Breast dent is highly suspicious of malignancy

kdholt · September 2020

So I had breast cancer 12 years ago. Thought I was doing great and hoped I’d never have to deal with breast cancer again. Last week I found a dent in my breast (Same one I had cancer in but different spot) I’d never noticed before. Instant panic kicked in. Today I saw my breast doctor. She did not think it looked suspicious of anything but ordered a diagnostic mammo and US. The mammo showed nothing, but a lesion (1”) with a vascular component showed up on the ultra sound. The radiologist called it highly suspicious. I saw the imaging. My dr and I were both shocked and cried together. I have a biopsy tomorrow but I can’t quit crying. I’m sure it’s cancer and worried that it’s stage 4 because I’ve had some rib pain the last couple of days too along the bottom of my bra- although I’ve had pain there before and it’s always gone away so I’ve never worried about it. Can anyone talk me off the cliff? Is a second bout with breast cancer a death sentence. It can’t be good odds to get cancer a second time. Anyone ever had a mass with a vascular component that wasn’t cancer? Sorry I’m probably not making any sense. Just so upset

Beesie · September 2020

Oh, I'm so sorry.

But.. can a mass with a vascular component be something other than cancer? Yes.

And is a second diagnosis of breast cancer a death sentence? Absolutely not. If this is a localized cancer and particularly if it's a new primary breast cancer (rather than a recurrence of your previous diagnosis), then it could be an early stage, very treatable cancer. All of us diagnosed with breast cancer are at risk to be diagnosed again, not just with a recurrence but with a new primary - that's something too many of our MOs don't tell us. My MO told me that my risk to be diagnosed again was about double that of the average woman my age. So getting a second diagnosis, while often shocking, unfortunately isn't really surprising.

As for the rib pain, well, rib pain - costochondritis - is pretty common. So don't jump to any conclusions.

Good luck with your biopsy tomorrow. I'll have my fingers and all other appendages crossed for you!

kdholt · September 2020

Thanks Beesie! I will latch on to anything positive I can right now! In February my breast dr told that if I got another cancer in that breast it would more than likely be a new primary because of the amount of time that has passed. My original cancer was at 12 o clock. This new mass is at 7. I’m just shocked because I was told I only had a 5% chance of ever having cancer in that breast again.

AliceBastable · September 2020

I'm sorry you're going through a scare. I'm even sorrier you have a doctor who cried; that's just appalling, especially since she didn't have any definite information. I'd be hightailing it out of there to find a different doctor. Good luck, and I hope it is just a scare.

Beesie · September 2020

I'm guessing that 5% was your chance of recurrence. That would make sense with a small grade 1 cancer.

A new primary is something different, and as I mentioned in my previous post, it's not something that all MOs mention to their patients. I looked back at your posts and see that you were 45 when originally diagnosed. The average 45 year old has approx. an 11.5% chance of developing breast cancer at some point in her life. My MO told me that my risk to be diagnosed again, having been already had breast cancer, was about double the average woman's risk. Some studies suggest a lower risk and some suggest a higher risk. From my reading, I've concluded that "double the risk" seems about right. That would mean your risk to be diagnosed again would have been 23%. Of course even if that's wrong and your risk was equal to the average woman - having breast cancer one time certainly doesn't make any of us less likely than the average woman to be diagnosed again - your risk would have been 11.5%.

You're a woman. You have breast tissue. You can develop breast cancer. It doesn't matter that you've already had it. It infuriates me that so many doctors don't explain the risk of new primaries to their patients.

I hope this is a false alarm but if not, I hope it's a new primary and is small and early stage. Good luck!

wrenn · September 2020

We all need doctors who will cry with us. The most healing I have done with health professionals has been through relationship. I once cried with my doctor over her having put her dog down the day before. I believe empathy goes a long way. Most doctors have the same explicit information regarding medicine but the tacit relating is where healing takes place in my opinion.

This doctor very well may have been moved to tears by her patient's fears and not about what she thinks the results will be.

Like Beesie (who has way more knowledge than I can hope to have) I hope too that if it is cancer that it is a new primary. I hope you get results soon. Take care.

AliceBastable · September 2020

I also want doctors who have empathy and can express it, but I want that expression to be verbal and controlled. I don't want to picture a surgeon, for example, bursting into tears in the operating room and not being able to see (or think) clearly. But I tend to not cry over health issues, so if one of my doctors did, I'd really freak out.

kdholt · September 2020

Beesie thank you for sharing your knowledge. It is so helpful to hear from someone who has had breast cancer personally and yet has some Real background knowledge about it. I have always appreciated your posts when I’ve scanned these boards. You either do a lot of research or you have a medical background or both.
Wrenn, I agree with you about relationships. One of the reasons I love the cancer center I have continued to go to for the last 8 years for all of my follow up mammos is because they make me feel like a person, not a number. Nothing is double top secret. I get results before I ever leave the hospital. They are open about everything. I have had the same dr the entire time. She didn’t cry out of fear, but out of empathy. She knows me and knows the degree of my health anxiety, and so she felt bad. She did remind me that right now I need to remember this is just a biopsy. We don’t know for sure what we are dealing with. I have a very high degree of confidence in my Drs here. The oncologist I saw before this place was a nightmare! I need the warm reassurance not the stoic see you next month kind of personality.

wrenn · September 2020

kdholt, I'm glad you have a doctor you can feel comfortable with and who sees you. My oncologist was very cold and remote. It was not comfortable. A couple of people who had him quit him and got new oncs. I so hope this is benign but keep coming and sharing how you are doing with it all. Not just because ranting is a bit of a relief but we have people like Beesie who can give us clear pictures of what to expect. I find that helps. Keeping you in my thoughts.

kdholt · September 2020

So I had an US guided biopsy today. It wasn’t horrible. I don’t know anything definitive yet but despite the fact I’m pretty sure it’s cancer again there were 2 positive take always from today. The radiologist did tell me that there are many benign conditions that have a vascular component-something Beesie stated last night. So that was good to hear again. The other is that the lymph nodes they measured were not enlarged at all. So hopefully if it is cancer it’s an early stage

This is off topic slightly but if this is cancer it is very close to my chest wall. For some reason this makes me nervous. Do chest wall tumors have a poorer prognosis?

kdholt · September 2020

I’m still waiting on results from my biopsy on Thursday. Most of the day is fine & I’m able to distract myself but other times panic sets in and it’s all I can think about. So this is another question I hope someone has experience with. If this is cancer is it still possible it could be stage zero? Has anyone had LCIS or DCIS that presented with a breast dent or is that only seen in IDC/ILC

Tmh0921 · September 2020

Hi!

I was Dx with my second Invasive Ductal Carcinoma last year after almost 20 years cancer free. It is NOT a death sentence. Mine was in a different area than my first cancer, but in the same breast. My oncologist believes it's a new cancer, not a recurrence. I did have a double mastectomy and chemo this time, but my oncologist says we are aiming for another 40+ years. Realistically, I know cancer is a crap shoot, but I'm staged at stage 2A this time, so I'm opting to share my oncologist's optimism for now.

Tracy

**edited to add that my tumor was close to the chest wall too. Imaging and surgery found tissue between it and the chest wall with clear margins. As long as it’s not attached to the chest wall/invading the chest wall and you have clear margins it shouldn’t be of concern

kdholt · September 2020

I got my results today and although I was expecting it, it was not what I was hoping for. I have IDC. Right now it appears to be grade 2. Hoping the rest of pathology comes back tomorrow. I’m so sad. I never wanted to have to do this again and now I’m afraid it’s going to be something I deal with for the rest of my life. Guess I will hop on to the IDC board. Thank you

SandyAust · September 2020

kdholt, I am sending you a hug. You can do this. I think and hope once you have full information and a treatment plan, it will be easier to cope and regroup. Unfortunately, breast cancer is one of those diseases that can either recur or result in a second primary. Take care

Breast dent is highly suspicious of malignancy

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