Hoping it's fat necrosis - biopsy recommended

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TizzyLish
TizzyLish Member Posts: 41
edited April 2017 in Not Diagnosed With a Recurrence or Metastases but Concerned

Ugh. I'm spiraling down into a pit of terror. I had an ultrasound in September on a palpable lump on my prophylactic side and it was ruled as probably benign fat necrosis. Last week I had a six-month follow up and now they're recommending a biopsy or excision. I feel sick.

First u/s report: Right breast 5:00-5:30 position, 5 x 3 x 6 mm ovoid anechoic to hypoechoic structure. This does not demonstrate flow on Doppler examination. Probably benign nodule in the superficial tissues of the 5-5:30 right breast. Given the location, morphologic appearance, and lack of flow, this likely represents a small area of fat necrosis. Six-month follow-up right breast ultrasound is recommended for stability characterization. Category 3: probably benign

Six month follow up u/s: Ultrasound of the right breast at 5-5:30 position demonstrates a 8 x 4 x 7 mm solid nodule superficially within the reconstructed breast. This does not appear to be in the subcutaneous tissues. It has increased in size where previously it measured 6 x 3 x 5 mm. Needle biopsy or excision of this nodule is recommended for definite diagnosis. Category 4: suspicious finding

Now I'm just sitting here waiting for someone to call me to schedule a biopsy.

I am so scared. It's been almost two years since my original diagnosis and, even if this turns out to be benign, I'm wondering if a day will ever come when I'm not scared any more. Can anyone out there relate? Thanks for listening.

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    "Can anyone out there relate?" is a pretty dumb question. Sorry about that. I guess I need help with two things:

    First, I know no one here is a doctor, but can anyone tell me about their experience with fat necrosis? I can feel this lump. It's hard and smooth. It's been there for ages. I mistakenly thought it had something to do with the tissue expander, so it's been there for over a year. I can't feel that it's any bigger, but the u/s says it's a little bigger than it was in September. Again, this is on the right. My cancer was on the left. I'm still holding out hope that it's fat necrosis and not something more sinister.

    Second, fear. Does it ever get better? When it comes, I'm practically paralyzed with terror, and all I want to do is sleep because I can't worry when I'm asleep. I have Ativan which I take on occasion when I'm feeling particularly scared, but am I going to need it forever? Maybe I need to talk to a therapist. I'm hoping you ladies are the next best thing. :)

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  • LAstar
    LAstar Member Posts: 1,574
    edited March 2017

    I had both fat necrosis and oil cysts. The fat necrosis was plum-sized and felt sore occasionally. The oil cysts are common after any breast injury and were M&M-sized and painless for me. The oil cysts were worrisome because they feel like little lumps under the skin. I noticed that several women in my MX cohort experienced them roughly around a year out from their surgeries. Mine resolved on their own after another year or so. I'm sorry you have to have a biopsy, but maybe it will help put your mind at ease to get some good news after too many rounds of the opposite.

    I just had my 5-year diagnosis anniversary. Fears still lurk but not on a daily basis. I got to the point where I realized that, if I did have a recurrence, I was wasting some beautiful life worrying about it. Cancer has taken enough from us.

    I find that getting good sweaty exercise on a regular basis helps everything -- sleep, stress, weight. I need to do it more frequently, but I can certainly tell when I've gone too long without it.

    Hope to hear good news from you soon!

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    Thank you so much. I do feel that way -- like I'm wasting so much time, wasting all the days that I could just be happy instead. I don't know how to be vigilant without being a basket case.

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  • LisaAlissa
    LisaAlissa Member Posts: 1,092
    edited March 2017

    "I don't know how to be vigilant without being a basket case."

    Hi TizzyLish!

    I have a suggestion: Make your calendar your best friend. Talk with your various docs and ask what you should be doing to be vigilant about your health (scans, BSE, prescription reviews, appts with your various docs, periodic blood tests, whatever). Put those things on your calendar, then tell yourself,

    "I've got a plan, gotten medical advice about my plan, and I'm working my plan. If I don't have a scheduled "vigilance activity" today, then my plan for today is to enjoy my life!"

    Then go do something that has nothing to do with BC!

    If you start to worry that there should be something else on your "vigilance plan," get advice from your medical team and either add it or not.

    But don't let BC take over your life...it's had enough of it already!

    HTH,

    LisaAlissa

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    LisaAlissa, that is excellent advice. Thank you.

    I have an appointment with my PS on Thursday afternoon to talk about my options re. this lump. (He's the one who sent me for the original u/s back in September.) I imagine he's going to tell me that we can biopsy it or just take the whole thing out. I want it out. I'm also worried that having it taken out will take a couple weeks to get scheduled, so maybe I should just have a biopsy first to get an answer faster to save me from losing my mind.

    Sigh. I'll update after the consultation.

    Thank you both again so much.

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    The chances of a new primary on the contralateral side after a bilateral mastectomy are pretty darn low, aren't they? Possible, but low?

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  • KBeee
    KBeee Member Posts: 5,109
    edited March 2017

    Hoping you can get a biopsy soon, and that it is benign

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    Thanks KBeee. I always follow your posts and hope that if I have to do this again I can be as strong an advocate for myself as you are. You inspire me so much

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    Hi y'all. I met with my surgeon this afternoon. He seemed confident that it's fat necrosis for several reasons, but said he "never says never" with cancer patients, so he'd like to take it out. Excision next Wednesday.

    I don't want to be naïve and believe a thing just because a doctor says it's so, but I felt good about his approach and his demeanor. I'm not as anxious as I was earlier in the week, and I'm hoping this is just a benign little bump in the road.

    I'm also getting in touch with a therapist who specializes in anxiety pathology and physical health.

    I don't post a lot, but I read A LOT, and I'd like to thank everyone here for being such an incredible support system and resource for women like me who find themselves feeling scared and alone.

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  • LAstar
    LAstar Member Posts: 1,574
    edited March 2017

    Well, that is encouraging! You will be so relieved to get that clear path report! Keep us posted! You are not alone. {{hugs}}

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  • Emily2008
    Emily2008 Member Posts: 605
    edited March 2017

    My breast surgeon was pretty certain my bc recurrence was NOT fat necrosis when she did an ultrasound on it. Fat necrosis looks different from cancer in that type of imaging. She even showed me the difference while she was doing the exam. All that to say, if your surgeon feels pretty certain it's necrosis, I would absolutely breathe a sigh of relief. Have it removed so you don't have to worry about it, but definitely assume this is NOT a recurrence.

    This has been my experience, anyway.

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  • Juliecc
    Juliecc Member Posts: 4,868
    edited March 2017

    Good luck! I'll be having a small hard lump surgically removed 4/28. I have had it since last summer. All of my doctors have felt it and think it's fat necrosis. The ultrasound says the same but my surgeon is removing it just to be sure and for my peace of mind. It's between my skin and pec muscle.

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  • KBeee
    KBeee Member Posts: 5,109
    edited March 2017

    So glad they're being cautious. Let us know the final result. Praying for good news for you...and for you Juliecc

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    Thank you! I go in first thing tomorrow morning. At pre op yesterday, the PA warned me that pathology could take ten days or so depending on how busy the lab is, sooooo I'm trying not to stress about it. I won't know anything tomorrow anyway. I'll sure be glad to have it out, though. Like I've read here several times, "the best kind of lump is the kind in a jar!"

    Julie, I'll be thinking about you! Hoping for benign results for both of us!

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  • Juliecc
    Juliecc Member Posts: 4,868
    edited March 2017

    Good luck, tomorrow, Tizzy. Is the surgeon taking out a little more tissue around it or just the lump itself? I hope your surgery is easy

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited March 2017

    Home from the biopsy. The surgeon said it looked "very benign" and thinks it was a sebaceous cyst.

    A little background -- I had a bilateral mastectomy with tissue expanders and then implants. Because my breasts were so droopy, the PS did a little procedure on the underside as part of the reconstruction, basically folding a bit of the extra skin and tucking it underneath like a flap to give a bit more lift. So, there's a fold of extra skin INSIDE the bottom of my breasts.

    I said, "So I had a pimple inside my breast for a year." He said, "Basically. It had nowhere to go!"

    Path report in about ten days. Surgeon said, "I'm not worried at all." So, I'm going to try not to worry either. Thanks so much for the support, ladies. You are awesome.

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  • Juliecc
    Juliecc Member Posts: 4,868
    edited March 2017

    it sounds like you'll be getting good news in 10 days!

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  • KBeee
    KBeee Member Posts: 5,109
    edited March 2017

    Sounds like great news!

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  • LAstar
    LAstar Member Posts: 1,574
    edited March 2017

    So encouraging! Rest well!

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  • TizzyLish
    TizzyLish Member Posts: 41
    edited April 2017

    Just got the call -- benign sebaceous cyst. :) Thanks to all of you for your encouraging words!

    For the future, in case anyone searches "lump prophylactic side after bilateral mastectomy" or some such combination of words: This was about a 1 cm hard, smooth oval lump. It didn't hurt constantly, but did start to ache if I wore a bra all day.

    Thank you again. :)

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  • groucho2
    groucho2 Member Posts: 51
    edited April 2017

    Congrats, TizzyLish! I am so happy to find out that it was benign and nothing to worry about. I hope you have a good celebration tonight!

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  • Juliecc
    Juliecc Member Posts: 4,868
    edited April 2017

    Great news! Congrats!

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  • KBeee
    KBeee Member Posts: 5,109
    edited April 2017

    Great news!

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  • LAstar
    LAstar Member Posts: 1,574
    edited April 2017

    Yay!!!

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  • cwayman650
    cwayman650 Member Posts: 102
    edited April 2017

    I'm so glad I found this thread. I'm 10 weeks post op from having a bilateral diep flap. I just found a Lukoil I'm the cancer side. It's at the 7:00 (of the top is the 12:00). About the size of a large peanut m&m. It is in the scar area, but is totalled different feeling from the rear of the scars. I want sure which Dr to call so I called my regular m.d. I can't get in till wed. My stomach is in a knot and I'm really nervous.

    Thank you for listening and being here. I don't know what I would do without this group.

    Carolynn

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  • cwayman650
    cwayman650 Member Posts: 102
    edited April 2017

    I'm so glad I found this thread. I'm 10 weeks post op from having a bilateral diep flap. I just found a Lukoil I'm the cancer side. It's at the 7:00 (of the top is the 12:00). About the size of a large peanut m&m. It is in the scar area, but is totalled different feeling from the rear of the scars. I want sure which Dr to call so I called my regular m.d. I can't get in till wed. My stomach is in a knot and I'm really nervous.

    Thank you for listening and being here. I don't know what I would do without this group.

    Carolynn

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  • Juliecc
    Juliecc Member Posts: 4,868
    edited April 2017

    Cwayman, after my bmx with expanders, then implants, I had several small hard lumps that resolved on their own. They were actually in a row below my mastectomy scars. Ask your doctor anyway. I am getting a lump removed 4/28 because I'm 3 years out and I need peace of mind.

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  • cwayman650
    cwayman650 Member Posts: 102
    edited April 2017

    Thank-you so much Juliecc. I just don't want to start all over again. I guess this fear has reared it's ugly head again. Dang it.


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