Topic: Breast lump felt but not seen on ultrasound

Aug 20, 2012 09:28 PM MrsCich wrote:

I meet with the plastic surgeon Thursday and double mastectomy next Wednesday.  :/  Oncologist after the mastectomy and lymphnode dissection so she can come up with my game plan.  BS said since I'm so young, chemo is pretty much a sure thing since breast cancers among younger women is usually aggressive.  BLAH!! 

Aug 20, 2012 10:34 PM, edited Aug 21, 2012 11:22 AM by TinaT

Aug 21, 2012 10:58 AM Infobabe wrote:

 jennyb4 

Jenny, the DCIS cells move along the duct and can be in a small area or all through the breast.  There can be grades 1, 2, or 3.  It can remain that way but some go on to go through a change in the cells makeup and become invasive.   Once invasive, it can travel throughout the body through the lymph system or through the blood.  

It is unknown when and if the DCIS will change to Invasive Breast Carcinoma (IBC).  If the DCIS is in a small area and can be treated with lumpectomy with big clear margins, in some cases nothing more must be done.  

It is possible that microscopic DCIS can remain in the breast, though it appears to be slow growing and may not be evident for a long time.  However, if the woman is younger and they have 50 years of life ahead of them they do not want to risk invasive cancer as it is a long time for DCIS to develop.  Therefore, mastectomy gives more peace of mind with regard to recurrence.  This is especially true when the DCIS is extensive.  So shape and size matters.  Please read this page for a clearer explanation.  Others have said this better than me.

community.breastcancer.org/for...

Aug 21, 2012 02:06 PM TinaT wrote:

MrsCich - Hopefully, they'll be able to easily locate the sentinel node and will only have to remove one or two rather than doing a whole dissection (unless full dissection is the plan based on your age?).  Keeping my fingers crossed for you on that.  And great to hear that your BS does NSM with inframammary incisions (some don't).  Sounds like you've got a fabulous team so far - hope you land a great PS as well! 

Aug 29, 2012 01:19 PM, edited Aug 29, 2012 01:20 PM by TinaT

MandyK - Hi, it's natural to be concerned when you feel something is different or isn't "right".  Odds are definitely in your favor that there's nothing ominous going on, most lumps and bumps are fibroadenomas or other benign things.  Many of us have required an MRI to evaluate lumps and bumps, especially if your breast tissue is dense.  Dense tissue is difficult to evaluate thoroughly on mammogram and even is sometimes difficult with ultrasound.  If you are really concerned and don't want to wait and re-evaluate in 6 months or a year (which is what I assume they've told you) start asking about an MRI.  A breast surgeon usually has the greatest success in jumping through the insurance hoops to get it approved.  If you have a family history or if you feel something that they can't find on other imaging studies that helps a bit to get it approved. 

Did you have your ultrasound done at a general imaging center or at a center that only does breast imaging?  Did you see a general surgeon in 2009 or was it a breast surgeon? 

If I'm reading your post correctly it's been almost 3 years since you saw a surgeon.  I would ask for another consult with a breast surgeon, perhaps someone different than you saw before.  Be honest and say that you are becoming very concerned, that you feel another possible lump,  and you want this area examined by a breast surgeon and (hopefully) get an MRI.  Again, chances are in your favor that this will be something benign, but it would be good to put your mind to rest either way. 

Listen to that little nagging voice and be persistent!

Aug 31, 2012 02:14 PM, edited Aug 31, 2012 02:15 PM by TinaT

If you need more imaging studies and if you have the option I would also recommend going to a breast imaging facility where the techs and the radiologists and the equipment are all dedicated to breasts.  A radiologist who looks at breasts all day long and a tech who images breasts all day long are liable to take a closer look at what you're feeling than at a general radiology center.  Just my observation from my own experience.....

Sep 7, 2012 01:01 AM, edited Sep 7, 2012 01:05 AM by TinaT

jennyb4 - Hi, obviously the breast surgeon can feel what you are feeling or she wouldn't be doing an excisional biopsy.  At least you're not being dismissed and that's encouraging, right?

I had 3 biopsies with ultrasound guidance and 2 with MRI guidance, but none of them were palpable.  Since your area is palpable and the surgeon obviously doesn't feel a needle biopsy would be as helpful as an excisional biopsy that sounds reasonable.  As you said, just get it out.  If it was me, that would help to put my mind at ease.  I had an excisional biopsy in 2009 and it was a bit unnerving because I had to have needle localization, etc. before.  Since yours can be felt it should be pretty straightforward.

Fingers crossed for you that this turns out to be nothing exciting.  Good luck! 

Sep 7, 2012 01:51 PM TinaT wrote:

Sorry if my choice of words was confusing .  When I said unnerving I actually meant it was a bit stressful, not that they numbed anything.  The area I needed biopsied in 2009 couldn't be seen or felt from the outside so right before the biopsy I had to have a series of mammograms and a needle/wire threaded so the tip was right at the suspicious area.  Otherwise, the surgeon wouldn't know what tissue to remove.  You won't have to go through that process.  Since yours can be felt on the outside it will be a much simpler biopsy.....the surgeon can go by sight and feel.  So it should be pretty straightforward.  I had general anesthesia because the surgeon had to go deep.  It's nice that you can get the twilight sedation, works great and much easier to recover from.  You should feel fine, except obviously sore from the incision.  They'll probably send you home with some pain meds and ice packs.  Every surgeon seems to do something different regarding stitches and sutures.

I agree with you, even if it's nothing you will at least know and won't have to keep following it and wondering.  I hope you can get it scheduled soon and be done with it!!!   

Sep 11, 2012 12:51 PM TinaT wrote:

Sep 17, 2012 08:55 PM Infobabe wrote:

 Wimpy17

Did your insurance company give you any flak about paying for the BSGI?  They are dragging their heels about paying for MRIs. 

Oct 9, 2012 06:55 PM flygirl38 wrote:

Hello, I just found this board and am hoping I can get some solid advice.  About 2 weeks ago a minor ache on the outside edge of my left breast woke me.  I decided to feel the area and found a small 'lumpy" area that did not hurt on palpitation.  It really doesn't hurt still, just a small ache to remind me it is there.  After a week of it only getting slightly more distinct (just enough that I didn't think I was imagining it) I made an appointment. The nurse practitioner did send me to get a mammogram, but because she felt the "plug" on my breast implant (which I explained had already been checked out), but she said she was not concerned about the area on the outside of my left breast because it was just thickened tissue.  The mammogram today showed thickened tissue as well, so they did an ultrasound.  During the ultrasound the technician said she could feel the "ridge" even with the equipment (imaging tool) she was using to scan, but did not see anything suspicious.  Her "guess" was a pulled muscle.  I have gotten well beyond the "I'm imagining it point", and it is definitely different from the right side, with a little ache to it as well.  Should I be concerned, and if so, what do you recommend as a follow-up?