Mind is spiraling….
Ok friends. For some reason, I’m spiraling. Background story: I have a history of DCIS, left breast. I had a DMX as my breast oncologist surgeon was in agreement with the surgery. This all happened in 2017. Direct implants at the same time. A year later in 2018, had fat grafting in both breasts. All has been well; have had ultrasounds every six months since 2017.
Just last month, I found a small, pea sized hard lump in my right breast, the non-cancerous size. Immediately called my breast surgeon oncologist where she performed another ultrasound and said it looked like fat necrosis, but to be sure, she had a radiologist look at it. He too thought it looked like fat necrosis but wanted a mammogram as well. Mammogram results are as followed: Birads: 2, benign. For reference, it’s been NINE years since diagnosis. NINE.
Impression
There is no mammographic evidence of malignancy in the right breast. BI-RADS Category: Overall: 2 - Benign
Recommendation: Recommend clinical follow-up and further imaging
History: Patient is 46 y.o. and is seen for palpable lump in the upper right breast. History of nipple sparing mastectomy with implant reconstruction.
Films Compared: Prior images (if available) were compared.
Findings: This procedure was performed using tomosynthesis. Computer-aided detection was utilized in the interpretation of this examination. Right There are scattered areas of fibroglandular density. There is an area of fat necrosis in the upper region of the right breast, posterior depth. This correlates with the palpable finding noted during physical examination. There is no evidence of suspicious masses, calcifications, or other abnormal findings in the right breast.
Sooo…. Why am I still so nervous? Is it truly PTSD? I’ve always suffered with anxiety, but this is next level. I should be elated! But yet, here I am overthinking that the radiologist was wrong or the mammogram didn’t image the entire breast.
I’m not sure what I’m looking for nor am I sure of what I am asking.
I just need some reassurance, maybe?
Comments
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Hi @rrobin0200, Anxiety is real and sometimes something new like finding a lump can make it worse. If you have reason not to trust the accuracy of the imaging center you can get a second opinion on the read from a radiologist who is a mammography specialist.
Change always seems to bring some anxiety. New parents worry about the baby getting sick or choking on something small. A teenager who has just received a license and is driving independently causes a different type of worry. Starting a new job that you want comes with some anxiety about how well you will fit in. While the recurrence rate for DCIS with a mastectomy is low (about 3%) it is possible and finding a lump reminds you of that.
Some people find counseling helps them manage anxiety. Others speak to their PCP about medication to help. It's definitely worth pursuing treatment if anxiety is taking over your life. All the best.
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thank you, maggie15 for your reply, and Happy Easter!
The radiologist that looked at my imaging is at one of the Breast Centers here in my city. So it’s not that I don’t trust her; it’s just my mind just doesn’t stop intrusive thoughts about this particular topic. I have seen a therapist who has prescribed several different medications and none seem to work.
I’ll figure it out, I always do. I have another appointment on the 14th (which was my original 6 month follow up anyway) so maybe another breast surgeon oncologist that I’m going to see will help me put my mind at ease as well.
All the best!
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I can definitely relate - had a DMX with immediate DIEP flap recon in June 2020 and around a year afterwards, maybe a little more, and before any fat grafting, developed a hard pea-sized lump at the surgical seam on the left recon breast which gave me awful anxiety - going through so much surgically with wound healing issues and post-surgical pain, etc. only to have a recurrence or new form of bc happen?! Anyway, I went through a mammo and sono (thought I was done with that stuff having had a DMX…) and it was diagnosed as BIRADS 3, likely fat necrosis. That fat lump went away within a year or so by the way, reabsorbed by the body. Had 2 rounds of fat grafting on the right recon breast to even things out…and more than a year after the second round of grafting, a similar type lump turned up on the right side. That time I didn't get as freaked out but it was still pretty concerning. My gyn (don't see an onc) wrote the script to have both sides undergo a mammo and sono. Nothing found in right and for the left that lump was graded BIRADS 2 and once again diagnosed as likely fat necrosis. Since then the left lump went down in size and softened a bit so maybe starting to get reabsorbed but still there. I was told no need for any subsequent tests on it unless it gets bigger. So I just keep an eye on things by examining the recon breasts with soapy hands thoroughly every few weeks to make sure no change and no new lump. If anything does crop up I'll have it imaged asap just to make sure. By staying on top of it like that, I found it reduced my anxiety. Hope you can get to a similar place, . The only anti-anxiety drug I ever took (and occasionally still do) was diazepam which I found helpful, at least to be able to relax and fall sleep in the evening. Also for being able to fall asleep - magnesium glycinate + melatonin + tart cherry juice combined around 30 min before trying to go to sleep are very effective for me.
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thank you, @abigailj, for your reply. Although I hate that any one of us has to endure this, it does help a little to know I’m not alone. I go back on April 14 … which was the the date of my original follow up… so I’m going to see what this other breast surgeon oncologist says about it. Kinda like a second opinion.
I hate being able to feel this lump everyday. It’s a constant reminder. However, I think that I would rather feel it than not, just so if it does get bigger, I’ll be able to tell. Maybe that doesn’t make sense. But I feel more in control.Hugs.
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