiated tissue needs a long time to heal.  If surgery is performed now, we risk complications of wounds and tissues that never heal.  Besides he does not see any reason for removing fat necrosis.  He - like the oncologist and onco radiologist - advised a wait-and-monitor approach.  He said the only risk we have by opting to leave the fat necrosis in is: it could in very rare cases turn into an abscess and maybe that's why the first surgeon wants to have it removed.

    So I'm going to have a new ultrasound in three weeks' time and see.

    Thank you again for your concern.

    xoxo 

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  • Tomboy
    Tomboy Member Posts: 3,945
    edited October 2014

    Phew!!! thank you for letting me know, and I hope you are feeling better about it. Have you tried the search funtion to the left of the page to try and find out more about fat necrosis? That way when you go in next, you will have educated yourself about it, and will know the right questions to ask. I am so relieved for you!

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