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Forum Name: Breast Cancer

Question: Treatment possibilities after 3rd tumor in same breast?


 tekkie50 - Thu Apr 23, 2009 9:52 pm

Hi, I am a 57 year old white female, postmenopausal. I had my annual mammogram in December of last year. They found calcifications and probable tumors. I had a core needle biopsy which revealed LCIS and ILC adjacent to each other. Tumor size 7 mm. I had a lumpectomy and sentinel node biopsy. Good margins and node was negative. As part of a work up for brachytherapy I had another mammogram, and the calcifications had changed some. Another lumpectomy, DCIS, different breast quadrant. I have not yet met with my oncologist to discuss treatment, but am looking for input so by the time we discuss this I will have had time to consider options. I would like to avoid mastectomy if at all possible. Thanks for your input!

Tekkie50
 tekkie50 - Fri May 29, 2009 9:41 pm

Things have gotten rather scary. I had a consult with radiation oncology to do whole breast radiation (25) plus boosts (8), and have an appointment to go do the simulation next Tuesday. However, I have now found warm swollen red areas on both breasts. The area on the breast with the tumors is larger than the area on the other. The area is nowhere near the incisions. The one on the other breast showed up the following day. I am very concerned that it might be IBC. In the meantime I am on antibiotics and have a appointment scheduled for Wednesday. Any input would be very helpful.

Thanks,

Tekkie50
 Dr. Tamer Fouad - Tue Jun 02, 2009 10:11 am

User avatar Hello,

I apologize regarding the delayed reply. What I understood from your message is that we are dealing with DCIS that was removed by lumpectomy and is to be followed by radiation therapy. What were the pathology details for the latest lumpectomy in terms of grade, surgical margin etc.

Your concern regarding the inflammatory breast cancer cannot be resolved over the internet unfortunately. You must be examined. Whether you are at increased risk of inflammatory breast cancer because of your previous diagnoses is unlikely. Inflammatory breast cancer is a very aggressive form of breast cancer. It usually presents unilaterally and not bilaterally. Again, nothing can be excluded though.

Please keep us updated.
 tekkie50 - Tue Jun 09, 2009 5:17 pm

Hi,

I thought that I had replied the other day, but clearly I did something wrong. My apologies!

In January I had a lumpectomy that removed both ILC, and LCIS, right next to each other. The ILC was .7 cm, T1N0, huge margins, ER/PR +, Her2 -. I wanted to do brachytherapy and there was quite a delay in getting started. When they did a mammogram as part of the workup they found DCIS. It was about .1 cm, but one of the margins was not OK, so they did a re/wide excision and the margins are now acceptable. Tis. This tumor was about 6 cm from the first and below the areola. I guess this makes these tumors multi-centric. I don't know what this does to my likelihood of recurrence, and what is the best treatment to keep that number low without opting for treatment that has significant complications.

At the same time I am having this other issue with a reddish splotchy area on my right breast, and a nipple that is flat to slightly inverted. On my left breast I have a small pink swollen area at the bottom of the areola and below. I have seen both my GP and an oncologist and have been on two antibiotics (I'm 5 days into the second antibiotic and there is no change). All I am certain of is that this is abnormal for me and I am very concerned.

In the meantime, I have started radiation and have had 4 whole breast treatments (180 centigrays/day) of 25, to be followed by 8 boosts (200 centigrays/day).

Anything you can suggest for me to follow up with would be helpful!

Thanks for your input,

Tekkie50
 Dr.M.Aroon kamath - Tue Oct 06, 2009 6:57 am

User avatar Hi tekkie50,
With a series of breast biopsies and lumpectomies, the breast architecture becomes so distorted that it is likely to become increasingly difficult to interpret any of the imaging modalities.You need to keep this in mind in your future treatment choices and decisions (mastectomy vs no mastectomy).Good luck!

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