How common is a 2nd cancer in other breast?

annettek

I am apparently one of those rare ones where mammos did what they were designed to do...after following microcalcifications in my right breast for 8 years via a small marker they left in following the biopsy - after my very FIRST mammogram- that was fun, not even back to my office when they called me back- this past October they noticed "activity" at that spot and it was the same drill, back in my office 30 minutes and I get a call, to which I said...if it is postive for cancer take both I don't want them. Never wavered, no regrets. I realize it can come back somewhere else as some other form, but that is true for anyone. I would never have been able to relax at a time I need less stress more than ever. That is just me and my decision for what it is worth. That next day (actually two days later as the next day I saw a BS) in the waiting room for the second mammo and biopsy every single woman in there was getting either their breast that had a lumpectomy rechecked or their remaining breast checked. What I didn't understand is why all who asked were shocked that I was sitting there saying I would have a bmx if the biopsy was positive. I guess it comes down to personal decision. As they were just making me more comfortable with my decision. One was very disturbed with me and said I was being cavalier about removing my breasts. I corrected her and said far from it. I mean really, it was amazing to be asked to defend my decision. I would not. I just said good luck with what you are doing but this is what I will do if I have BC. She was mad at me but I know she was just pissed off. Hell, I was pissed off and scared out of my freaking mind. It didn't help after the second mammo when the radiologist came in and called out my name. I said yes, do i need the biopsy after all (as the BS was saying very doubtful such small activity but we have to check) and he shouts ABSOLUTELY ABSOLUTELY ABSOLUTELY hahaha Geez, I told him one ABSOLUTELY would have been sufficient....i laugh because actually I am grateful that no matter his lack of tact, he is great at what he does and the team he heads up. 

suzieq60

I was diagnosed with a nasty but small HER2+ve lobular cancer in the left breast in October 09 - lumpectomy/chemo/herceptin/rads. At my first mammo a year later they found a spot in my right breast which we can see on the mammo from the year before - it wasn't reported as it only showed on one view (no thanks to the surgeon for not ordering a MRI prior to surgery). This one turned out to be a tiny lower grade ductal. I chose to have another lumpectomy/rads because I want to give the Arimidex a chance to do it's thing. Both were very highly hormone receptive - caused by HRT and the pill in my opinion. It's been a roller coaster ride but I'm glad I didn't have a BMX. I won't have a choice if there is a next time.

My onc told me lobular tends to appear in the other breast as opposed to going elsewhere.

Sue

hrf

I had first in Oct 2004. Had lumpectomy, chemo, rads. In Feb 2009 had dx for other side - a new primary. I'm BRCA2+ and docs told me I should do dmx or would have a 3rd dx. Despite surveillance, the second one had already gone to lymph nodes before being found

sherryb

Our stories are so similar. I had my mammo in Dec/09 and biopsy in Jan/10 and diagnosed with DCIS. Here's the scary part there were two places, one was neg and one was positive in the biopsy. I too had very dense breasts. I had a gut feeling to do a BM, but was looked at as though I was off my rocker. So I went with a breast reduction and low and behold, not only did the neg. turn out positive, but they found another location, that's makes 3 on right of grade 3, very aggressive. Well, in Jan/11 found something suspicious on left, needle and turned out OK., but found a lump on left and went in to have checked and that seemed OK, but found somethng on left anyway, so go in for sterotatic tomorrow. Like you said, I am not nearly as freaked this time, but if had to do all over, would have opted for the BM. This every 6 mo. of worry is getting old. I am going with at least a unilateral, maybe a BM. I am almost 54, don't need them. But, like you, so soon......  

bdavis

I have had these feelings too... I had a lumpectomy in December, then chemo and was supposed to have rads but have chosen to have a BMX in two weeks... My reasons are fear of recurrance/new cancer and fear of radiation. I currently have a  pappilloma in left (cancer) breast that needs coming out and they are watching something on right side... plus I have  history of ADH... this was all just too much to monitor every six months and even though 4 doctors recommended rads, they all understood my concerns and said I would be having biopsies in my future, and didn't have an issue with my decision... Of course I am very nervous, especially since this MX is all my choice.

ellieg

I so wish that I'd followed my gut instinct. I always said that if I was diagnosed with breast cancer, I would have bilateral mastectomies. My grandmother died of lung metastases and I also have 2 aunts who have BC and my mum's cousin too. I'm in UK and they haven't checked me for BRCA1/2. I requested the mastectomies at the time of my first diagnosis, last year, and I was told that it was "overtreatment" and that a lumpectomy with rads, Zoladex and Tamoxifen would be sufficient. My first lump had masqueraded as a fibroadenoma on scans and fine needle aspiration. I had it for two years and it was only removed because I asked for it to be removed because I didn't like the feel of it. I found a second lump in my other breast, only 6 months after my first diagnosis. A fine needle aspiration showed lipoma and surgeon wasn't concerned. I still had a bad feeling about the second lump and I had to wait for a follow up appointment 3 months later. I could tell the lump had grown and the surgeon agreed to take it out. I had a lumpectomy, which turned out to be a second cancer but the margins were not clear. FNA of swollen axillary lymph node after surgery showed cancer cells and pathology of lump showed lymphovascular invasion. This second cancer is an aggressive one, Her2+++ and totally different to the first, which was a stage 1. Even with the Zoladex and Tamoxifen, the second cancer has grown and is ER+. Apparently, the receptors could be "switched off", there could be a mutation and it's possible that Tamoxifen can have the opposite effect on a tumour, in that it can actually cause it to grow, rather than stop it. I dont know my stage now as I'm waiting for CT scan results of chest, stomach and pelvis. I see onc later this week to discuss chemo and herceptin. I had echocardiogram today. I will have the chemo before the mastectomies. I may need rads as the tumour was close to the chest wall and the lumpectomy consisted of breast tissue being removed down to fascia level. Basically, I've been told I'm unlucky in that I grow "sneaky cancers" that don't show on ultra sound scans, mammograms or fine needle aspirations. I was never given core needle biopsies but when each of my lumps were taken out, the pathology was bad news. So, I would urge all women to follow their gut instinct and don't be put off by the surgeons or oncs. Push for what you feel is right. My answer to how common is a second breast cancer?..... don't take the risk if you feel something isn't right. Everyone is different, so don't go by statistics. I wish I'd followed my instincts.

hrf

unfortunately having a second bc is much more common than i realized

Aliceann

hrf, you are so correct about recurrences.  It is much more common than people realize.  I sure was surprised when my recurrences were found.  Regarding the subject; I did not have a recurrence in the other breast (YET), but one of my recurrences occurred in the lymph nodes in the right axilla.  I ended up with more side effects from that occurrence than in the others.  I still have a right breast after I was convinced it was not cancerous.  I would have had that removed, but my surgeon had originally gone in for a surgical biopsy only.  She ended up removing numerous lymph nodes.  I decided I didn't need another surgery then, as I was headed for Chemo and radiation shortly after the surgery. 

Lena

...do you mean a totally different cancer, as in, if your first one was, say, hormone negative, but the new one in the other breast is hormone positive -- or just any second tumor in the breast that was healthy at the time your first bad breast was diagnosed?

I ask because I was first diagnosed in the right breast Feb 2009, but around March of THIS year, we found a tumor in my LEFT breast, which had been totally "clean" in 2009 when the right breast was full of tumor. Biopsies of both (the oncologist rebiopsied the original one specifically to compare it to the new one) showed the same kind of cancer in both. That is, IBC, ER/PR+, however...my original tumor at diagnosis had been HER2+, but now it was HER2- so they were both the same. Those tumors are gone now though, both of them. I had a BMX in May.

bdavis

Lena, It is my understanding that RECURRANCE can only occur in the original breast... if it shows up in 2nd breast it is not a recurrance, but a NEW cancer... even if they have similar characteristics.

Unknown

Hi all - since I've just been dx'd w/a second primary, thought I'd jump in on the recurrence versus second cancer topic - bdavis is right - it's a recurrence if it's in the same breast or if it's mets, a second cancer if it's in the other breast. My first cancer was crazy aggressive, invasive, ER/PR and HER2+ and stage 3. This new one (so far, we'll have full path when I get my BMX in September) is DCIS, grade 1, ER/PR+ (no HER2 done b/c it's DCIS). Not as big a deal as the first one, but a heck of a lot more surgery . . . . .

hrf

I had 2 different primaries. If there was any good news, that was it as opposed to a recurrence. The first in my right was IDC TN. The one in my left was ILC 100% ER+/80%PR+. About as different as could possibly be

bdavis

so sorry for you guys.... this is why i opted for BMX after lumpectomy... just couldn't bear the idea of going thru it again... and I know its still not a 100% protection.

hrf

Doc said if I had done bmx with first occurrence, risk would have been lowered by 90% so odds are I wouldn't have had second one. I just never believed it would happen again and I thought that because I was being followed so closely, anything that might happen would be caught so early that minimal tx would be required. Bottom line for me - I couldn't do it and got hysterical every time it was mentioned to me. Guess I ended up in the same place but worse

bdavis

no... you made an effort to avoid MX... no regrets... now you will put it behind you, once and for all

Padiddle

Just the topic for me!  I was diagnosed in 2000 with stage IIb IDC.  Had right mastectomy, chemo, rads.  In 2009, diagnosed with metastatic disease.   I'm in treatment with Zometa and FEMARA.  My mammo for the left breast on Monday was abnormal.  I had an ultrasound today and the radiologist is recommending ultrasound guided biopsy.  I don't understand.  I'm in treatment for metastastic disease.  Just stunned??????????  Jean

bdavis

So sorry Jean... it for sure isn't fair. so what now?

zoey1

I had 2 primaries, diagnosed 4 years apart, same breast (different areas). Both were ER/PR positive, less than 1 cm, stage 1, but first one was grade 1 and last one was grade 2. I refused Tamoxifen first go around but am now taking daily (started dosing night ofdiagnosis!). Had mx April 2010 with DIEP reconstruction. What a trip this has been!

Warm regards to all of you!

Unknown

Jean - I'm so sorry to hear this! It's not fair and really, makes no sense . . . hoping this is some sort of firedrill and nothing that needs more attention. You're doing enough, darnit!

Betsy - if I'd had a MX in '01 it would've been just the left - no one thought it was necessary and it would've done me no good now . . . the upside of this is I will have a matched set (really trying hard to look on bright side here, can you tell?).

The hard part for me in this is "why?!" No family history, no gene mutation . . . dunno if I'm just a mutant or if I've got something not yet discovered. Would love to know . . . . 

bdavis

Sarah... I think the gene thing is not a complete picture... they test for 2 genes... I am convinced that with a family history of prostate cancer, that my cancer is somehow related... both hormonal ...

And KAren, where did you go for your DIEP? I just returned from NOLA where I had a hip flap surgery.

Unknown

Betsy - would agree w/you . . . someday maybe they'll determine a link between prostate and breast cancers. After all, there is a probable colon/breast link. My issue is there is NO cancer in my family at all, either side, male or female. Baffling.

mixin

My original diagnosis was ILC in the right side and mammographically stable in the left. However, since I had lobular, they did an MRI on both sides and then found DCIS in the left.

I'm hoping I got my 2 at the same time and don't have to worry about it again.  

bdavis

Mixin... I am sure you have gotten it all...

Ginny465

13 years cancer free....left breast stage 2.......now on right breast.......find out tue. if cancer....I think it is.   Do i have both breast taken off???? help   in a

state of confusion

state of confusion..............

ReneeinOH

Ginny465, you'll get more information that can provide a foundation for an answer to your question.  

I'm trying to make this decision. (WARNING: this might be part rant.)  This week, I saw my BS (head of the comprehensive breast center in my area; been at this 30+ years). I could have opted to get more biopsies to see if I was a lumpectomy candidate, but given the "multiple areas of concern" I said skip that part and go right to mastectomy. He said a double mast. will not increase my chances of avoiding BC coming back; that the chance of it showing up somewhere else is greater.  

I still can't shake whether he is really "in tune" with what is going on with me. I asked him if I was high risk; he said no. I'm like "really--my mom w/BC and sister w/DCIS in her 40s, plus my dad's sisters?" He didn't have my aunts' info (5 out of 6 had cancer; three w/BC; one of those in her 40s and died from it; dad had cancer too), despite me typing up a sheet because there wasn't room in the form to give all the info. After pointing out that, he said, OK, then you'd be high risk. But still same recommendation. And, I pointed out that I have dense breasts and said does that mean I'll have to get MRIs annually? He said, he didn't know about that; usually doesn't happen (other surgeon I have consulted on this said I would need that to detect cancer in that area from that point on), but that would be determined later on... MRIs is a BIG negative for me.

I guess I said my peace by making very clear that I want to do everything in my power to eliminate cancer from my body and do not want to be sitting in his office 10 or 20 years from now (although I'm sure he'll be retired by then) with BC in the healthy breast. I really don't want to go through this part a second time. I know I can only control/reduce risk so much (cannot remove the possibility of it coming back; will make some lifestyle changes, etc. I can improve, but I have to say I'm really healthy, exercise, eat better than most, not overweight, don't smoke, etc.  I just wonder WTF? why is this showing up when I'm 45. My BRCA 1&2 came out negative). What I do know is having to deal with this--breast surgery removal and whatever tx to follow--sucks big time. Worrying about something I don't even cherish (I'm done with these things. They served their purpose, but right now they are the enemy to me in my eyes) really ticks me off.

Timbuktu

I wanted both breasts off but the surgeon said that once it's invasive it can be anywhere in the body.  the same cancer doesn't jump from one breast to the the other, it would have to be a new cancer.  That's what I was told but it doesn't make much sense does it?  If it can be anywhere in your body why not the other breast?  Still, even if that's so, the other breast is scaring me.  It was hard to find the cancer in the one breast, I have very dense and large breasts that are hard to examine.  I don't know why they are so against getting rid of both breasts at once.  Someone told me it might be because insurance doesn't cover it.  Who cares???It's my life!

carlads

Timbuktu,

I had a BMX insurance had no issues covering it.  My BS was totally in support with me having it done.  I guess it's true it can go anywhere, I just felt why take the chance of getting it in the other breast.  I think with IDC most insurances will cover it.. 

Timbuktu

carlads, you were lucky!  My surgeon didn't even want to do a mastectomy, just a lumpectomy.

I don't know what's going on.  

I wish I had the other one off!  But the thought of going in again...not sure.

I'm really not happy with my surgeon.  

Karen3

Hi all

When I was first diagnosed with TN IDC in Sep 2009 I had genetic testing and a BRCA 1 mutation of 'unknown significance' was found. So after neo adjuvant chemo (with little response) I had a lumpectomy Jan 2010 and rads with just annual mammos for follow up. If you have a faulty BRCA gene mutation you have a 25% chance the cancer will show up in the other breast. I had clean mammo January 2011 so I thought all was well. Then summer 2011 felt a pain in my opposite breast and a 'raised ridge' which was growing day by day. I informed my surgical team and Sep 2011 I had a CLEAN mammo and a CLEAN ultrasound. They only did a biopsy because of my previous history. I had serious heavy bleeding as a result of that biospy. When I went into surgery they had no idea how extensive it was as it was totally invisible to scans. It was found to be 4cm DCIS grade 3 and again TN and no doubt quickly on its way to becomming another IDC. I am thankful for the pain I felt which drew me to the area! So, if you have a family history then you have a much higher chance of contralateral BC. I am now classed as BRCA 1. If you have dense breasts then even with clean mammos etc the cancer may not be found until it has progessed. Mammos detect 80% of BC so do not rely on them totally. Also be vigilant! Keep checking for any changes - including pain. I had a bilateral mastectomy in December 2011 and I am doing fine now.

LivingLovingLaughing

I am 59, was diagnosed in 1996 at 38 with stage 1a dcis with micro-invasion 4mm. After some mismanagement of my case, I ended up with a mastectomy and reconstruction. The cancer was caught very early, no lumps, just some calcification on a mammo. Went for yearly mammos on second breast and then 10 years later they found something, almost identical but stage 1 and so I decided to have a second mastectomy with reconstruction on both (the other breast needed a new implant).

There is no clear answer - we just have to go with what we believe is the best course for us. My plastic surgeon said if I knew what I knew today back then would I have chosen to do both. My answer was no, it was a healthy breast and I really was happy with my decision at the time and even to this day.

I have 2 daughters, 28 and 31 and I know I should go for the BRCA testing but have not so far. I am so undecided. My cancer doc thinks it is highly unlikely that I have it and asked what would I do with the results.

1. If I do have it, would it push my children on a course of action for something that may never happen.

2. If I don't have it, will it give them a false sense of security.

It really scares me to find out - could do with some help on this one.