Concerned about a lump... is this possible?

Double mastectomy about 2-2.5 months ago, currently on Tamoxifen. I have tissue expanders in and have been getting small fills and everything was going well. Well, a couple days ago I found a lump on my left "breast" - exactly the same location as my IDC. The lump is maybe a dime in diameter and is visible (sticking up through the skin) a little. It is not at my scar and not at the corner of my tissue expanders (which are mostly filled now anyway), and it is not where my TE port is. There is no bruising and I have no swelling, so I don't think it is anything like that.

How worried should I be? Calling plastic surgeon tomorrow to see what they recommend. I am nearly certain the lump was not there after my last fill 2.5 weeks ago, but I haven't really checked out my "breast" since then.

I know anything is possible, but it seems statistically insane to have a recurrence after only 2 months, especially when my IDC was only a grade 1. I don't have genetic results yet, but Oncotype score was low (cannot remember now exactly what it was).

Has anyone experienced this? Could it be a random ball of scar tissue or something?

I know I can't have an MRI and I assume no mammo, so does that leave only ultrasound? How would they biopsy? I kept my skin but not my nipples. Margins were clear.

I am devastated that even a scare will delay or halt my reconstruction.

I'll let you know what my PS says tomorrow.

Thanks for responding. I never considered it could be a node. Interesting.

I think I'll call my plastic surgeon and my oncologist tomorrow. I was released from my breast surgeon when my margins were clear after my bmx, and I really don't want to go back there if I don't need to

I also have a strong family history.

So, called PS and was told it's not related to expansions (how could they know without exam??), and they said call MO.

MO wants biopsy, so I see breast surgeon on Friday. Will ask for imaging and anything else to rule out cancer before agreeing to another biopsy. Still having a hard time believing it could be the cancer already, even if it is in the same location.

I'll update Friday.

Well, visit to the surgeon and immediate ultrasound today.

Ruled out: scar tissue, anything to do with TEs, anything fluid (cyst, hematoma,seroma,etc.)

1.2 cm x 1.4 cm (not positive about 1.4 number and maybe not in that order) and looked suspicious on US. I'll edit this info when I get a copy of the report.

Surgeon said if not for TEs, he would biopsy, but there's a good chance that would result in needing to remove TE and start over even if benign. He "hopes" it is fat necrosis and will monitor every four weeks with an ultrasound, unless MO wants something different. He said "fat necrosis and cancer can look the same on US" (which to me implied it looked like cancer).

If it grows or changes at all, I will need a biopsy. If it remains 100% stable, I may be able to watch it until exchange surgery and have it biopsied then. It if shrinks over time or becomes less solid, that points to fat necrosis, he said.

He did seem to genuinely agree with my thoughts that it would be very unlikely for a stage 1 with clear margins to recur in 2-3 months while on tamoxifen.

Mixed feelings. Was hoping for "Aha! I know what that is!" but I am glad there's no biopsy right now. Can't believe I have to live with a visible and palpable lump in the same spot my IDC was in, see it every day, & feel it constantly. It will not be easy.

BS said my skin is so tight that there's a risk that any cut will result in tearing or another problem. And my skin is definitely tight. I had to skip a fill and then go all the way down to 30 cc at the last (and the upcoming) because of it.

I've decided that if the lump is stable at the 4 week US, I'll get a second opinion. And if it has grown or decreased in size, we will proceed accordingly.

I am so sorry that you have to go through this again. My plastic surgeon was actually the one who did my last surgical biopsy, so perhaps BS could talk with PS and see if he/she has any openings. That person is also going to make sure you have a good cosmetic result. The main focus is your health and getting the lump out; looks is secondary, but it is another option for a surgical biopsy. PS did mine because they did not think it was anything and they were just doing it to appease me. Do keep us posted.