Tiny recurrence after mastectomy and radiation -- whats next?
Hi all. I had a left mastectomy 3 years ago followed by radiation due to close margins (<1mm) on the front, outer side, and back. I had very small breasts with three small IDC tumors in the left side and a scattering of DCIS, so I think close margins were unavoidable. I've been on tamoxifen for 2.5 years, starting as soon as radiation completed. Unfortunately I was just diagnosed this past week with a very small recurrence of IDC in a small focus in the "deep dermis" above my implant. I check regularly, and this little peppercorn-sized nodule appeared out of nowhere. I have my implant above the muscle, so it feels like a very thin layer of skin covering it, and the bump was easy to feel. (for what it's worth, it showed as a small shadow using the flashlight test too.) It was 4mm on ultrasound, and pathology said the IDC focus was only 2mm. Still ER/PR positive, HER2 negative. No grade reported. (??) It was an excisional biopsy with negative margins, thank goodness. Two years ago my beloved breast surgeon moved, so I was switched to a general surgeon who I do like as well. But now I don't know what comes next. He is going to a conference "soon" and will consult with colleagues there and get back to me, but I have no idea when to expect his next call.
I know 2mm is teeny tiny, but it's scary that it started growing again. I assume my HT will be switched, but I don't know if anything else will be recommended. Have any of you had a similar recurrence? Did you have any treatment for it if it was removed with negative margins? The surgeon said since I had radiation before, I likely won't be able to have it again. I want to ask for at least a breast MRI, since the implant is above the muscle, and I have no way of knowing if any additional nodules started growing behind it. And does this warrant any full-body scans? I'm a little nervous of being somewhat dismissed since it's so small, but what if it started growing elsewhere? I am much stiffer nowadays (and only in my 30s, ha), but I chalked that up to tamoxifen. I do have rib pain, but it's been uncomfortable since reconstruction, so I assume that's from the surgeries there and perhaps radiation too. I just hate that fear is creeping back in.
I would appreciate any sharing of similar stories including if you had additional treatment or scans as a result. Thank you!