3 years out - New Finding on Mammo Today (BiRad 4)
I was diagnosed with Stage 1, IDC, 100% hormone positive when I was 40. I'm now 43. I had a lumpectomy and 30 treatments of radiation. I'm currently on daily 20mg Tamoxifen and Lupron injections every 3 months. I went for my yearly mammogram today and they're seeing something in my opposite side. Original cancer was in my left breast...this new finding is in my right side. I'm thankfully scheduled for a biopsy tomorrow, but I'm worried. It's a BiRad 4. I forgot what this spiral down the rabbit hole of worry felt like. Maybe it's nothing, maybe it isn't. Posting the results to get some thoughts and anyone with similar findings. Thanks all!!
FINDINGS:
RIGHT
E) ASYMMETRY
Mammo diagnostic bilateral w 3d & cad: There is an asymmetry seen in the
right breast at 6 o'clock in the posterior depth on the CC view. This is a
new finding.
US breast right limited (diagnostic): There is a 6 mm x 5 mm x 4 mm
irregularly shaped, non-parallel, hypoechoic mass with angular margins
with no posterior features seen in the right breast at 7 o'clock, 6 cm
from the nipple. The mass correlates with the asymmetry seen on the
mammogram. Associated features include internal vascularity.
There is a biopsy clip more anteriorly in the right breast from a prior
benign biopsy at the site of a fibroadenoma.
Imaging of the right axillary region shows normal appearing lymph nodes.
Comments
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I'm so sorry you're going through this again. Thank goodness though you're not having to wait around long because we all know this part is excruciating. As far as guesses go, I don't think anybody here can tell you anything really besides that it's apparently really small. That obviously is good no matter what. Lymph nodes appear normal, too, so that's another good thing. Hopefully what it is is benign but even if it's worst case scenario it reads like you discovered it very early.
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Thank you for your comment kaynotrealname! I had my biopsy this morning and they said the results should be in on Friday. When I asked the radiologist her impressions after the biopsy she said she was "extremely concerned" with the way it looked and how it felt when she was doing the biopsy. I'm worried. Really, very worried. I'm going through a horrific divorce from an abusive husband, and have been for over a year now. I'm a single mom to 4 kids ranging from kindergarten to senior and my closest family is 4+ hours away. Another cancer diagnosis is just not something I want to add to my overflowing plate right now, so fingers crossed and many prayers said it isn't.
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Well crap. No you don't need this at all but it seems cancer never cares what you need. Hopefully though it isn't that. Fingers crossed but know we're here for you at least on-line.
Also, I had a rising senior when diagnosed. They can help quite a bit. Not that I wanted to burden them too much but I expected her to help me and she did.
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Well crap indeed :( It is official. I have breast cancer again. My results popped up in the patient portal this morning. I'm still waiting on the details of the type and a call from my oncologist on what to do next. Ugh, not what I thought I would be dealing with when this week began :(
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I am so fucking sorry. It sounds like another primary and not a recurrence so for that I guess it's good but I know that cancer no matter what sucks a big one. If you have any questions, need to vent, or really anything at all I'm here. But you know now, at least the waiting is over with, and you've been through it once and can do it again. I hope it's as easy a treatment as breast cancer can be.
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Thanks for your continued comments kaynotrealname! I'm feeling a lot more positive (maybe not the right word lol) about this new diagnosis today. It was just really hard to wrap my brain around it at first, but as I get more information I feel a lot better. I remember it being the same way the first time around. I had an MRI today. Thankfully, I actually work for the hospital network I am being treated at and some strings were pulled to help get me in right away. I wasn't going to say no to the help. My MRI was read and the results were in my portal before I even got home from the appointment. My work family didn't want me worrying about it over the weekend...so grateful for them! Nothing worse than original suspected. Not in the lymph nodes, that they can see. Slightly bigger at 7mm than the ultrasound read, but still really small. I'm so grateful that they caught it so early again. Still waiting on the HR and HER2 status, before figuring out a solid treatment plan. I know I can do this again though...not that I want to, but I know I can.
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Well that's about as good as you can expect for breast cancer. I'm glad you're feeling better and I do hope this weekend brings you much needed rest.
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Oh @mama2fourkiddos we're so sorry to hear this! You CAN do this again, and we're all here to support you through it.
The Mods
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Not sure I should start a new post or not since I'm diagnosed now, but I'll just stick with this one for now. So the HR and HER2 status came back. It's HER2 negative and ER+ (90-95%) and PR+ (40-45%). I've decided on a lumpectomy and radiation. The surgery is scheduled for 9/15. I met with my surgeon this morning and I was quite surprised when she said chemo is a possibility. I never had a mammaprint or oncotype testing with my 1st cancer. It was ER+ and PR+ both at 100%. HER2 negative (+1). But they're ordering both or one of those tests now. I've been on Tamoxifen 20mg since December 2020 and Lupron injections since January 2021. They're concerned that maybe the cancer is more aggressive since a new one started up while I was on hormone therapy (not a recurrence). I messaged my medical oncologist today and asked if I should get the Lupron injection that's scheduled on 9/6. He wrote me back and said to not get the shot and also stop taking my daily Tamoxifen as of tomorrow. Has this happened to anyone? What are the side effects for coming off of Tamoxifen without tapering? Ugh, I hope my period doesn't come back during all of this since I'm going off Lupron. Thoughts anyone?
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Chemo is a possibility. I had 68% estrogen and 95% progesterone and it was enough to put me in the intermediate scoring section on the oncotype (the lower your hormone levels, especially progesterone, you tend to trend higher on an oncotype test). I didn't particularly care all that much and in a way was thankful. I had a grade 3. I wanted to hit it with chemo since it normally responds well to it but my family didn't want me to have it. When my score came back they shut up and I could do what I wanted without a ton of commentary (I would have done what I wanted anyway but commentary from others is a pain :) So I would be prepared for that possibility. However good news is it won't be a ton of sessions more than likely as long as you don't have node involvement. I had four sessions called T/C. They weren't fun and once I was on my fourth session I felt like dog ass but it was quick, my recovery was quick, and for the most part my life stayed pretty on par with what it was before diagnosis. I did lose most of my hair despite cold capping but it's come back in nicely even if I do have a messload of curls now. As far as stopping your medications, yes, they like you to do that before surgery. The reason is blood clots. You'll be able to start right back up again though when your surgery is over. Remember though your tumor is small. Even if it's aggressive, aggressive for a hormone positive tumor isn't aggressive like for other tumors. So going off your endocrine therapy poses no real risk, not for the short time you'll have to be off it. Good luck! I'm so glad you're moving quickly.
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So I haven't updated in a while, but my oncologist sent out my original biopsy for a mammaprint and it came back as low risk, so chemo not recommended. I had a lumpectomy and SNB on Friday, 9/15 and the surgeon said it went well. However, today the pathology results came back and it's worse than expected. Originally they said size was 7mm, but it was actually 10mm. Originally, it was grade 1 (Nottingham 5), but it's now grade 2 (Nottingham 6). On the ultrasound and MRI the lymph nodes looked good, but when they removed 2 during the SNB one came back with a macromet of 4mm. I don't even know what to think. I never ventured down the rabbit hole of positive nodes. What will they need to do now? Take more lymph nodes? Chemo? I've been at peace with everything going on, but this has rattled me. I don't even want to tell anyone what's going on. I'm afraid I'll break down. I plan to call my nurse navigator tomorrow. I don't have any appointments with my surgeon and MO until the 1st week of October.
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Hi @mama2fourkiddos ! I’m sorry it’s worse than what your originally were told. I think this happens unfortunately.A mammogram and ultrasound may say one thing but it’s the path results where the real information is found. I myself was in a similar situation as you… also with dense breasts. Mri, mammo, ultrasound made it seem not as bad but once I got my path results it was worse than expected. Two lumpectomies and a double mastectomy later we finally got it all. I also had a positive node 10mm and for that reason I had to have chemo. They did not remove any more lymph nodes. Hopefully once you meet with your doctors it will help with the anxiety, to have some answers. Hang in there, it sucks you have to go through this again!
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Are they doing an oncotype test also? That will take the whole of your tumor, not just one part of it, and analyze the genes and see whether chemo would make a difference. It'll probably conclude the same as the mammoprint but the oncotype test is the gold standard. That might give you some additional piece of mind if it comes back as chemo not recommended. And as far as the pathology having surprises unfortunately that's common. Mine was much bigger than they thought. It didn't influence my treatment though. As far as what's next, I'm not sure. I know in the UK they might recommended an axilliary node dissection. Not sure about that here. Maybe they'll hit it with radiation and call it a day. But I'm so sorry. Surprises are just awful. This should be the last one though and now you'll be able to proceed with your treatment plan.
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I'm sorry you're dealing with this! I hope you'll get positive news and soon.
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Hi @mama2fourkiddos , I'm sorry your path results were worse than what the biopsy and imaging predicted. Unfortunately this happens. I went into surgery with a diagnosis of 1.6 cm DCIS and ended up with 3.2 cm IDC, 1/3 nodes and LVI. My oncotype score put me two points away from a chemo recommendation. My radiation plan was changed from just whole breast to whole breast plus nodes and the AI recommendation went from 5 to 10 years so it wasn't a drastic change. Hopefully you will have an updated treatment plan soon.
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@kaynotrealname - I hope they'll do the oncotype test on the full tumor. The biopsy sample for the mammaprint was grade 1, so I don't know if the larger sample would cause it to come back differently since its now grade 2. The mammaprint came back as +0.163, which is just this side of Low Risk. But all of that is also based on it being no positive nodes. Now I'm not so sure with the macromet. I hate surprises and I just didn't see this one coming...again :(
@flowergirl1975 - how many lymph nodes did you have removed in your SNB?
@salamandra - thanks, fingers crossed I get some answers soon!
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@mama2fourkiddos I had two nodes removed . First came back the 10mm macromet and the other was negative. I get the shock of finding it in your nodes. I was having diagnostic mammograms every 6 months for 5 years and I remember originally thinking how is this possible? I have been so good about going to avoid a situation like this and yet here I was with a stinkin positive lymph node. Totally sucks!!! I was not super excited about having to do chemo but the thought of the possibility of any floating cancer cells in my body really scared me. I completed 4 rounds of TC Sept 1st and I will tell you it was very doable . I also cold capped and kept most of my hair. I guess I’m telling you this because if you do need chemo, I hope you don’t, it is not as bad as the media/tv portrays it to be. At least mine wasn’t. Fingers crossed for no chemo though ☺️
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