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All TopicsForum: Second or Third Breast Cancer → Topic: Cancer in post mastectomy, reconstructed breast?

Topic: Cancer in post mastectomy, reconstructed breast?

Forum: Second or Third Breast Cancer — For those confronting a new primary diagnosis or undergoing treatment.

Posted on: Apr 22, 2008 07:30PM

tiinajk wrote:

Has anyone had or heard of anyone getting a new cancer in a reconstructed breast? 

On my "good" side I had a prophylactic, skinsparing mastectomy with LD flap reconstruction.  There was no sign of disease in the tissue removed.  Now I have a small spot (2mm) in that breast that while it looks benign in images, the surgeon wants to biopsy but its not visible under ultrasound.  I now have to wait 6 months.

Has anyone else been in a similar position?

5/6/2003, IDC, 2cm, Stage II, Grade 3, 0/1 nodes, ER-/PR-, HER2- BRCA1+ Dx 5/6/2003, IDC, 2cm, Stage II, Grade 3, 0/1 nodes, ER-/PR-, HER2- Surgery 6/16/2003 Lymph node removal: Right, Sentinel; Mastectomy: Right; Reconstruction (right): Latissimus dorsi flap Chemotherapy 8/14/2003 CEF Dx 10/15/2003, IDC Chemotherapy 2/19/2004 CEF Surgery 8/20/2004 Prophylactic mastectomy: Left; Reconstruction (left): Latissimus dorsi flap; Reconstruction (right): Latissimus dorsi flap Surgery 10/31/2005 Reconstruction (right) Surgery 7/9/2008 Reconstruction (right) Surgery 3/29/2016 Reconstruction (left)
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Apr 23, 2008 02:07PM Marilyn543 wrote:

This Post has been removed by the Community.
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Apr 23, 2008 03:32PM Nichola wrote:

Hi Tinajak

I had a recurrence (satellite nodules) in the skin of my reconstructed breast.  (I had a skin sparing mascectomy with LD recon).  I was grade 1, stage 1 and my onco surgeon said it was very rare.  Did you have a skin sparing masc?

I have never heard of a new primary in a reconstruction and I cannot understand for the life of me why they have to wait 6 months?  Can you not get a second opinion?

Sending you my prayers and hugs...

Original DX Stage 1, Grade 1 multifocal IDC 2004. Multiple nodule recurrence in skin of reconstruction, Nov 2007 and reconstruction removed. DIEP/tram replacement reconstruction Dec 2008. May 2010 DX chest wall recurrence. Dx 11/27/2007, 1cm, 0/10 nodes, ER+/PR+, HER2-
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Apr 23, 2008 04:21PM Beesie wrote:

I do recall that there was someone on this board about a year who had a recurrence in their reconstruction breast - she'd had a TRAM, I believe, and the recurrence was found with an MRI.  That's the only situation that I can recall.

BTW, please DO NOT CLICK ON THE LINK IN THE POST FROM MARILYN543.  THIS IS SPAM.   Please instead click on "Report this Comment" and hopefully soon that post will be deleted. 

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage IA, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Apr 23, 2008 04:47PM tiinajk wrote:

Thanks for the replys. 

Nichola, yes I has skin-sparing mast with immediate LD flap reconstruction but not nipple-sparing. I realise that this means there is still a minimal amount of breast tissue left under the skin but can I be so unlucky as to get it again.  Next month will be 5 years from my diagnosis with no sign of disease till now. 

The small lump was found by a breast MRI but you need to be able to see it with ultrasound to be able to take a biopsy.  They tried to find it and even though they knew where to look, the lump was too small to see under ultrasound.

At this stage, they don't think it's anything, (something about not reacting to the contrast during MRI) so the six months is to see if there is any change.  Only problem is that it will cost me another $400 to get a new MRI then as it is not covered. Oh well... as a school teacher I have sooooo much expendable income. <smile>

T

5/6/2003, IDC, 2cm, Stage II, Grade 3, 0/1 nodes, ER-/PR-, HER2- BRCA1+ Dx 5/6/2003, IDC, 2cm, Stage II, Grade 3, 0/1 nodes, ER-/PR-, HER2- Surgery 6/16/2003 Lymph node removal: Right, Sentinel; Mastectomy: Right; Reconstruction (right): Latissimus dorsi flap Chemotherapy 8/14/2003 CEF Dx 10/15/2003, IDC Chemotherapy 2/19/2004 CEF Surgery 8/20/2004 Prophylactic mastectomy: Left; Reconstruction (left): Latissimus dorsi flap; Reconstruction (right): Latissimus dorsi flap Surgery 10/31/2005 Reconstruction (right) Surgery 7/9/2008 Reconstruction (right) Surgery 3/29/2016 Reconstruction (left)
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Apr 25, 2008 06:02AM Nichola wrote:

I researched this subject big time...:  Iwould like to mention that recurrences in reconstructions usually appear in the original cancer site/ biopsy sit and /or scars.  (Mine were in all these places)

The fact they have noticed any abnormality so early has to be applauded and I'm sure won't require anything drastic!

Can I just vent...It makes me so mad that you lovely ladies even have to THINK about ANY costs.  Its SO wrong!!!

Original DX Stage 1, Grade 1 multifocal IDC 2004. Multiple nodule recurrence in skin of reconstruction, Nov 2007 and reconstruction removed. DIEP/tram replacement reconstruction Dec 2008. May 2010 DX chest wall recurrence. Dx 11/27/2007, 1cm, 0/10 nodes, ER+/PR+, HER2-
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Apr 25, 2008 11:03AM lastminuteD wrote:

tinajk - I had  a local recurrence in my reconstructed breast (silicone implant) 15 months from original diagnosis.  I was finishing up tattoo color touch up - felt a place that just didn't feel like the other scar tissue area - saw my surgeon two days later and he did a biopsy in his office - he felt it was scar tissue but for my peace of mind did the biopsy - unfortunately it was IDC again - had a re-excision to remove it. 

backup a bit - had a mast for multi-focal DCIS, discovered .2cm IDC, had axillary node dissection 0/5 nodes, put on tamoxifen - no chemo or rads recommended because IDC so small and negative nodes.  Recurrence was 3.5cm - received a/c & t/h (till 8/1!! - almost done!) and radiation.

My suggestion would be to call your surgeon and discuss if a breast mri or other test might show it better and a biopsy again instead of waiting which sounds too stressful to me.  if he declines - a second opinion just to ease your mind that you are doing everything you can.

Dawn

THINK HAPPY!!! Dx 12/27/2005, IDC, Right, <1cm, Stage IA, Grade 3, 0/5 nodes, ER+/PR+, HER2+ (FISH) Dx 3/27/2007, IDC, Right, 3cm, Stage IIA, Grade 3, ER-/PR-, HER2+ (FISH)
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Apr 27, 2008 05:36AM tiinajk wrote:

Already had a breast MRI, that's what found this lump.  The problem is that you can't biopsy under MRI and it's too small to find under ultrasound to get a biopsy that way.  This new lump is in the "good" breast that has never had any sign of disease but was taken off preventatively so if it is cancer, it would be a new primary.

I'm already at my second opinion in a way as I was originally going through public health getting nowhere so have now been seeing a private specialist and she is known as the best available. 

So pretty much out of options for the time being....  I just hate haveing to wait... 

5/6/2003, IDC, 2cm, Stage II, Grade 3, 0/1 nodes, ER-/PR-, HER2- BRCA1+ Dx 5/6/2003, IDC, 2cm, Stage II, Grade 3, 0/1 nodes, ER-/PR-, HER2- Surgery 6/16/2003 Lymph node removal: Right, Sentinel; Mastectomy: Right; Reconstruction (right): Latissimus dorsi flap Chemotherapy 8/14/2003 CEF Dx 10/15/2003, IDC Chemotherapy 2/19/2004 CEF Surgery 8/20/2004 Prophylactic mastectomy: Left; Reconstruction (left): Latissimus dorsi flap; Reconstruction (right): Latissimus dorsi flap Surgery 10/31/2005 Reconstruction (right) Surgery 7/9/2008 Reconstruction (right) Surgery 3/29/2016 Reconstruction (left)
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Apr 30, 2008 01:08PM hopefor30 wrote:

Why can't they biopsy via MRI?   I just had an MRI guided biopsy about 6 months ago --  was no different than the stereotactic one I had -- they just used MRI to locate abnormality rather than mammogram --

M.

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May 1, 2008 11:56AM azsunshop wrote:

My bc came back in 2006 at the original site.  I decided to take them both off and had recon. surgery at the same time.  It took a year to have the full recon. surger with the saline implants.  THis Feb. I noticed small rash like bumps under both breasts.  Guess what it turned out to be! ?  Unbelivable!  A third time!  Just finished radiation and am on Arimidex.  I did not think it could come back if there were no breasts, but it is bc!

azsunshop

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May 22, 2008 04:01PM Sociologist wrote:

Hi Ladies,

I'm going through the same thing. I had a skin sparring mast in July 2007 and the implant put in Dec 18th 0f '07. Just went for my 1 yr. check up and the dr. found a lump on the mast side (I was going for the exam and to ask him to remove the implant...I hate it because it hurts all the time!). Went for the ultrasound today and now need a biopsy. This is crazy!!!  But...I've lived through this once I can do it again. Hoping for the best but planning for the alternative.

Margaret

Dx 6/14/2007, DCIS, Stage 0, Grade 2, ER+/PR+, mastectomy 07/12/07; silicone implant 12/18/07; implant removal 06/22/09; lumpectomy on mx side 06/21/10, PAP flap 05/2012
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May 22, 2008 07:23PM AnnNYC wrote:

Margaret!!!

I was just wondering where you've been!!!  Just three days ago I was looking you up to see when your last post was!

I'm sorry you're going through this worry -- my fingers are crossed for biopsy to prove benign,

Best,

Ann

Dx 3/9/2007, IDC, <1cm, Stage I, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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May 22, 2008 07:23PM - edited May 22, 2008 07:24PM by AnnNYC

Oops == double post, sorry...

------------------------------------------------------------------------------
Dx 3/9/2007, IDC, <1cm, Stage I, Grade 2, 0/5 nodes, ER+/PR+, HER2-

Dx 3/9/2007, IDC, <1cm, Stage I, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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May 30, 2008 06:58AM ali_lpn wrote:

My recurrence is in the reconstructed side...it isn't a new primary though.  I had skin sparring TRAM flap with silicone implant.  I noticed a few small lumps and within a month the implant was rock hard and had NUMEROUS lumps and an ulcer.  I honestly thought my implant had burst (deep down maybe I knew).  When I finally got in to see my plastic surgeon and she saw my breast, the look on her face was priceless.  At that moment, I knew I was in trouble.  I was back in chemo in less than a month.  I have mets in both femurs, spine up to T10, sacrum, groin, left axilla (lymph involvement on the opposite side from the first), and both hips...I think that is it :)  I am so sorry you have to wait 6 months tiinajk.  I cannot imagine how stressful that is and how long 6 months must feel.  It sounds like you have a doc who is the best so hopefully she is doing the right thing for you.  Maybe you could go back and see her and she could help ease your mind a little by giving you some more information.  You are in my thoughts.

Ali

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Jun 10, 2008 05:23AM Sociologist wrote:

Good Morning Ladies,

My lump is benign! I'm extremely relieved. The docs said it was just scar tissue from the mast. Just wanted to let you know.

Margaret

Dx 6/14/2007, DCIS, Stage 0, Grade 2, ER+/PR+, mastectomy 07/12/07; silicone implant 12/18/07; implant removal 06/22/09; lumpectomy on mx side 06/21/10, PAP flap 05/2012
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Jun 10, 2008 08:41AM TenderIsOurMight wrote:


This is great news, Socialogist. Thank you so much for letting us share in your relief.

Tender

It cannot be emphasized too strongly that treatment of each patient is a highly individualized matter. (FDA-approved labeling for warfarin (Coumadin) NDA 9-218/5-105)
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Jun 12, 2008 07:38AM ozzie2 wrote:

I have had a local recurrence in my recon structed breast which was made with breast tissue from my other breast , this has shocked all..

it also has come back in the same place as the original BC but then they found it has spread to many bones now and  nodes..

so yes it does come back in the rec breast it can also change hormone status..mine didnt lucky me..!

and most times if Bc is to come back it comes back in the scar area.. mine is also there..

good luck and I hope the results are B9

hugs

oz

DCIS and IDC 96. ER/PR + HER2- bone skin mets06 ,Lung mets May08
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Jun 14, 2008 06:47AM Peggins wrote:

Sociologist, so glad that your lump is benign! You commented that you wanted to have your implant removed because it hurt all the time. Have you considered that you might have truncal lymphedema? I have a silicone implant and also was in pain until I was referred to a lymphedema therapist who dx and treated me. My arm had never swollen so I thought I was fine, I never knew you could get it only in the trunk, and neither did my 4 doctors whom I complained to for a year!

Find a certified lymphedema therapist in your area and go for an opinion. If it is LE and you remove the implant you will still have LE and still be swollen and in pain.

The LE section of these boards has many knowledgeable sisters on it.

Peggy

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Sep 16, 2008 11:49AM SuzCA wrote:

I have what we 'think' is a local recurrance near the original inscision site of 3 1/2 years ago.  I had a double mast back then and implants. The left idc side implant failed repeatedly and I ended up getting a TRAM flap for that side.  After 5 different surgeries on that breast, the TRAM revealed a small amount of dcis and IDC. I am waiting for the tumor board to decide whether I should do further TX or if surgical removal with very wide margins was sufficient. 

DX 4/2005 Stage II?(vascualr invasion) IDC, DCIS, LCIS, weak ER+, PR-, HER2-, IDC, DCIS loc reocc, IDC 8/2008
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Oct 1, 2010 01:58PM Ondagrow wrote:

Has anyone had this experience recently...

‘FunNY hOW lIfE sHoWs uP WiTh nO nOTIficATion aNd I mUst aDjust’
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Oct 2, 2010 02:16AM ellenj wrote:

I am currently having biopsies of two lumps in my non cancer reconstructed breast--surgery is next Friday! The concensus is that they are fat necrosis and benign. Fingers crossed. I am pretty nervous & stressed.  Hope my beautiful recon does not get messed up! And really hope I do not have cancer! But I know that if I do, I kicked cancer's *ss once and I can do it again!

Good thing I have a busy job!!

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Oct 2, 2010 07:30AM lago wrote:

I haven't read through all the posts but we all have to remember that even though we have had a MX/BMX there is no surgeon that can get all the breast tissues. Some surgeons do a better job and than others but even the best can't get it all. This is why you still need to be checked even though you don't have your breasts.

Of course your chances are less because there is less tissue but it can happen.

DONE!! goo.gl/IoaN6U • Tattoos 2.7.2012 • Nipples 10.6.2011 • Exchange 6.24.2011 • Chemo 1.18. 2011 • BMX 8.31.2010 Dx 7/13/2010, IDC, 5cm, Stage IIB, Grade 3, 0/14 nodes, ER+/PR+, HER2+
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Oct 6, 2010 10:22PM bemmett wrote:

I am so happy to have found this thread. This site has been so amazing for me.  I was diagnosed July 19, 2010 with extensive DCIS with minimal microinvasion (left side only).  Because I'm 'young' (34), I had a BMX on Aug 19 with immediate reconstuction (silicon implants). No chemo or radiation was required/recommended.  One month post-op I found a small lump - but on the non-cancer side (no where near the scar)!  I've had 2 mamos which were silly - they couldn't see anything but the implant.  Also, 2 ultrasounds.  The first the dr said "it's so small, don't worry about it.  Come back in 6 months."  I saw another dr who suggested it's suspicious and I'm now having a biopsy done tomorrow.  I never had a MRI originally and looking back wonder why.... 

 I'm trying to think positive.  I realize it would be super odd for a new cancer to show up but it does happen, right?  What else could it be? It feels like a tiny little round pea (exactly like what my cancer felt like). 

 So sorry for others who are going through this as well.

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Oct 9, 2010 01:43PM slmdavidson wrote:

sohardbnme - there are more of us than one would expect.  I've been through it.  Had a small lump show up near my mastectomy scar 16 months after my surgery.  My surgeon was confident it was a fat necrosis as are most of those, but it was not.  Luckily it was small.  Lago - you are exactly right.  They cannot get every breast cell removed when they do these surgeries.  My cancer was multifocal so was in more than one place which probably put me at a great chance of recurrence.  You do have to continue to do self exams!!!!!  Can't say that enough.  If you find something get it checked out. 

Bemmett - I am thinking that it would be really unsual for you to develop a cancer that quickly since it wasn't found in that breast to start with.  Hoping and praying it is just scar tissue or a fat necrosis.  Can you keep us updated?  (((Hugs)))

Laura

Dx 9/18/2007, IDC, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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Oct 9, 2010 02:20PM slmdavidson wrote:

Tagging this thread....

Dx 9/18/2007, IDC, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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Oct 12, 2010 03:39PM bemmett wrote:

Thanks!  I'll give a short update.  I saw the surgeon (for the biopsy) but she said it was a clogged vein and no biopsy was required.  Then, I got the report from the radiologist which said it "had no vascular abnormalities" (so it wasn't a clogged vein).  The radiologist got on the phone with the surgeon and now I'm scheduled to see the radiologist again.  The radiologist report rated the lump with a Bi-Rad score of 4b.  So... the wait continues.  I'm anxious and assume it's nothing but none of the doctors are being very helpful yet.  

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Oct 21, 2010 07:53AM beckward wrote:

Bemmet,  I remember your situation from the "recurrence after BMX" forum, but wanted to add to what I posted there.  I had the US guided needle biopsy that showed "granular tissue" and blood. (same pathology as a scab!)   My onc. insisted on the biopsy because the lump was in same spot as original cancer and felt the same.  Basically it was an irritation (from implant?) that bled and is healing now.  

I do have a swelling where the needle tracked under the skin to get to the lump.  I'm thinking that any bleeding that happens near the implant has nowhere to go, so just stays in a pocket and causes a lump or swelling.  I'm betting that this swelling doesn't go away soon.  Just wanted you to have this info.    Beth 

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Oct 22, 2010 09:47AM - edited Aug 20, 2013 04:59AM by CHRISTY2

. I am in a similar situation. I had a BMX with immediate TRAM 1 year ago for High-grade DCIS with comedonecrosis. The pathology report did not show any microinvasion. About 2-3 months ago I noticed a small lump (about pencil eraser size)under the skin on my right reconstructed breast (my original cancer was on the left) I kind of did not even worry about it at first because I just figured it was probably a small area of fat necrosis but then i started doing research and have read that IDC can sometimes be mistaken for High grade DCIS with comedo necrosis and it is not uncommon for micrometastasis to be overlooked. I am not sure wether or not it can go from one breast to another though. Does anybody know if fat necrosis occurs 10 months out from surgery? Or is this something I should even worry about at all. I have a PET scan scheduled for Nov.1st. UGGGHHHHH I feel like I am going crazy!

CHRISTY Dx 10/25/2009, DCIS, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Oct 22, 2010 12:49PM slmdavidson wrote:

Hi Christy,

I had a recurrence of invasive ductal carcinoma 16 months after a BMX due to DCIS.  However my recurrence was on the cancer side.  My breast surgeon was CONVINCED that this new tiny (pea size) lump was fatty necrosis.  He was shocked to find out it was cancer.  He's done surgery on thousands of women, and I'm on his second patient where a cancer returned that quickly.  My assumption is that it only takes a few cells left behind to cause more trouble.  If you had nothing going on the left side, I would say that it's incredibly unlikely that it's cancer.  The rate at which cancer grows would also lead me to think that.  Mine was very unlikely to be a new cancer.  I can't remember the details, but it's like years, before a cancer develops into a lump from just a few cells (ones that you may not see on a mammogram/mri).  I know Nov 1 seems like a lifetime away, but the PET scan would probably give them a good answer.  Otherwise, your other option is to have a needle or excisional biopsy but doubt that you'd get results much faster.  Is the lump really hard like gravel or is is more soft and pliable? 

Take care and keep us updated.... prayers for no cancer!!!!

Laura

Dx 9/18/2007, IDC, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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Oct 22, 2010 01:09PM CHRISTY2 wrote:

Hi laura,

Thanks for your response ! My lump is small and hard and in the oposite breast that my original cancer was in. The path report did not show anything in the breast tissue but then again i worry because it was read by a general pathologist. I am actually thinking about having my blocks and slides sent to M.D. Anderson for a second opinion from a pathologist who specializes in breast cancer. It probably isn't anything but I can't help but to worry.

CHRISTY Dx 10/25/2009, DCIS, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Oct 22, 2010 01:48PM - edited Aug 20, 2013 04:59AM by Kadyann

I had a masectomy with LD reconstruction in January of 2004.  Original diagnosis was DCIS w/ microinvasion of 1.9 mm (T1A) grade 3, er/pr-.  At the time I was told that the idc was too small to test for Her2.  In July I felt a lump about the size of a grain of rice.  It was not by the masectomy scar but was in the same quadrant of original biopsy.  My surgeon was sure that it was fat necrosis, but it did light up on an MRI so I had a biopsy.  It was IDC but was grade 1, er+ and Her2+.  Had pet scan and other staging tests and so far everything looks good.  The margins were clean the first time but went back in to be extra sure.  Original doctor thinks it is new primary.  Went to Mayo clinic for second opinion and they are not so sure.  Oncologist that I saw says that original 1.9mm of idc was too small to grade and may have been grade one even though dcis was 3 with comedo necrosis.  However, he says there is no way to know for sure.  I started TCH regimine October 5th and will be on herceptin for the rest of the year.  So even 6 1/2 years out I was not out of the woods.  It is very discouraging!

Lorie

Dx 8/27/2010, IDC, <1cm, Stage I, Grade 1, ER+/PR-, HER2+

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