Fat necrosis

The other thing is, I don’t want to have to go and have it checked every single time it changes or gets bigger or more shows up. That was the whole reason I had a double mx to begin with. I don’t have time to be going to the doctor and having scans every time a lump shows up. I am dealing with trying to divorce a husband who has disappeared, a mother who just suddenly died, trying to find a new place to live and needing to find a new job ASAP. I can’t be having all of these appointments now or in the future. It’s making me wonder if I should have the implants removed, have a capsulotomy to remove the scar tissue and just not even think about reconstruction until I am a few years down the road and looking more in the clear for no recurrence. I am triple negative and now they are saying that after five years the risk of recurrence for triple negative is as close to zero as one can get.

that’s the thing, I am very high risk for recurrence. I was triple negative, stage III with a 6 cm tumor. I started chemo with Taxol and the tumor grew to 10 cm. So then I was put on AC and the tumor shrunk but only to about 3 cm. So I failed the first chemo and only had a partial response to the second. And then at surgery they were only able to get a less than 1 mm margin. The surgeon told my family right before he started surgery that he was actually very concerned that he would not be able to get a negative margin. He ended up being able to, but again, it was less than a millimeter. My residual cancer burden after surgery was 2 on a scale of 1 to 3. But they told me that even though it wasn’t a three, I am still extremely high-risk. So the idea of having any lumps is disconcerting. The idea of having any lumps and not doing anything about it is disconcerting. The idea of having a lump exactly where my original cancer was that seems to have gotten bigger is disconcerting. The idea of having a lump that didn’t show up at all on MRI or ultrasound is disconcerting. The idea of new lamps popping up in my armpit a week after I had an MRI and ultrasound is disconcerting. The idea of having any lumps and having them say they are “pretty sure” they are fat necrosis is disconcerting. The idea of feeling a tiny tiny tiny spot on my sternum is disconcerting. The idea of having to go to the doctor every single time I feel even the tiniest change is disconcerting. The idea of applying for, interviewing for and finding a new job while not knowing if I already have or am going to have a recurrence that is going to blow my life up again is disconcerting. There is really no good scenario.

I just hate how the way the first alarm showed up feels exactly the way my cancer started. And the spot on my sternum has that internal itch that I had with my original tumor. I don’t really have another way to describe it except an internal “itch but hopefully some of you know the feeling that I’m talking about. I have an appointment on Tuesday with the plastic surgeon. But he is not a cancer doctor and I just know he’s going to tell me that it is common and it is fat necrosis or scar tissue. And then I will have to go back to my oncologist yet again for another appointment, where she will now be in a bad position because she has already sent me for imaging just recently and now I have new lumps. Who knows if my insurance will even cover more imaging this quickly. I just wonder if having the implants removed Will help with some of this, because if this is fat or scar tissue forming in response to the implant, meaning I will have less lumps if I just go flat, it might be best to just do that.

Are you talking about your breast surgeon or the plastic surgeon? I have two different surgeons. The breast surgeon who did my mastectomy is out on medical leave. The plastic surgeon who did my exchange surgery is who I am seeing on Tuesday. The reason I am seeing him is because the breast surgeons nurse practitioner told me to go check with him to see if the lump I am feeling is anywhere near where he may have placed a suture or something.

Going back to my initial question, can anyone tell me if fat necrosis gets bigger over a relatively short period of time? Or if you feel a pea-size lump of fat necrosis, does it remain pea size?