The chest wall basically everything to be found around the outer rib cage, if I understand correctly. My latest recurrence was on the chest wall/axilla area and there was cancer tangled up around muscles, ribs, an artery, a vein, and right next to a nerve. Just had surgery to remove all that. Ugh.

moth: what liver tests would be off that could be considered connected to cancer?

Mavericksmom: I hope you don’t have a recurrence. Can I ask you (maybe I missed you sharing this already) how was your ILC caught the second time you were diagnosed? Did you feel it or was it caught on diagnostic

Very interesting Moth. Thank you for sharing.

Mavericksmom, did you meet your MO? How did it go?

moth:

Thank you for sharing that info. I had questioned my alt and ast last time I had my bloodwork recently. They were just above normal. My ast I think was 50. Just above normal. But my alt has been in the 20s and doubled to 40s. So my question is if there is a issue would the numbers be in the 100s?

I don’t know if my ggt or fast was ever tested. Should I ask for that? What is a fast test?

My glucose is good and my bili has been fine.

But my ast and alt were not in normal range. So was curious regarding that. Dr wasn’t concerned tho. And I don’t think I’ve ever had a manual liver test like you described??

Mavericksmom: That is interesting about the genetic testing. I am negative for brca too. But have quite a bit of cancer in one side of my family. I do think they still haven't made genetic connections to cancer. They haven't looked at all genes yet. They still have alot to keep learning about cancer and its connection to our genes. I think some families with so much cancer in them....there has to be a connection. But I think they will find that there are some genes that haven't been connected yet to cancer but may be connected in the future. Not that I want to have a cancer connected gene. But it would explain why we have cancer in our family.

I hope all goes well with your diagnostic tests on Tuesday. Keep us posted on how that goes ok? Will say a prayer all goes well. Sending a hug your way!

Ohhhh that is wonderful news! Thank you for letting us know! Yes I hope you have a wonderful Summer!!

Mavrick's Mom - Hooray. Great news.

Thanks everyone! LilyWasHere, where IS the champagne, indeed! LOL

A BIRADs 3 means that the Radiologist assesses a less than 2% risk that what the imaging shows might be cancer. The 6 month follow-up is used to assess stability, which further confirms that the lesion is benign.

Here's a description of what fat necrosis looks like on an ultrasound:

"On sonography, the appearance of fat necrosis ranges from a solid hypoechoic mass with posterior acoustic shadowing to complex intracystic masses that evolve over time. These features depict the histological evolution of fat necrosis. Fat necrosis may appear as cystic or solid masses. Cystic lesions appear complex with mural nodules or internal echogenic bands. Solid masses have circumscribed or ill-defined margins and are often associated with distortion of the breast parenchyma. In a retrospective study of the clinical, mammographic, and sonographic features of fat necrosis by Bilgen et al., 26.9% of lesions demonstrated increased echogenicity of the subcutaneous tissue with or without small cysts, 16.6% were anechoic masses with posterior acoustic enhancement, 14.2% were solid-appearing masses, 11.1% had cystic masses with internal echoes, and 3.9% had cystic masses with mural nodules. A specific sonographic indicator of fat necrosis is a mass with echogenic internal bands that shift in orientation with changes in patient position." Fat Necrosis of the Breast: A Pictorial Review of the Mammographic, Ultrasound, CT, and MRI Findings with Histopathologic Correlation

.

And this article on masses seen on ultrasounds explains which descriptors are indications of a benign mass:

"Breast ultrasound: criteria for benign lesions

Several studies have described the sonographic characteristics commonly seen in benign lesions of the breast:

1. Smooth and well circumscribed
2. Hyperechoic, isoechoic or mildly hypoechoic
3. Thin echogenic capsule
4. Ellipsoid shape, with the maximum diameter being in the transverse plane
5. Three or fewer gentle lobulations
6. Absence of any malignant findings"

Ultrasound characterization of breast masses

.

From both of these articles, it appears that descriptions on your report seem to hit all the key words to suggest that this is benign.

Not that anyone else's experience is particularly relevant since every situation is different, but I've had a few BIRADs3 over the years, and none of them ever amounted to anything, not even the need for a biopsy.

Hope this helps.

Glad the information was useful. I have to admit that I was surprised by the description of fat necrosis. I didn't realize that it could appear with cystic components, although I knew that the description of your mass had all the right words to indicate that it's highly likely to be benign. I had a biopsy once for what turned out to be fat necrosis, but mine showed up as a solid mass. I guess that's why the biopsy was necessary - it was not as clear from the imaging that it was fat necrosis and therefore benign.

BlueGirlRedState, my tests were run at Invitae too! I had to pay for them, $250, prior to testing my blood. I had a choice of going with them or Myriad, the company that did my previous testing for BRCA genes. I chose Invitae because they do genes for MDS, which my sister died from. Myriad doesn't do that test, but I wouldn't have had to pay anything if I had more tests done through them. I wanted the MDS gene testing so I put out the money. I have an appointment next Friday with my MO who also works for the genetics department and my genetic counselor to go over the results.

Beesie, glad you learned something too. I also felt better knowing you had a lot of BIRAD 3's, not that I am happy you had them, but just to know others do and they are benign.

BadBoobAgain - I'm sorry you are going through this again. I too thought a bilateral would end it all. This is the 3rd time for me, twice left, now R-axilla Taking Ibrance and Arimidex. Tumor shrunk from 2.5 cm to 7mm , so seems to be working. Oncologist also had a genetic test, over 20 known markers checked, I did not have any. PET scan Sept 2019 showed no metastasis. Hope everything goes as well as it can for you.

2009 ER+ left breast. 52 yrs. Lumpectomy, Sentinel node removal, negative. Radiation 6 weeks, tamoxifen 5 years. Dense lumpy left breast, normal right.

2016 ER+ left breast. Probably a new cancer, but unknown. 4 rounds TC Aug-Oct 2016, Bi-lateral (my choice) Nov 2016, no reconstruction. 2 sentinel nodes remove, negative. Anastrozole 1 mg starting May 2017. Joint issues noticed immediately. Stopped Anastrozole after 3-4 months due to joint stiffness in. After several months of no AIs, fingers were feeling better. Started tamoxifen March 2018.

6/18/2019 Noticed Swelling in R-arm, opposite side from where lymph nodes removed. Long story short, imaging for clot, lymphatic therapist. More imaging, biopsy 8/2019, 9/2019. Started Ibrance and Arimidex. Tumor shrunk from 2.5 cm (Sept 2019) to 7 mm (April 2020). Hoping scan in August shows more shrinking, with luck it will shrink to oblivion. Oncologist thinks I should consider surgery, but I am very concerned about nerves, tendons, muscles, and worsening lymphedema. So will see what August shows.

BadBoo - sorry you have to be back. I would definitely get a second and a third opinion.

If you had a BMX in 2007, that should have scooped out everything. Yes, there can be a recurrence. I had a distant recurrence in a lymph node by my collar bone. But still, they went back in in 2012 and did a revision of the first mastectomy - and now again? I agree. I could have been madder than hell the second time but apoplectic the third. Sounds like your surgeon has failed you. Or the treatment proscribed was incorrect? Or??? Did you have chemo or rads either time? Please do go see a different breast surgeon for at least one second opinion. If you went to a general surgeon before, so go see a specialist breast surgeon. And whether you have or have not had chemo &/or rads, please go see a medical oncologist (MO) for a consult. And please make sure you have a CT and an MRI and a PET/CT this time - before and after.

Badboobagain, how did your recurrences present? Lump at incision? Can you offer more information on your pathology reports?

Really hope you come back and update.

I'm back and thanks to all who responded. CT and Bone scans are negative and I had an MRI this morning to see where this cancer has gotten to in my reconstructed breast. In answer to some of you, when I was first diagnosed with DCIS in 2007, I had a second opinion on my biopsy (confirmed the initial read) and the mastectomy surgery was done at Johns Hopkins. I had close margins and, upon presentation of my case to the tumor board, they recommended no further treatment. BRACA 1 and 2 negative. However, they decided that I should have an annual MRI to monitor for local recurrence. That's how they found my small recurrence of DCIS in 2012. The "revision" of my mastectomy was done at the University of Kansas Medical Center by a different surgeon, the same year in which the Center was recognized as a National Cancer Institute-Designated Cancer Center, so I had good confidence in my care. Again, no further treatment was recommended. Every annual MRI since 2012 has been negative, including the one I had in Fall of 2019. I was no longer being seen by an oncologist, but rather by a nurse practitioner who runs the very wonderful survivorship center, having "graduated" to that protocol in 2015. I found this tumor myself, a tiny pebble I could feel just under the surface of my scar. My surgeon from 2012 has moved out of state, so tomorrow I will be seen by the Department Head, who came to KU last year from MD Anderson. Needless to say, both the surgeon and the Oncology Department are very interested in my case. I have a lot of questions -- including about getting a second opinion on the diagnosis. Also, I just had my blood drawn for the Myriad multi-gene test.

I'll keep you all posted and thank you for your responses!