mammogram clear but still worried as indent on breast

Busymum2015 · October 2015

I have an indent on my right breast about the size of a fifty pence piece I had a mammogram today and it was clear. I originally went to my gp because of indentation. She could see where it was and felt a small lump and referred me for an urgent ultrasound. At the hospital the doctor said he couldn't see indent,I explained it is harder to see with artificial light and the doctor noticed a small lump. He felt my breast and said I suppose I will have to take your word for it go for a mammogram. Which I did and it was clear. But I am still worried my husband has photographed my breast in natural light and the indentation is so obvious its scary. Should I ask for a second opinion.

Jinx27 · October 2015

I would get another opinion or speak to your dr again. I had an indentation and thought is was a benign and that wasn't the case. My gyn and gp assumed it was benign, a third gp suggested I go for imaging.

It took a breast surgeon to find it and biopsy it.

Keep investigating until it has been confirmed! Best wishes to you ☺

AmyQ · October 2015

Busymum I agree get another opinion. Good luck to you. I hope it turns out to be nothing but for now, it is something.

Amy

Busymum2015 · October 2015

Thank you AmyQ and Jinx27 I am going to go again tomorrow to ask for a second opinion.

nks

Busymum2015 · October 2015

Hi all update went to GP this morning she said yes she can still feel lump and see indentation (which hospital doctor said he couldn't) but as mammogram clear there was no need for a second opinion. I asked what could be causing indentation she said the lump tethering and it was probably due to breastfeeding ( I have 6 month old twins) I advised her I hadn't breastfed due to both babies being lactose intolerant and both babies are exclusively bottle fed. She replied sometimes things take a while to go back to normal give it another 4 weeks and come back if I am still concerned. I am 44 years old and have 7 children ranging from 27 to 6 months and have never experienced anything like this with my breasts. I did have a fibroid removed from my breast when I was 20 but that was just a large lump about the size of a golf ball. HELP!!

DivineMrsM · October 2015

Follow your instincts. Sometimes a lump will not show on a mammogram, even if it is large. The lump I had was over 2 inches long, and it didn't show on the mammo. Invasive lobular carcinoma can sometimes hide like that. I had an indent in my breast. The lump could be felt. Yet did not show on the mammo.

See if you can get a doctor to order an MRI which could show images better than a mammo. If you feel strongly about this, don't allow those in the medical field to minimize your concerns. It is your body. Even if it turns out to be nothing, you can still feel good that you are looking out for yourself. Best wishes.

Busymum2015 · October 2015

ThedivineMrsM was your breast indent round, mine is sort of round with jagged edges if that makes sense. The lump I can feel is very small. I just feel something is wrong. I did say to the doctor I had read certain things can be missed with a mammogram and she said no if you have an indentation it would show something suspicious, I am just not convinced. Thank you

Sam2U · October 2015

I agree-follow your instincts. Is there a certified breast center near you that you could go to for a second opinion?

Busymum2015 · October 2015

Hi Sam2u not sure but I am going to do some research and find out. I have just been on the cancer research uk website about invasive lobular carcinoma and it states on there that it is difficult to diagnose and often does not show on a mammogram even when symptoms are present. One of the symptoms is an indentation. Thank you

Busymum2015 · October 2015

Meant to say I am going to print off and take to gp.

Jinx27 · October 2015

Best of luck Busymum, I'm not convinced yet either! Find a breast center or a cancer center and have them give you an opinion. It could be another benign mass. I want them to confirm if it is or isn't.

My indentation was at 5 o clock on left breast and was only seen when my arms were by my side. They thought it was fibroadenoma, then lobular cancer but then initial path report from the biopsy said ductal carcinoma.

Keep Pushing! I'm praying for the best for you!

Busymum2015 · October 2015

Thanks Jinx mine is on the right breast about 5 o'clock. It's frustrating when you are made to feel you are creating a fuss about nothing. I sent my sister a photo of the indentation (she lives a 6 hour drive away) knowing she would say stop worrying if it didn't look too bad. She said that is not normal get back to GP and don't quit until they listen.

ABeautifulSunset · October 2015

I wish I had been more insistent. It took three mammos over the course of a year and a half (following what was supposedly a benign lump) before someone finally sent me to a breast surgeon for an ultrasound. BAM! Huge cancer tumor... Actually two. I dont mean to be an alarmist. Maybe it is nothing, but you need to get an ultrasound at minimum, maybe an MRI. I was surprised to learn how many doctors actually have their heads up their asses.

Busymum2015 · October 2015

Thanks Stefajoy

Busymum2015 · October 2015

Hi Ladies

Just an update I spoke to a Macmillan cancer nurse yesterday for further advice before I went back to my GP. She was shocked that only a mammogram had been done as I have 6 month old babies and my breasts would be very dense so anything would be unlikely to show up. She also said a GP should not just assume that the indentation was caused by my breasts returning to normal after having my children and that she had not heard of this causing tethering of the skin before. She advised that I get seen as soon as possible and ask to be referred to a breast cancer clinic. She also said I can choose which clinic I go to and to research online the reviews of each clinic before making my decision.

Feeling a little more positive that I have an action plan and have made an appointment to see another GP at the practice for Monday 19th. This was the earliest appointment they had but at least its a start.

Thank you so much for all the information and support. I will keep you all posted.

DivineMrsM · October 2015

I'm so proud you for advocating for yourself. That's the way to do it. I'm so happy you found a nurse who had the insight to acknowledge your concerns and point you in a better direction.

Busymum2015 · October 2015

Thankyou x

Busymum2015 · October 2015

Hi ladies an update re gp appointment. I showed the gp the photos of breast in natural daylight and he immediately agreed I needed a second opinion and asked which hospital I wanted referring too, unfortunately it could take up to 2 weeks for the appointment to come through but at least he listened and understood my concerns. The hospital I had mammogram done at hadn't even sent the report through to the gp yet.

On another note I have had horrendous pain in my knee (on the same side as dodgy boob) the previous gp said it was arthritis it would get better on its own take anti inflammatory medication. I brought it up telling him it is much worse are there stronger anti inflammatory tablets I could take. He said I shouldn't have arthritis at my age and said he was ordering an mri on my knee to see what is going on. Why can't all doctors be like him instead of brushing you off.

Hopefully next update will be soon and a definite positive outcome.

Thanks again for your support x

lisa-e · October 2015

Busymom, I am glad you are getting a second opinion. My BS felt a dimple (indent) and decided to remove what ever was causing the dimple when I had a lumpectomy for DCIS. What was causing the dimple was a smallish invasive ductal carcinoma. This tumor was not seen when I had a diagnostic mammogram.

Dimples in the breast can be caused by tumors and should be investigated.

Busymum2015 · October 2015

lisa-e I am hoping for a positive outcome, but worse case scenario if its something nasty I want it to be caught early. Thank you for your support and advice.

Busymum2015 · October 2015

Quick update ladies telephone call from breast clinic today I go Friday afternoon. At least I should have some answers then!

Busymum2015 · October 2015

Had a miserable weepy day today trying to be so positive telling myself it will be fine! But no wasn't happening today....maybe tomorrow will be better either way only one more day until I see bc specialist.

mothertime · October 2015

I had gone to 7 doctors for a lump in my breast. One did a mammogram and it was normal. All doctors said "it's your age and women go thru this" . I called a cancer center, that doc felt the golf ball size lump that the other doctors called normal. He did surgery and removed a precancerous mass. He said that if I wouldn't have listened to my body, it would have turned to cancer. Persistence pays off. Push on and make someone listen. Hug

Busymum2015 · October 2015

Hi mothertime thank you so glad you caught yours intime. Hopefully I will have some answers today. I feel incredibly sick with nerves and just want today over with now. I am not giving up until they tell me a 100% percent either way what is causing the indentation. I will post here later today how I went on. X

Busymum2015 · October 2015

Hi all I saw breast cancer doctor today she could clearly see even in artificial light the indentation and could feel lumps, but said it was lobular tissue. I had an ultrasound which was clear, the mammogram results from previous hospital had not been sent through even though they had been requested. But she said she 99% sure its not cancer. I said I wanted her to be a 100% sure and what was causing indentation, she thinks it could be due to breasts returning to normal after being pregnant with twin's. I asked fir a mri as I wanted more than a guess, she said she didn't think it necessary as it can give false positives. To which I replied I would rather have a false positive than a false negative. Because I wouldn't quit she agreed to see me in 2 weeks as she should have had time to review the mammogram as well. I asked how long should I wait if the indentation got worse or didn't go. She said 3-4 months and then she would review again.

So my question to you ladies would be should I be happy with 99% or do I keep pushing for a 100% answer one way or another? My gut tells me to keep pushing, but then I worry I am just being paranoid!

JohnSmith · October 2015

I've been quietly following this thread waiting for your test results. I figure it is time to chime in.

You wrote: "I saw breast cancer doctor today she could clearly see even in artificial light the indentation and could feel lumps, but said it was lobular tissue"

What is your doctor referring to when they say "lobular tissue"? I've never heard of that term and I've been researching lobular breast cancer everyday since my wife was diagnosed with ILC in April 2014. To me, "lobular tissue" means lobular breast cancer, but assume they are referring to something else.

In terms of the indentation, my wife discovered her breast cancer by the physical "dimpling" (indentation) that you have described. She could also feel a palpable lump (if I recall, it was about the size of a green pea). Feeling this lump is slightly unusual since ILC lacks a sticky protein called Ecadherin. Without this protein, the cells have a harder time forming a lump and instead the cancer grows in lines. Another member of the forum accurately described Lobular this way: "Lobular is so hard to detect initially as it starts growing as delicate fern fronds, and only when big enough gets sufficient density in the middle that it shows on a scan - sort of like palm of hand, with frondy fingers - which is why when they actually do surgery, they are frequently surprised by the larger size, as the extensiveness of the fronds don't show until you are in there".

In terms of diagnostic detection, this characteristic growth makes Mammograms and Ultrasounds ineffective at detecting Lobular. This was the case with my wife. However, the digital MRI revealed her lobular cancer and estimated it to be about 1.8 cm. After surgery, final pathology revealed it to be 2.2 cm, which is fairly close to the MRI size estimate.

Here's the data that supports the use of MRI's for Lobular.

July 2015 Article: "Lobular breast cancer series: imaging"
excerpt from article: "Studies have repeatedly shown that MRI is superior to conventional imaging, not only in terms of its increased sensitivity for detecting ILC, but also for the detection of ipsilateral and contralateral disease" [30]–[32].
Citation sources:
30: Abstract: "Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers."
31: Abstract: "Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer."
32: Abstract: "MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer".

I hope I don't make you more paranoid. In the end, you are doing the right thing by asking for the MRI and I support your vigilance. Feel free to visit the ILC section of the forum, if you have questions.

ShetlandPony · October 2015

An indentation and lumps are normal? I say follow your gut, Busymum. You understand the risk of a false positive breast MRI that could lead to a biopsy. If you are premenopausal and have dense breasts, that can help justify the breast MRI.

Busymum2015 · October 2015

John Smith thankyou your post was very informative. I am sorry to hear your wife was diagnosed with ILC.

The doctor said lobular tissue like it was a normal thing and nothing to worry about. I didn't think to question it at the time, but so wish I had.

I am determined to get an answer where I can stop worrying. I am going to ask what would she do differently in 3-4 months as I am not convinced the indentation is "normal changes due to previous pregnancy" and ask they carry out those tests now. I will continue to push for an mri. I have done some research and the hospital I am attending has a private patient facility for breast mri scans, so if need be I will ask to be referred there for the scan (I still need a referral from a doctor to attend the private scan).

Shetland Pony thank you I have never asked for a second opinion in my life, but I can't quit until I have an answer that I feel confident in. I have become a serial boob flasher to family and friends, everyone's response is oh I thought you meant a dimple, that is not right!

Thank you once again for support hugs to you all x

Busymum2015 · November 2015

Hi all going back to the breast clinic tomorrow and demanding an MRI, I have been busy with my twins and tried to keep occupied so not to worry too much. As as update I have notice on the opposite side of the same breast there are two further indentations these are long rather than round just under my breast. At first I thought they were stretch marks, but definitely not they look more like a dark shading on the skin and if I stretch my boob up just above these is another indentation that looks like someone has stuck a pen nib into my boob...weird!

I have a question I have pain in my other breast when I feel for any lumps (this is difficult due to scar tissue having previously had a golf ball sized lump removed 20 years ago) the pain is kind of between my boob and armpit! Maybe I am just being a worry wart! Its a tender type pain that makes me go ouch!

Hopefully I will get an answer I am happy with tomorrow....fingers crossed.

Thanks again

Busymum2015 · November 2015

ps also got the letter through from previous mammogram stating the doctor could not see anything concerning and there was "no visable indentation. Obviously there was because everyone else could clearly see it... maybe he needs new glasses :-)

Busymum2015 · November 2015

johndean I hope you get a positive result and are all clear. Best of luck x

mammogram clear but still worried as indent on breast

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