How could a lump have cancerous and noncancerous parts?

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StaceySue2U
StaceySue2U Member Posts: 281
edited February 2016 in Waiting for Test Results

So I've got this lump that the doctors all say is probably cancer, yet when the first doctor biopsied the "wrong part" of the lump, it came back "normal breast tissue." Now I'm going back tomorrow to have the "right part" of the lump biopsied (the part where there's a little starfish-shaped thing on the mammogram). The lump that I can feel (which is more of a thickening, not a hard lump like most people describe) is about 5cm X 1.5cm, and the part that looks cancerous on the mammogram is only millimeters.

How could part of a lump not be cancer if the rest of the lump is and the lump wasn't there before? Why would it form into a lump around a cancerous part? Is it an immune response to the cancer?

It's very confusing to me.

Also - if the palpable lump is so big but the part that turns out to be cancer is small, would that mean the cancer was being caught early or late?

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  • Affinity42
    Affinity42 Member Posts: 28
    edited January 2016

    My disclaimer (I'm not a physician), but my understanding is that cancer cells infiltrate healthy cells and can grow quickly or slowly. In that case you can have an area with healthy and cancerous cells.From your description it sounds like they didn't obtain a sample from the spiculated part of your mass. I'm sorry you have to go through another biopsy.

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  • april485
    april485 Member Posts: 3,257
    edited January 2016

    " if the palpable lump is so big but the part that turns out to be cancer is small, would that mean the cancer was being caught early or late?"

    Your question appears below so people know what part I am referring to. No one can tell from just a film if it was caught early or late. The only way to know that is pathology and staging. Unfortunately, that will come after your second biopsy because they missed the part that they feel contains the cancerous cells. Sorry you have to do this twice and sorry I could not unbold or take out the italics...Hugs!

    Loopy

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  • Janet456
    Janet456 Member Posts: 507
    edited January 2016

    My story is so similar to yours. I had a big lump with a Birads 5 rating and the biopsy came back benign. Great news, but they said it was discordant so did another biopsy, still benign. The whole lump was removed after the two biopsies, and it was actually benign but they did find DCIS around the lump. Good luck xxx

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited January 2016

    Janet it's good to hear it just came back DCIS. How frustrating that you had TWO discordant biopsies!! How has it been doing? Any recurrence or problem at all?? I just don't get how your lump that appeared so suspicious could be benign and yet they just happened to find DCIS (microscopic, I'm assuming?) surrounding it.

    What's confusing me is this: lumps are LUMPS. Clearly cells are either swelling up or dividing abnormally quickly inside of the lump, or the lump would not exist. If the lump had not presented itself I never would have called my Dr. and it never would have been investigated, and I wouldn't have had an abnormal mammogram and biopsy. The lump is what caused them to see whatever is so suspicious on the mammogram. If there is cancer nearby which somehow caused this lump, but the rapidly dividing cells inside the lump are not cancerous - what are they? Why are they dividing quickly and how are they related to cancer? Do the nearby cancer cells secrete some sort of chemical that makes nearby healthy cells divide quickly? Has anybody wondered about this? Researched it? I see on other threads where people mention they have parts of the lump that are cancer and parts that are not.

    My biopsy was of my large lump, and directly between two much smaller stellate masses inside of the lump.

    I want this lump GONE even if it just comes back "atypical lobular hyperplasia" again. Clearly it is not normal at all. I don't care if the palpable lump isn't where the cancer is, I want it out of there. I want the whole breast gone.

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  • kaylynn
    kaylynn Member Posts: 124
    edited January 2016

    WOW Janet that is scary,both b9!.now we know how they mess up and miss stuff I guess. My biopsy just came back B9 with a Birad of 4.They arent sure what it is a couple possibilities one a papilloma. Mine also is growing at an alarming rate they say.The alaming area is only 7mm but the whole area is 6cm.They want mine removed which they probably will with yours to Stacey.My surgery is Monday.I will be glad to have it removed and get an all clear on the total thing.

    Oh and I asked the dr is there a chance it can come back cancer after the whole thing is removed and she said no.We know that isn't always true.

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  • april485
    april485 Member Posts: 3,257
    edited January 2016

    Staceysue, it could be debris from the rapidly dividing cells surround the lump. From what I understand, that is one of the ways lumps form...from debris shed by the rapidly dividing cells. For example, that is why they will often watch microcalcifications carefully over a 3 or 6 month period. If they cluster together or form a linear area, they are generally cell debris shed by something that is dividing quickly (many times a cancer) so that is why they biopsy a larger area than just where the calcs are located. If they miss (and that is easy to do because they are going in blind unless the clip was placed properly during a wire guided stereotactic biopsy) they must do an excisional to make sure.

    Best to you and keeping fingers crossed it is all benign debris from a pre-cancerous area.

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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited January 2016

    There are other types of tissue that cause lumps that are not cancerous, nor do they have anything to do with cancer. The lump I found (my left side) turned out to be part fibroadenoma (completely benign) and part IDC. The biopsy that took 6 cores came back as a fibroadenoma. The only reason I had an excision was because my breast surgeon had a ton of experience and didn't like the look of one side of the lump. The fibroadenoma was probably there first and the cancer just happened to grow in the same spot.

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  • Janet456
    Janet456 Member Posts: 507
    edited January 2016

    My actual big lump was a tubular adenoma, which does exactly look like breast cancer on imaging. The two lots of biopsies were correct as it was benign, the DCIS was picked up as an incidental finding. I was told to look at my big lump like a Fairy Godmother - i'll take that :) xx

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited January 2016

    Back from the biopsies, can't stop crying. Radiologist #3 said it's probably cancer. She did vacuum assisted biopsy and got about 20 samples and says she's sure if it's cancer she got some of it. I've developed a resistance to lidocaine and it was very painful. My sister and I both cried all the way back home. I'm living in an RV in my dad's yard (because DH and I were in the middle of transitioning to full-time RV living, with the plan that I would be a travel nurse, when all this happened. I was going to spend a few months with my family until DH retires in May). My sister asked my stepmom to pick me up some sweet tea and some melatonin and leave it on my door step and leave me alone to be a hermit for a few days. I appreciate it but feel bad for Dad and and my stepmom. I will hopefully have my results Friday.

    Janet I really hope my lump is a fairy godmother too! That gives me a lot of hope. I guess there are actually 2 lumps. Maybe they'll find LCIS in all of those clustered microcalcifications and it won't be big bad tumors.

    I asked the radiologists how lumps can be cancerous in spots and she explained that tumors were kind of like calico cats - clusters of normal, abnormal, and cancerous all together in the same "animal."

    SummerAngel, how are you doing now? How do you like your reconstruction?

    How about you, CT? Is your prognosis good since they got it while it was still DCIS?

    Karlyrie, God bless you and may the whole lump come back B9! I will be watching for your results.

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  • kaylynn
    kaylynn Member Posts: 124
    edited January 2016

    I wouldn't take 100% stock in that the radiologist knows it is cancer. Most of them seem to say that or imply that. They had me convinced mine was cancer to.Even told me about the cancer board we now have and when I would go for review on it! They are wrong so many times. What was your Birad score?

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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited January 2016

    StaceySue, I hope you feel better soon. My doctor didn't use enough lidocaine during my first biopsy so I white-knuckled the entire thing. No fun!

    I'm doing great now! I'm lucky in that I didn't have to have chemo or radiation and I didn't have any complications from any of the surgeries so I started feeling better very quickly. I'm very happy with my reconstruction, scars are healing nicely and I will be getting nipple tattoos in June to complete my foobs.


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  • Sanduchi
    Sanduchi Member Posts: 21
    edited January 2016

    Hey ladies-

    Mind if I join you? I am having an excisional biopsy/lumpectomy on Friday. BS thinks it's a fibroadenoma, but the CNB found some flat epithelial atypia. So, because of the atypia, she wants to take some layers of tissue around the lump (roughly 2.5cm) just to make sure.

    She isn't particularly worried about it, but it's a "just in case". However, after reading some of the experiences here, I need to be ready for anything. I am 99% sure it's nothing, but for peace of mind, I want this thing out!

    Oh yeah, I'm 31, distant family hx of BC, no other health issues.

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  • kaylynn
    kaylynn Member Posts: 124
    edited January 2016

    Join in!!!,there will always be scary stories and there will be miracle stories.But we are all individual.So many out comes for sure.I am glad mine is going so I will know for sure one way or another.

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  • Roxgirl
    Roxgirl Member Posts: 16
    edited January 2016

    Hi Sanduchi.

    I am somewhat in the same boat. BIRADS 4b from mammo, but bx was B9, fibroadenoma. However, because of my age [44], and family hx of breast ca, none immediate, but both grandmothers and 4 aunts, they think I should have this removed. I am going back and forth on this. If B9, why have surgery? On the other hand, who knows what they will really find? My other option was to recheck in 6 months. I see BS on 2/8 and will see what they recommend. I travel for work and am the only income as I am single mom of 2 in college. Not sure what to do. :(

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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited January 2016

    Roxgirl, my situation was similar. (I'm also the sole provider for my two daughters, one in college, so I understand the stress.) If your doctor wants it removed, it's probably a good idea. I had mine done on a Thursday morning and was fine to work on Monday.

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  • Roxgirl
    Roxgirl Member Posts: 16
    edited January 2016

    SummerAngel, Thanks for the info regarding your procedure. That is quite helpful.

    I guess my biggest fear is having surgery when it is not really indicated. If Fibroadenoma is not a precursor for cancer as I have been reading, then

    why the removal? I can't feel it and it does not cause me any pain. Only found on yearly mammo. On the other hand. maybe its best to be safe than

    sorry.

    I see you are from Colorado, me too :).

    Go Broncos!

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited January 2016

    Wow there are so many of us in the same boat.

    Thanks for the encouragement, Karlyrie. It's really good to hear that they can be wrong even when they sound so positive about it. I got the impression that my score was BIRAD5 because the first radiologist said she was 98% sure it was cancer, then recently when my records finally came in the mail I see she had it marked as BIRAD4 but with no letter after it. Then when I saw these doctors (at KU Med Center, which is a really good breast cancer center), they all said the negative biopsy results were discordant. So I guess that implies it was 4 or 5 in their opinions too. What was your BIRAD score? Did yours turn out to be B9?

    Thanks for the good wishes, SummerAngel. White knuckling it definitely describes what happened today - I tried hard not to break anybody's fingers. They were so sweet, holding my hand and stroking my shoulder. I bet you'll feel more whole once you get your nipple tattoos. Did you go larger? How do your foobs compare to your originals? If I have to do anything I think I'll get the DIEP. I'm overweight now but even when I got down to 124 lbs and worked out and cross country skied I still had a "mother's apron". I have to admit I'm looking forward to a "free" tummy tuck. The only thing better than a free tummy tuck would be finding out it's not cancer :)

    God bless you, Sanduchi, and may your results come back completely B9.

    Roxgirl, I'm 46 and also have a strong family history - all on my dad's side. We're starting to wonder if our great grandparents who came from Austria were Ashkenazi Jewish because there's just so much BC on that side. My grandfather's family only married other Austrian immigrants up until his generation, and they all came from the same place in Austria. They do look very Jewish. I'm the oldest in my generation and the first one to possibly have it at this age. Hopefully if it's CA I can get genetic testing. I want mine OUT even if the biopsies come back B9. I want the whole thing examined and want to be 100% positive it's not CA because if there's even a little area of LCIS I want to get the most aggressive treatment possible. I can't handle the thought of being checked every 6 months until something looks suspicious again and then going through all of this again. I'm wanting to go into travel nursing and trying to get back here every 6 months would mess everything up bad. What are you majoring in? How old are your kids? I have one son. He's 25 and has two beautiful little girls.


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  • Roxgirl
    Roxgirl Member Posts: 16
    edited January 2016

    Hi StaceySue2u, 

    I agree with you on the annoyance of every 6 month check-ups and going thru all the steps again. 

    I do meet with the bs in another week so will definitely take their opinion seriously. 

    And I am not in school, lol, my two sons are. 24 and 21 years old.  I am a consultant and currently on a 3 year contract in California but am allowed to fly home yo Denver each weekend if I need to. I do have health insurance but because I am a consultant I do not get other benefits like sick days, etc.. 

    However I am allowed to work from his me if needed so if I have the lumpectomy, that is what I will do. 

    Trying to weigh the odds. 

    Have a blessed evening. 


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  • kaylynn
    kaylynn Member Posts: 124
    edited January 2016

    Stacey mine was a birad 4,i never did see a letter.But me and my sister both said they way they acted they were pretty sure it was cancer. I was terrified by their actions. If I had to go through it again I will know to just wait and see.

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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited January 2016

    Roxgirl, I understand what you're saying about unnecessary surgery. I was given the choice to wait 6 months instead, but I knew my surgeon was very experienced and well-respected so I followed her advice to have it removed. It's always good to get the opinion of a very experienced doctor or two. (Yay Broncos! I love it when they're in the Super Bowl!)

    StaceySue, I did go larger. I was a rather deflated B cup before. Now I wear a D cup. It doesn't look that large, though, so even though the letter shocked me at first, I actually look balanced now. They don't look like my real breasts, that's for sure, but I really like how they look and can't wait for the tattoos! I looked into a DIEP but the doctor said I'd end up with smaller breasts because although I have some loose skin from pregnancies, there's not much fat underneath and he would have had to take the fat from elsewhere. Even with my implants the doctor took the fat for grafting from my thighs.

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited January 2016

    I think if they take all the fat from my lower belly, they'll almost have enough. I'm going to convince them that taking my double chin will make it just perfect :)

    I'm one of the odd ducks who has always thought implants were pretty. If I could get implants and get a tummy tuck that would be great :)

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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited January 2016

    I'm with you! implants look nice to me as well, as long as they aren't too large. DIEP definitely looks very natural, but I was never fond of the "natural" droop that formed after I breastfed my children, and I really like that I don't even need a bra at all now if I don't want to wear one!

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  • kaylynn
    kaylynn Member Posts: 124
    edited January 2016

    Anyone know recovery time for the excisional biopsy/lumpectomy? I was told today they have book the OR for 1 1/2hrs for the surgery for me. I was thinking maybe half hour. I am guessing 3 days off from work(desk job)? I have my ice packs ready and front closure bras and sports bras.

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited January 2016

    I was told I could go back to work the second day. I probably could have gone back the day after. I had very little discomfort and only ended up taking one pain pill. You may have lifting restriction for a week or so though.

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  • kaylynn
    kaylynn Member Posts: 124
    edited January 2016

    Thanks,i am not into pain pills.I only took OTC when I had a hysterectomy so I will probably not need much. I noticed your DX says Sclerosing adenosis. I think that was the other term the dr used when telling me what the pathologist said for possibilities.But she said it was very rare so she didn't think so. Is it rare?

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited January 2016

    It tends to look like cancer on imaging, but is benign. It is kind of an "aging breasts" type thing.

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited January 2016

    I hope they put you under for the lumpectomy? Apparently lidocaine doesn't work for me.


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  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited January 2016

    I was under for the lumpectomy. I had it done on a Thursday morning and took Friday off. I was feeling great by Saturday, it was super easy to recover from.

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  • Affinity42
    Affinity42 Member Posts: 28
    edited January 2016

    I'm thinking Radiologists need to keep their traps SHUT until Pathologists study our "areas of concern" hang tight. This could be benign, have faith!

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited January 2016

    Thanks. I've never been so scared in my life - and I'm sure everybody on here can relate.

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