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Upcoming biopsy for "subareolar mass" 1 year after mastectomy for extensive DCIS

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I am trying not to get too panicky yet, and I'm more annoyed than scared at this point. I was diagnosed with DCIS in January 2023 after many years of monitoring and multiple biopsies that showed benign papillomas. I then found out I was CHEK2 positive and stepped up the monitoring with annual MRIs. I had very "busy" breasts so there seemed to be something to biopsy frequently. I eventually went to Dana Farber for a second opinion, worried that I should be having papillomas excised or that we weren't missing anything.

Their radiology reviewed and found an area they were concerned about that my local radiology hadn't mentioned. I had another biopsy and that was DCIS. Due to my history and CHEK2 I opted for nipple sparing bilateral mastectomy and reconstruction with silicone implants. I had the DMX and tissue expanders surgery March 2023 and exchange surgery in June with fat grafting. They found extensive DCIS throughout 2/3 of left breast and lots of other pre-cancer abnormalities in both.

I noticed a lump in my left (cancer) breast within a few months after exchange. At follow-up with my plastic surgeon she was not worried about it, said it's probably fat necrosis but recommended an ultrasound. I had one a couple of months later locally and they thought it looked benign and suggested another ultrasound in 3 months. At that ultrasound the spot had reduced in size, which was a good sign. However, they saw something else in the subareolar region that they recommended an MRI. This spot they said could be a papilloma possibly but not sure from US.

I had the MRI locally again and the results were comforting - everything looks benign and non-suspicious. I felt confident by the way it was written that nothing to worry about. Went to my 1 year surgical folllowup at DF and they reviewed the images and disagreed. Their impressions say "Left 9:00 subareolar 1.0 cm mass, likely correlating with an area of focal non-mass enhancement on the MRI, indeterminate. Ultrasound-guided core needle biopsy is recommended at this time." My surgeon's PA who I had met with couldn't say whether it was possibly a papilloma or recurrence or something else, just that they were using an "abundance of caution" given my history and she wants me to have the biopsy there instead of locally. Which I agree with because now it's twice that the local radiology missed something.

Whether benign or not, this concerns me that either something was left behind in surgery, breast tissue with ducts and either residual or new disease. I know that they can't remove every cell but it seems so soon for there to be recurrence or new findings rather than something left over?

I'm worried about the biopsy. I'm annoyed that I'm back on the cycle of imaging and biopsies and worry that was the reason I chose DMX. I'm exhausted from a year of surgeries (also had a hysterectomy with ovary removal this January) and follow ups. And struggling with being out of shape from inactivity and lack of motivation, not to mention the hormonal changes. Next available biopsy appointment is not until June 24 so it's a long wait.

Sorry this is so long. I don't want to talk about it with my friends or family until I know something (my boyfriend knows). If any experience with having a biopsy post-reconstruction (sounds challenging?) or experience with recurrence or having other results post DMX I'd be happy to hear it. Thank you :)

Comments

  • monarchandthemilkweed
    monarchandthemilkweed Member Posts: 155
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    hi I just wanted to offer some support. While I haven’t had your exact experience. I too had busy breasts before cancer and also have the Chek2 mutation.

    I really hope it’s another benign finding. Keep us posted

  • triscuit
    triscuit Member Posts: 34
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    Thank you @monarchandthemilkweed! I appreciate it. I'm distracting myself pretty well with traveling at the moment.