Can it be that fast?

Hi everyone

I’m not sure if anyone can answer this but I thought I would try anyway.

My mum has been dx with secondary breast cancer with liver mets. She had a mamogram in April 2011 which was clear. She discovered a lump at the beginning of November which she saw her GP about straight away. They began tests and it was clear that it was already in her lymph nodes and after further testing, it was revealed that it had spread to her liver. She is having chemo and herceptin treatment at the moment.

At the start, everyone kept reassuring us that it had been caught early due to the clear mamogram six months before. We now know that this was not the case so I’m wondering if cancer can get to that stage so quickly. To go from clear to advanced in six months seems very quick. Has anyone heard of it progressing this qucikly? The other option is that something was missed on her mamgram. Would anyone know if we can find this out in some way?

Thanks for any info or advice you could give!

Thanks
Adele

Hi there,
so very sorry to read of your Mum’s diagnosis which must have been a terrible shock, epseically as it seemed everyhting was fine just months earlier.

I’m not medically qualified, just a woman affected by breast cancer who has read up stuff. Sadly, it is possible that a mammogram would show as clear only a few months before a diagnosis of cancer, primary or secondary. I think lumps need to be about 5mm to be clearly identifiable on a mammogram, and even at that, some kinds of breast cancer don’t always show up. The cancer could have been there and just a bit too small to see/feel. Certainly as I understand it, it would not have appeared from nowhere in less than a year

Sadly, it is possible to have a very small lump and for the cancer to have already spread to the lymph nodes or beyond, but this won’t all have happened suddenly since April last year. Even the most aggressive cancers take a long time to grow to a size where they can be detected… from one microsocpic cell to a lump that can be felt or seen. Sometimes this can literally take decades. How cancer spreads is a bit of a mystery to me, but it can be via lymph or vascular I think. All it needs is one or two rogue cells to escape (which no-one would be able to see) and then what is called metastasis can occur.

It is possible that a lump was missed on the mammogram, but as to whether the delay in finding her cancer made any difference, it not possible for me to say. The important thing now is to get the best possible treatment for your Mum, and her doctors will be doing that.

There are lots of ladies on here, of all ages, with secondary breast cancer, some of whom have been treated successfully for many, many years and live good lives. I am sure they will be along soon to help you.

I wonder if you would find it helpful to call the helpline (number at the top of the screen) to talk to someone? The main BCC website also has lots of useful leaflets that might help.

Take care and hope your Mum’s treatment is successful

Hi Adele.

Firstly so sorry that you and your Mum find yourself in this space.

I had a mammogram just over a year before finding a lump, which turned out to be two reasonably small tumours with node involvement but no evidence of further spread.

I was told by the BCN that the previous mammogram will be on file and you can request for it to be re examined. I am to meet with one of the radiologists to discuss, arranged by the BCN. I am not sure that I am not opening a can of worms in a way but would like to put the thought that something was missed to rest.

Hoping that your Mum is not finding the chemo too hard and wishing you all the best xxx

Hi Adele

Sorry to hear about your mum’s diagnosis and hope that she is getting on OK with chemo.

I also have secondary breast cancer. I had a routine screening last June and they saw a suspicious area on my scan, however it was tiny and I had no lump that I was able to feel. I was told it had probably been caught in time and was booked for a MX, however a CT scan showed widespread progression to liver lung and bones. I was very healthy and had no symptoms.

A few rogue cells can be all it takes, so tiny they would not show up on mammogram and as to whether it can happen quickly, it may be that these cells have been circulating for some time before developing a blood supply and beginning to grow - you just never know.

Unfortunately, BC seems to have a mind of it’s own but on the positive side, there are lots of women doing well with secondaries.

Laurie x

HiAdele, I had a clear mammagram just a month before I was diagnosed (as I felt a hardening behind my nipple) my tumour was in fact 9cm and I did have lymph node involvement.

I asked the question about why my mammogram was clear when I obviously had a large tumour at that time - I too met with the senior radiologist to discuss this and she showed me the xray pictures of both my mammograms (I had one 3 years prior which again was clear). In fact whilst mammogram screening is fantastic in that it does detect abnormaliites in the breast - it is only 90% accurate ie 10% of ladies who have abnormalities will have a ‘clear’ result - this is due to different types of cancers and as was my case 'dense breasts. That is why they only routinely do mammorgrams on ladies over 50 as prior to that it is felt that breasts can be dense and they will not pick up anything. I unfortunately am over 50 and have dense breasts so it was not picked up that way.

I was told that self checking for changes and lumpyness and general shape appereance or ‘weight’ is as important as a mammogram and I do this vigently on my ‘good’ breast.

My consutlant also told me that (although all cancers are different) they will grow about 2cm a year - so in fact my cancer would have been there for over 4 years (obviously this is an average and some cancers are slower/faster growing than others)

It is worth asking your consultant and meeting with your radologist to see if it was overlooked or in fact there is another reason. The medics do actually welcome this as it helps with their learning and development too - and gives them a different perspective.

I am not clear on how quickly secondries can occur - Myself I have had clear scans for secondaries but I know from info from this site we are all different and some ladies without any node involvement get secondaries and others (like me) with huge tumours and lots of involvment don’t - its the mystery of cancer and why this disease is such a sh*tty disease and they can creep up on you at any time…

Hi Adele, I have been screened annually for over 20 years. I had a routine mammo and ultrasound in April 2010 and only a cyst showed up which I declined to have aspirated (they were a fairly regular occurrence). In August 2010 the ‘cyst’ was getting bigger and slightly painful so I thought I’d ask to get it aspirated. I was speechless to find that within that short time scale not only did i have a growing lump in my breast but I also had a palpable lump in my armpit. Both lumps were biopsied and turned out to be grade 3 triple negative metaplastic breast cancer. The surgeon and radiologist went back over my previous scans but have advised there was nothing there that led them to believe I had a tumour. I have since discovered that metaplastic tumours can look like cysts on mammogram/ultrasound. I now have MRI as well as mammograms as my breasts are still very dense. A recent mammogram was clear whilst the follow up MRI showed something ‘odd’. Thankfully on biopsy this turned out to be another cyst. It’s unbelievable how fast some of these things grow unfortunately.

Hi Adele

I am sorry to hear about your mums diagnosis and can only imagine how distressing it is to have progression diagnosed so early. As someone else has already said there appears to be such disparity between us all, with bc being quite different in its cause and it being treated. I do hope that your mum does well with her treatment and that both you and her recieve all the support you need at this time.
Some of the comments have raised a question for me, and I certainly don’t want to take away from the situation you and your mum are experiencing. However, is it possible to have clear lymph nodes and yet have mets? I had no lymph node involvement and therefore did not have any MRI or other scans. The old paranoia is back again, having just completed Herceptin and all other treatments (surgery, chemo and rads) last year. Any advice would be appreciated. Take care all. J.

Hi Adele

Sorry that you’ve had to join us here but hope that your mum is coping with her treatment.

I found a lump in my breast only 8 months after having a mammogram which was clear. I had a WLE with no lymph node involvement but because it was graded as aggressive I had to have chemo, rads and herceptin. Because the lump was discovered early my prognosis was good but 3 months after finishing herceptin I experienced pain in my left hip and had to have a bone and ct scan and secondaries were found. I had assumed, wrongly, that because my lymph nodes were clear that I wouldn’t have secondaries. I sometimes wonder if my secondaries were there earlier but treatment had kept the pain under control and I never had any scans. I am currently on chemo, herceptin and pamidronate for my secs ( bones and liver) .

It seems as though everyone’s cancer is different and we just have to cope with the hand that life deals us even though it seems really unfair sometimes. I have found it hard myself to deal with the knowledge of secs so for your mum to have it thrust upon her so quickly must be devastating for her and she will need time to deal with that. I have found much comfort from the forums especially the secondaries as there are so many inspiring women on here that give you so much hope and that’s something that we all need.

Hi I just wanted to say i had mx and snb was told my lymphs were clear only a yr after I was dx with secs like u I was under the imp that it wldnt have spread and maybe was there all along but to small to see its very hard to cope with sec but we do somehow tc all Laura

@jaynek sadly, cancer can spread without showing up in lymph nodes. Blood stream is the other main system for transport, and after blood goes back to the heart it goes out to lungs, back in, back out to anywhere, so secondaries bloodborne can be anywhere there is a blood supply.

That is also why they don’t ever want our blood in future, after a cancer diagnosis, just in case it has little micromets in it that filtering etc wouldn’t remove and they could be transmitted to the recipient. I don’t know if this ever did actually happen or is just a theoretical possibility. Corneas apparantly are safe and we can still donate those because they have a clever non-blood system for nutrition of the lens, otherwise it would be full of blood and not see-through…

But no, you can progress even with clear lymph nodes. I think it would be a very good idea if everyone got a full-body CT (or whatever?!) scan as part of planning - I went into surgery for my mastectomy knowing that my pelvis/abdo/chest was clear - to that resolution at least - but only because I asked, it’s not standard where I live. :frowning:

@Adele and your mum, all the best.

Hi adelelouise13

I am sorry to read of your Mums diagnosis. As revcat mentioned in her post it might help for you to give the BCC helpline a call on 0808 800 6000. Here you can talk through any questions you may have with a trained member of staff who will offer you a ‘listening ear’ as well as emotional support and practical information. The lines are open Monday to Friday 9 to 5pm and Saturday 9 to 2pm.

Best wishes Sam, BCC Facilitator

Hi there,
Ufortunatley, without showing any obvious symptoms the cancer can grow very silently for years, it seems.
I only found out from a gallstone scan, last year. By that time I had 2 tumours one of 7cm and the other of three.
The only symptoms I had really were to do with my bones, I had developed a ‘bad backk’ and was having physio for it as they suspected a torn tendon. It wasn’t straight forward and all the problems I had were confusing the physio.
Before that I was working as a gardener, fighting fit, humping bags of compost and digging away for about 20-25 hrs a week.
I hope they have caught everything early, I know a diagnosis like this is never good but many women on here have a good quality of life and enjoy it to the full, which is what I dearly hope for your mother.
Keep her strong and urself too, its so hard to watch a loved one go through all the treatment, its almost easier to do it.
Clare xxx

I had primary breast cancer in 2000. I had a 1cm ductal cancer with no spread to lymph glands. When I had my first mastectomy they found a 9mm lobular cancer in my breast that had not shown up on any scans or mammagram.
10 years later in 2010 I had a diagnosis of secondary breast cancer in my bones. This is from the lobular cancer that was not detected on a mammagram.
Now in 2012 it has spread to my lung from this original undetected lobular cancer.
It is beginning to dawn on me that cancer behaves in an unpredictable way and that the Doctors( however hard they try) have not yet get a full grasp of this very unfair disease.