New "primary" cancer; other breast--ewwww, ugh, yuck, boo

Some people are just crap magnets. I've had endometrial/uterine cancer, breast cancer, and kidney cancer, plus several non-threatening but sometimes nasty-looking basal cell skin cancers. Although I've had close relatives with each of those, the genetic test showed no connections. And except for the central/bilateral aspect of the endometrial cancer, everything has been on my left side - plus a largish neck lipoma and a hip replacement. I have like nine surgical scars from five surgeries on that side. I hope whatever hits next is on the right, otherwise the scars will start to overlap!

I'd like to share something posted on another thread. I had what ended up being called a "local recurrence" in a totally different area - my collar bone - with in TWO YEARS of my original diagnosis & BMX. I've saved and read this often. I didn't screw up. My docs didn't screw up. Sorry you have another ride on this darn carousel. Good luck with treatment.

Here is an excerpt from the below:

"Like a lot of cancers, breast cancer grows by simple cell division. It begins as one malignant cell, which then divides and becomes two bad cells, which divide again and become four bad cells, and so on. Breast cancer has to divide 30 times before it can be felt. Up to the 28th cell division, neither you nor your doctor can detect it by hand."

"With most breast cancers, each division takes one to two months, so by the time you can feel a cancerous lump, the cancer has been in your body for two to five years. It can certainly seem like a lump appeared out of nowhere – especially if you or your doctor have recently examined your breasts and not felt anything suspicious – but in reality, the cancer has simply doubled that one last time necessary to be noticeable. By the time you can feel it, a breast tumor is usually a little more than one-half inch in size – about a third the size of a golf ball. It has also been in your body long enough to have had a chance to spread"

Ah, so sorry to see you back here.

You are unfortunately far from unique. One of the nasty little secrets about breast cancer is that once we've been diagnosed one time, we are at higher risk to be diagnosed again with a new primary. A breast cancer diagnosis brings along not just the risk of recurrence (the first cancer showing up again in the breast or as metastasis in the body) but also a higher future risk to develop breast cancer again. My MO told me that my risk to develop a new primary was about double that of the average woman my age. I'm a research junkie and I've read all sorts of studies and articles about this. It seems to be all over the map, in terms of what our risk really is, but my MO's "double the risk" is probably not far off. What's interesting, and concerning, is that the risk might be considerably higher for those diagnosed with particular sub-types, such as triple negative.

There is a discussion thread on this topic from years ago that has once again been active lately and which includes links to a number of recent research studies about second primaries. You might find it interesting:

• Topic: How common is a 2nd cancer in other breast? https://community.breastcancer.org/forum/88/topics/763065?page=1

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Now that you've been diagnosed with two primary breast cancers, the question is, what is your risk to be diagnosed again? There unfortunately does not appear to be any answer to that question, making it much more difficult to know what to do from here, i.e. would a BMX be wise or is it unnecessary? Although the risk of a second primary is relatively well studied, and although our risk to be diagnosed a second time appears to be relatively high (as compared to the average woman who has never been diagnosed), the absolute number of women affected is quite small. Looking at this group (those who've had 2 primary breast cancer diagnoses) to determine the likelihood of a third diagnosis doesn't seem to have sparked any researcher's interest. At least I haven't been able to find anything. So the lack of information makes your decision on what to do more difficult.

What I can tell you is that screening is imperfect, particularly for those who have dense breasts - I don't know if you do. With luck, a good screening program including MRIs (which are most effective but often aren't always approved for screening purposes) will find a new cancer while it is small. But unfortunately there is no guarantee either that screening will find a cancer early or that a small early stage cancer might not nevertheless be extremely aggressive. My suggestion is that you ask your MO about your risk, and determine from your doctors how you will be screened going forward, should you choose the lumpectomy option.

My only comment about the stats you received is that all of them are specific to the possible outcomes from this diagnosis of breast cancer. None of them consider your risk to develop yet another new primary, or what might happen if that were to occur.

While no one saw you as being higher risk after your first diagnosis, and it seems that no one told you were, the simple fact is that all of us are higher risk once we've been diagnosed previously. As I said in my earlier post, I don't know the risk for a 3rd new primary. However having been on this site for a while and having seen quite a few women return with a third new primary, my guess is that if someone has been diagnosed twice - showing that your breast tissue provides a friendly environment for cancer cells - odds of a 3rd diagnosis are probably higher than average. The unanswerable question is, "how high?".

edj3

I'm thinking of a charm bracelet for mine and maybe banners for the front of the house - it would look like a tacky used car lot!

My mom was just diagnosed 8 years later with a new primary, now on her left breast. Originally diagnosed on right with triple positive. She had lumpectomy, chemo, radiation, and herceptin. This time around it was found incidentally on an ultrasound. The good news is that it is not Her-2 positive and very small, under 1cm. My Mom is 73 yrs old, and I am pretty sure the surgeon is going to pitch the conservative way to go, even though I would prefer her to get a bmx. It is not my body, so need to respect her wishes. I am also praying she doesn’t have to go through chemo again. Her Ki-67 is 10%. The nurse said this is slow growing, but does this value have a direct correlation to the grade of the cancer? It is IDC. She didn’t mention the grade and I am still waiting for the official results to hit her web portal

Ki-67 is proliferation, so I am thinking it is one in the same when it comes to grading. I looked back on my mom’s path results from 8 years ago and the ki-67 was over 30% after her lumpectomy, which was considered high. The legend said anything over 20 was high. Anything under 10 was low. My Mom is at 10, so she is at the higher end of low, Sorry you are going thru this as well again. My Mom is handling it relatively well, and we are just hoping it was caught early and no chemo is needed. I am grateful she went 8 years without a recurrence, so hoping she gets another 8 before anything else goes on

I'm sorry you are dealing with this again.

Definitely get genetic testing. I'd write down pros and cons of all options to help you decide what's best.

I learned with my recurrence that unfortunately, all they can do is guess your risk because there are little to no studies on local recurrences and future risk.

Hello Everyone,

I hope I’m in the right post about new primary. I had left breast cancer in 2015, went through neoadjuvant chemo,UMX,and radiation. Things were ok until about a little more than a week ago I felt right side breast sensation some fullness so it has discomfort. So I examined there is some fluffiness of area next to my armpit and looks like the breast is fuller and sag to the right. The breast feels soft but I can’t detect any significant lumps. I called the doctor to schedule an US but is this typical of a new cancer? One note is I just had 2D mammogram in 12/2019 and full breast US in 10/2019. I hope anyone has similar experience. Thanks

Hi Julie

I didn’t go to my OC because in my experience she’s not very quick or proactive in my concern. I talked to the nurse of my breast surgeon and he agreed for an ultrasound right away. I’m due for the six months follow up for the mammogram anyway. But since mammogram cannot really see my dense breast I want the US first. Sorry for the abbreviation, UMX is unilateral mastectomy. 2D mammogram is the traditional mammogram versus the newer 3D version which is clearer but has twice the radiation