8 1/2 years later, and in the waiting room again...

Hi everyone. In 2008 when I was dx with bc, I found such an unbelievably supportive community here. I attended an in-person support group, but the women were in such different stages of their cancer journey, that there was nobody I could relate to. I was a 35 year old mother of 3 little boys and had found out I was BRCA 2 pos. So, I turned to these boards, and was blessed beyond measure. So often, people think that it's bad for you to research too much because they're afraid it's feeding your anxiety. I am just the opposite. I need information, and for me, knowledge strengthens me; it doesn't scare me.

So. Here I am, 8 1/2 years after my first dx, and I found a lump in the same breast (left) that had the original cancer. I had a mastectomy with TRAM flap recon in 2008, 4 rounds of chemo, 2nd breast removed with an implant when I found out I was BRCA pos, total hyst., and close to 7 years on Tamoxifen. My BS performed an ultrasound in her office on Thursday morning, and was concerned enough that she had me come back later that afternoon for a core biopsy. She will call me as soon as she hears anything, which I hope will be Monday.

I have no idea what to think. Could it be fat necrosis? It's possible, but 8 1/2 years later for it to just pop up? It's definitely a new lump because I am meticulous about my breast self-exams, and I still see my onc 2-3 times a year, so he checks me, too. My BS wasn't sure what to make of it, and she's usually super reassuring about things. Twice I've seen her in the last handful of years for little issues with my breasts, and she was immediately able to tell me that they were nothing to be concerned about. Sure enough, they resolved with no problems. This time her demeanor was different. She said as she was doing the ultrasound and biopsy, "I sure hope this is nothing." Before you recoil in horror, this is the type of rapport she and I have. We would be friends if she wasn't my doctor, you know? And when she finished the biopsy, she said, in a more professional tone, "We need to discuss possibilities. If this is cancer again, it's very likely that it's just a local recurrence and I can go in and remove it. It doesn't mean that you have metastases." The very fact that she initiated these lines of conversation make me concerned. She is a wonderful surgeon, but has tended to minimize things, I think because many of the patients she has get very upset. She is quick to assuage concerns and fears ( I call this minimization, but maybe it's just good bedside manner). Anyway, with my history with her, I was really not expecting her line of conversation to take such a sober turn. I couldn't believe she would say that sort of thing prior to getting the results UNLESS she was concerned that it was cancer again. Again, I don't think this was unprofessional or anything simply because of the nature of my history with her. Trust me on this.

I want to be careful to not read too much into her demeanor and word choice. But it's really impossible for me not to. I know you all get it!

I'm just wondering if fat necrosis can pop up over 8 years after surgery? Is that even possible? What could she have seen on the US that made her concerned enough to 1) not immediately reassure me that it was just necrosis and 2) engage in a line of conversation about recurrence?

I've looked at US images of fat necrosis, and they can look very similar to cancer. But what do I know? I'm just not sure what to think, and I need some support from those who get it.

Thanks to anyone who can respond, or who just wants to (potentially) welcome back an old-timer.