Tiny red spot on chest in radiated area - what to do?

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Cubbie2015
Cubbie2015 Member Posts: 875
edited March 2019 in Not Diagnosed With a Recurrence or Metastases but Concerned

I have something odd going on with the skin on my cancer side, and I'm interested in any advice you ladies might have about what I should do next. Sorry this is kind of a long story, but I wanted to give the whole picture.

At the end of January, I noticed a tiny red spot on the left side of my chest (cancer and radiation side) about 2 inches above my mastectomy scar. It was very small, seemed flat but felt slightly rough, and there was no lump associated with it. I tend to have acne problems on my chest, but never in the area that was radiated - the skin is just so dry there, acne isn't an issue. I was hoping this was close enough to the edge of the radiated area, though, that it would turn out to be acne related. However, as other acne spots elsewhere on my chest cleared up, this one remained, so I tried putting some hydrocortisone on it. It seemed to be getting lighter with this treatment, so I was a little less worried.

I was then very busy for a couple of weeks as we were moving my mother to assisted living, and I kind of forgot about the spot and stopped putting the hydrocortisone on it. However, a couple of weeks later I noticed it was still there, although lighter than it had been before the week of hydrocortisone treatment. I had an appointment the next day for my Lupron injection, so while I was there I asked the nurse what she thought. She said it was just slightly raised, and said I should see my dermatologist.

I called my dermatologist and surprisingly was able to get in the next week - usually it's a three week wait. In the meantime, I started putting hydrocortisone on it again, and it resumed getting lighter and smoother. By the time I got to the dermatologist the following week, it was hard to see where it had even been, and it was completely smooth. The dermatologist said it might have been eczema. While she had me there, she did a complete upper body exam, and I asked about a couple of other items below my scar. It seemed like we had everything covered, and I hoped to stay out of the dermatologist's office until my regular appointment in June.

On Monday morning, though, I had a new tiny red spot, though, this one an inch to the left of the one that had just gone away, so right in the radiated area. Once again, it is very small, seems flat but feels slightly rough, and has no lump associated with it. It's not quite as bright red as the last one. I've been putting hydrocortisone on it for the past week, but it is not looking any better at all. It's not looking any worse so far, either. It's really worrying me, because I just don't get skin stuff in this particular area, other than a few pinpoint telangiectases from radiation.

I've debated all weekend about what to do. I saw the dermatologist on a Thursday, and this new spot showed up the following Monday, just three days later. It has some similarities to the previous spot, but looks a little different and is not showing any signs of going away with the same treatment. Should I wait another week? Call the MO's office and see if the nurse practitioner can see me? Just call the dermatologist's office and admit I have a new problem already?

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  • wallycat
    wallycat Member Posts: 3,227
    edited March 2019

    Cancer would not simply disappear, so that's a good thing. If you plan to see them again, leave the area alone so they can see what is happening.

    I've not had radiation, so I don't know how much a role that plays but I do get little red spots frequently. I've noticed that when I hold my cat, his toenail may ever so slightly grab through clothes and irritate a small area. I also have acne prone skin (curses!) and we have small spiders; fleas during spring/summer/fall....so I wait a few weeks without doing anything to the area to see how it progresses before I address any concerns.

    I hope you can meet up with someone to look at it and not need to worry. Best to you.

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  • fifthyear
    fifthyear Member Posts: 225
    edited March 2019

    Doctor can't tell you what is going on if they can not see or feel it. I would leave it the next time and see my onco. Maybe they can biopsy it. Good luck

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  • grainne
    grainne Member Posts: 245
    edited March 2019

    I wonder if these might be campbell de morgan spots? I have had a few round the chest area for years and was told they are age related ( though I think the first appeared when I was in my early 40s) and completely harmless. If you google them a picture will come up. Isn't it horrible having to worry about everything?

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  • Sara536
    Sara536 Member Posts: 7,032
    edited March 2019

    It might be a good idea to take a picture of it next time. It’s hard for a doctor to know what your talking about once it disappears.

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  • Cubbie2015
    Cubbie2015 Member Posts: 875
    edited March 2019

    To be clear, I currently have this second, new spot - no photo needed, since it is there to see right now.

    I have cherry angiomas (Campbell de Morgan spots) elsewhere on my body. This is different than than those. It's not as bright red and just generally looks different from them.

    I was trying the hydrocortisone because it seems that whenever I go to the doctors for anything, they always ask what I've tried, and I end up feeling kind of remiss if I say nothing.


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  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited March 2019

    I have had every kind of skin cancer... some basal cell cancers present this way... pinker, slightly raw looking, some times a little scaly or there's a bump of some kind. Some skin cancers can itch. I had a melanoma that itched before it appeared. Squamous cell cancers look like a pimple that popped (like a mini volcano) but wont heal. Melanomas can be black 'dots" on a mole or a black freckle. I am very freckly and have learned to ID most of them. But I go in 2 x /year and my last melanoma was caught by my dermatologist.

    If it's a basal-cell cancer, then it's definitely NOT life threatening but should come off.

    I do not have any idea how a skin met behaves but I doubt cortisone would improve it.

    The fact it has moved suggests some sort of exema/rash.... but better to have it checked to be safe.

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited March 2019

    I have lots of cherry angiomas and they're all different shades of red and different textures.

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  • Cubbie2015
    Cubbie2015 Member Posts: 875
    edited March 2019

    Alice, that's interesting. Mine are all either bright red or I have one that is purple. I suppose I could have one that's different, especially since I'm prone to getting little telangiectases in the area where I had radiation.

    Santabarbarian, I wondered about basal cell skin cancer, too. Having radiation is supposed to increase your risk of getting basal cell skin cancer in the same area where you had the radiation. I've already had one basal cell skin cancer on my face, and I'm possibly the palest person in the world, so it's a definitely a concern for me. I wasn't too worried when the first spot went away with hydrocortisone but the second spot that won't budge is worrying me.

    Grainne, it is horrible having to worry about everything. I have an anxiety disorder so it's hard for me to put things in perspective.

    I guess I'll call my MO's office in the morning and see if I can see the nurse practitioner, who can at least tell me how worried I should be. It looks like I'll be making another trip to the dermatologist though. It's just so embarrassing to have to go back when I just saw her 10 days ago.

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  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited March 2019

    I am beyond embarrassment! Come on in; the water's fine!!

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  • KBeee
    KBeee Member Posts: 5,109
    edited March 2019

    Hoping you get answers. Call MO and dermatologist and see who can get you in first...or get an opinion from both

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  • gb2115
    gb2115 Member Posts: 1,894
    edited March 2019

    I get red spots that come and go including my radiated skin... I just chalk it up to really sensitive skin. Sometimes the spots itch, sometimes not. I agree skin mets would not come and go. And this sounds like something for derm follow up rather than oncology, especially if they can see you before the spot starts to fade. If you can't get in right away take a photo for comparison. It doesn't hurt I guess to have the oncology NP look at it, but I imagine they will recommend going back to derm.

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  • grainne
    grainne Member Posts: 245
    edited March 2019

    I wonder if it is possible that cherry angiomas might look slightly different on tradiated skin?

    Btw, I am defo with santabarbarian.....faced with a minor embarassment or lying staring into the darkness in the middle of the night terrified, I know what I would choose. I just don't care what anyone thinks of me. I'm not prepared to be anxious for a second longer than I have to.

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  • Cubbie2015
    Cubbie2015 Member Posts: 875
    edited March 2019

    Santabarbarian and Grainne, I really appreciate the support on the embarrassment of having to go back. If you guys just forge ahead and do what you need to do, so will I.

    I took KBeee's advice to see who could get me in first, and went ahead and called the MO's office. While I was waiting for a call back from the nurse, I also called the dermatologist office. Amazingly, the dermatologist can get me in on Thursday morning, so I went ahead and took the appointment. The nurse at the MO's office called back a bit later, and she said that based on what I was describing, it would probably be OK to wait until my next Lupron injection on April 1st to take a look at it, but they could work me in sooner if I was anxious about it. I told her about the dermatologist appointment that was available on Thursday, and she said that that sounded like a good place to start, since they could get me in just as quickly as the MO's office could hope too, possibly quicker. The MO's office is a little understaffed right now, as they are trying to replace a partner who retired. Like gb2115, I suspect they would refer me to the dermatologist anyway.

    Thanks for everyone's input and support. It's good to know I can come here when I'm in a dilemma.


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  • wallycat
    wallycat Member Posts: 3,227
    edited March 2019

    I used to tell my patients (former dietitian ---stint in the cardiac area) if they have any concerns, GO to a doctor or emergency room.

    No one EVER died from embarrassment. Trust me. Medical professionals have seen it ALL. Frankly, I hate to say this, but these days, I wonder if we are seen more as dollar signs than just patients. The more they see you, the more they make. They'll LOVE seeing you as often as you're willing to go!


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  • trinigirl50
    trinigirl50 Member Posts: 343
    edited March 2019

    I've had red spots come and go since I had radiation. And not always on my chest, on my face, my feet, all over. Not cherry angiomas either. Dermatologist couldn't decide what they were. Just some kind of skin reaction. I still get the occasional red spot. They sound a lot like yours.

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  • AliceBastable
    AliceBastable Member Posts: 3,461
    edited March 2019

    Wallycat, the problem with that is some insurance plans will not pay for ER visits if the issue is not a life-threatening one.

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  • wintersocks
    wintersocks Member Posts: 922
    edited March 2019

    I get this too bumps/spots on my chest that seem to come and go. i saw the breast cancer nurse and she did a through check including a mammo on the recon and utrasound on the affected area. She said it was most likely due to radiation and was not mets at all and she was not worried it was mets. She as she told me if the cancer was going to recur it would be in the bones most likely and not mets to skin.

    I hope that helps to re assure you at bit.

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  • wallycat
    wallycat Member Posts: 3,227
    edited March 2019

    Alice, I realize insurance companies are getting worse and worse and WORSE, but anyone who thinks they are having a heart attack should for sure go to the emergency room. What the insurance outcome is is less important than saving your life.

    Seeing a derm is not an emergency and I certainly do not recommend that. I was merely pointing out that no doctor cares how frequently we see them. And that shame or embarrassment should be the LAST thing on a patient's mind.

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  • Cubbie2015
    Cubbie2015 Member Posts: 875
    edited March 2019

    JO, my MO mentioned angiosarcoma when she looked at my telangiectases last year. Not that she thought I had it, just that it was the reason that she wanted to check my skin when I said I had these tiny blood vessels. So I know it is on my MO's radar. My dermatologist is really good about doing a biopsy for anything that looks suspicious or is worrying me.

    Wally, I dunno...my doctors are so busy, and I'm sure they are tired of my anxiety disorder. I think they would like to see me a lot less often!

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  • Cubbie2015
    Cubbie2015 Member Posts: 875
    edited March 2019

    I saw the dermatologist yesterday. She said it looks like a tiny divot in the skin, rather than a bump (which explains why it seems flat). She said it looks like I got scratched by something there, and she's thinking that the redness will resolve over the next few weeks. She said that she didn't see anything concerning, and didn't want to do a biopsy and give me another scar to worry about if we could avoid it.

    My MO's office called today to follow up on how the dermatologist's visit went, and I asked if they could take a second look at it (following KBeee's advice). They are going to take a look at it themselves on April 1st, when I come in for my injection.

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  • KBeee
    KBeee Member Posts: 5,109
    edited March 2019

    It sounds like you have an on the ball MO to have the staff call to check how the appointment went. I am glad they are taking a look at it

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