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Topic: Local recurrence after mastectomy and radiation

Forum: Just Diagnosed With a Recurrence or Metastasis —

Meet others who are just facing the diagnosis of a recurrence of breast cancer or metastatic (advanced) disease. You are NOT alone.

Posted on: Sep 17, 2020 10:17AM

Secondtimeround wrote:

Good morning everyone, I want to start out by sending much love to all of you during your individual cancer challenges amongst a global pandemic and all the extra challenges that brings to you and your loved ones and families. (((hugs))). I'm really hoping for shared experiences with local recurrence and associated treatments. I've just been diagnosed with a local recurrence in my chest wall 5yrs post mastectomy & radiation; this one is also grade 2, stage 2 IDC, ER & PR+ but unlike last time, indeterminate HER2 - still waiting on the path report on that. I've just had my CT results and no lymph involvement which I'm taking as great news and labs show my tumor marker #'s are nice & low which I'm also taking as extra confirmation that there is no spread. However, I've got an MRI scheduled this evening and a bone scan tomorrow - aren't these a little superfluous seeing as the CT scan has shown no lymph involvement? I feel so ignorant asking this question! And if anyone has any insight into how (un)likely chemo is for recurrence with no lymph involvement, I'd appreciate the input. I'm imagining at this stage, that there'll be surgery to remove the tumor followed by hormone therapy (prob tamoxifen as it's been mentioned by my onco on numerous occasions) but I admit I'm so shocked at having cancer twice by the time I'm 47 I want to really nuke this damn cancer and make sure that I'm getting all my bases covered! Thank you for reading and/or adding input :)

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Sep 17, 2020 10:24AM ctmbsikia wrote:

Sorry to hear. On first cancer you had no hormone therapy being hormone positive? Do you still have your ovaries? Honestly that's a little shocking if you have had no other therapy other than the radiation. By todays' standards that's only done for stage 0 - DCIS, not an invasive cancer.

Dx 12/14/2017, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Dx 1/16/2018, LCIS, Right Surgery 1/30/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 4/10/2018 Whole-breast: Breast Hormonal Therapy 6/25/2018 Arimidex (anastrozole)
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Sep 17, 2020 10:37AM GraceB1 wrote:

I had a local recurrence in Feb and had both the MRI and PET scan done. I think once you've had a recurrence you're more likely to have mets and they want to check that part off immediately. Unfortunately cancer can skip the lymph nodes and head out to other parts first. Good luck!

Grace B I'm just special - primary neuroendocrine, less than .001% of all breast cancers. Start each day with gratitude. Dx 6/10/2013, Right, 6cm+, Stage IIIA, Grade 2, 2/11 nodes, ER+/PR+, HER2+ (FISH) Chemotherapy 7/12/2013 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 1/8/2014 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Targeted Therapy 2/12/2014 Herceptin (trastuzumab) Radiation Therapy 3/4/2014 Breast, Lymph nodes Hormonal Therapy 5/18/2014 Arimidex (anastrozole) Dx 1/29/2020, Right, <1cm, Stage IA, ER+/PR-, HER2- Hormonal Therapy Femara (letrozole)
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Sep 17, 2020 10:45AM Secondtimeround wrote:

Thanks for taking the time to respond - and to confirm, no hormone therapy to date and I'm pre-menopausal. There were many factors which went into not receiving hormone therapy after my original diagnosis which is why I'm certain this time round it'll definitely be a factor. I'm really interested in gaining insight from others on whether or not chemo would also be a factor alongside the hormone therapy treatment.

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Sep 17, 2020 10:54AM Secondtimeround wrote:

Ah ok, got it! Thanks GraceB1 that makes sense as to why the need for further tests in that case!

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Sep 17, 2020 11:23AM ctmbsikia wrote:

2ndtime-I believe it is all going to depend on Her2 and lymph node status. Until those are known can't say chemo will be needed. It is still possible it will not be needed if your scans are negative, Her2 is negative, and nodes are negative. Then, yes, hormone therapy may be your preferred treatment. As well as possible ovarian suppression.


Best wishes to you

Dx 12/14/2017, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Dx 1/16/2018, LCIS, Right Surgery 1/30/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 4/10/2018 Whole-breast: Breast Hormonal Therapy 6/25/2018 Arimidex (anastrozole)
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Sep 17, 2020 11:51AM Secondtimeround wrote:

Thanks so much for the input ctmbsikia - much appreciated :)

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Sep 18, 2020 12:16AM Krose53 wrote:

CanI ask you how you were diagnosed the second time since you had a mastectomy and were not getting mammograms?

Dx 11/16/2017, ILC/IDC, Both breasts, 1cm, Stage IIA, Grade 2, 2/5 nodes, ER+/PR+, HER2- (FISH) Surgery 12/27/2017 Mastectomy: Left, Right Chemotherapy 1/22/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 4/1/2018
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Sep 18, 2020 08:29AM Secondtimeround wrote:

Morning Krose53, both times, in 2015 & this month, I was diagnosed following self examination and finding a suspicious growth.

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Sep 18, 2020 08:58PM MinusTwo wrote:

I had a lump appear under my collar bone exactly 2 years after my bilateral mastectomy. It was quite obvious. MO suggested MRI. I suggested ULS the same day - which gave me the diagnosis. It was called a local recurrence and likely a random microdot that escaped surgery, or colonized before surgery.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Sep 18, 2020 09:15PM buttonsmachine wrote:

Sorry you are in this situation, it's hard going through a recurrence. In my case I recurred while on Tamoxifen, so I was switched to ovarian suppression and an aromatase inhibitor. Now I've moved on to ovarian suppression and Faslodex. There are many options for hormone therapy.

Chemo depends so much on your individual cancer features. I did chemo the first and second time around, but different drugs.

I also did radiation to the local area a second time - this is not done as commonly, but there are some situations where this makes sense.

Anyway, that's what happened to me. It's tough but hopefully there is no sign of distant metastasis for you. Also, I'd ask your doctors if you can get a baseline PET scan before starting this next round of treatment.

Hope that helps. Best wishes to you.

Diagnosed at 32. Local recurrences in skin one year later due to needle seeding at initial biopsy. Now dealing with MBC. Dx 8/2016, IDC, Right, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2- Dx 10/2017, IDC, Right, Grade 3, 2/12 nodes, ER+/PR+, HER2- Dx 8/2020, IDC, Stage IV, metastasized to bone/other, Grade 3, ER+/PR+, HER2-
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Sep 19, 2020 09:26AM Secondtimeround wrote:

Thank you so much for sharing your experience with me buttonsmachine, I really appreciate the insight & advice. I hope you’re continuing to thrive and be well. X

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Sep 19, 2020 04:34PM beep7bop wrote:

Had PET on Wednesday got call on Thursday to be in office on Monday at 9:00 am should I be freaking out?? Because I am

Dx 3/11/2019, ILC/IDC, Both breasts, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right
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Sep 20, 2020 12:44PM Secondtimeround wrote:

Hi beep7bop, I hope your weekend is going ok despite the wait for you appointment tomorrow. I don’t know the answer to your question I’m afraid but I wanted to wish you all the best for your appointment. I know the waiting can be excruciating & I wish there was something I could say to make it less painful but let us know how you get on

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Sep 20, 2020 03:24PM buttonsmachine wrote:

beep7bop, Don't freak out yet - I have had many things light on on PET scans that turned out not to be cancer. Sometimes, especially when we have had prior surgery or radiation, things light up. Sometimes things even light up elsewhere due to an injury or something. Anyway, just be reassured that it's not always cancer.

But it's always scary for those of us who have had a local recurrence, because we know the other shoe might drop one day. I deal with it by saving the worrying for when something actually happens, otherwise I just figure it's fine and my doctors will let me know when it's not. Maybe not the best strategy out there, but it works for me. I hope you get good news tomorrow.

Diagnosed at 32. Local recurrences in skin one year later due to needle seeding at initial biopsy. Now dealing with MBC. Dx 8/2016, IDC, Right, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2- Dx 10/2017, IDC, Right, Grade 3, 2/12 nodes, ER+/PR+, HER2- Dx 8/2020, IDC, Stage IV, metastasized to bone/other, Grade 3, ER+/PR+, HER2-
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Sep 23, 2020 08:31AM TETM28 wrote:

Hi, I wanted to share with you my experience in case it is helpful! I was diagnosed last year with stage 1B IDC and underwent a bilateral mastectomy. My lymph nodes were negative. My oncotype was 9, so I didn’t require radiation or chemotherapy. This August I noticed a red bump on my skin the same cancer side, by my implant. It turned out to be breast cancer and the only explanation is tumor cell seeding from the original biopsy which were outside of my margins from my mastectomy. I’m still lymph node negative. My doctors would have performed a wide local excision and followed by radiation as my only treatment, followed by tamoxifen or AI and ovarian suppression, but I had to begin chemotherapy because I am 15 weeks pregnant.

Dx 7/31/2019, DCIS/IDC, Right, 4cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH)
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Sep 23, 2020 07:36PM Secondtimeround wrote:

Thank you so much TETM28 for sharing your story and if I may extend all the very best wishes for your treatment going forwards. I hope you tolerate it well and have plenty of support on hand. Take care x

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery
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Oct 9, 2020 02:02PM - edited Oct 9, 2020 02:03PM by SuperJ13

SecondTimer, what did your local recurrence look like? I'm also dealing with a bump under the mastectomy skin. Thank you

Dx 6/2016, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Oct 9, 2020 02:14PM Secondtimeround wrote:

Hi superj13, there was no visible changes to my skin; I just happened to sort of notice a very slight profile as I stretched my arms back in front of the mirror one morning. It was a barely perceptible bump but enough to catch my eye. So, no obvious visible skin changes but when I palpated with my fingers, it felt exactly the same as my first one back in 2015. Moveable, firm spongy lump with a much more solid ‘center’. I’m sorry I can’t be more specific but I do hope you get yours checked out, of for no other reason than peace of mind Good luck :)

Dx 4/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/9 nodes, ER+/PR+, HER2- (IHC) Dx 8/28/2020, IDC, Left, 2cm, Stage IIA, Grade 2, ER+/PR+, HER2- Surgery Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement Radiation Therapy Whole-breast: Breast, Chest wall Hormonal Therapy Surgery

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