Local Advanced BC - Nodules in the skin - cutaneous metastasis - Skin Mets

Hello 

I am 51 years old and was diagnosed in May 2019 to have E+ BC grade 3, initially measured at 2cm from the ultrasound. They punch biopsied one lymph node and I was told the biopsy came back negative from cancer. I was told “early detection lumpectomy and radiotherapy only” 

The follow up to the lumpectomy revealed the tumour was actually 4.2cm and node came back positive for cancer after all. 

I opted to have chemo before a mastectomy and my last cycle was 5th Dec 2020. I had a Torso CT scan which revealed nothing sinister other than possible new tumours in the same breast which they took biopsies that came back as “none malignant” albeit the cells were not normal. My surgeon said she thought it was the extra margin they still needed to remove combined with post lumpectomy scar tissue which had moved the cancerous bits about. 

Chemo - E/C floored me each round I was in a dark room for 9 days and nights crying in discomfort from head to toe. Weak, sick, aching its hard to describe but it was beyond any “organic illness” such as flu. Dox ironically was a breeze in comparison and I was more or less OK at home albeit very tired. 

I then had a mastectomy with full auxiliary clearance and immediate reconstruction in early Feb 2020 with a extender.

Sadly the follow up revealed the tumour was 5cm and 5 lymph nodes had been infected (including the initial sentinel node) 3 with macro mets 2 with micro mets. 

I went on to have 15 rounds of radiation which ended in April 2020. But my implant failed. It was already red and swollen but no liquid could be found, no pus or infection and the two rounds of antibiotics had no effect. I managed to reach the end of radiation before the implant started to fall out and so two weeks after my last radiotherapy session I went down to get the implant removed.

I thought that was the end in terms of treatment and disappointments and ugly surprises but then I was told the skin they removed from the failed implant operation had cancer cells in it around the scar/wound to one side. 

And finally when I went to see the surgeon about these findings, I showed her some hard little red lumps in clusters to my sternum and underarm almost shoulder area which I noticed one or two about 5 weeks prior but assumed it was a result of radiation and/or surgery.

She told me she is worried and has seen this before in BC recurrences but not this fast. She has removed one for a biopsy and I have had a full body bone scan today with another torso CT scan I am awaiting for. 

I have an appointment in two weeks to get the results from both scans and the biopsy. 

What little research articles I can find on what I believe to be cutaneous metastasis tells me it usually means there is a distant tumour elsewhere and the prognosis is poor regardless. 

My surgeon was hugging me and saying how sorry she was and so I know she suspects the worst.

But I managed to get out of her that if there are no secondaries in my bones or organs etc the treatment is to remove reduce or “manage” the localised cancer. She added that she has a few ladies who have reoccurring cancer which tends to want to stay local. Thats my best case scenario but I am convinced (for the first time) I am dying now and probably sooner rather than later if the growth rate of my cancer and aggressiveness is anything to go by. 

I dont want to die a long slow painful death. It terrifies me. I hope they put me out of my misery with morphine rather than have me wasting away in agonising pain. 

I have never had these thoughts until very recently because I always had hope. I no longer have hope. 

I cannot find it in surgeons faces or in the voices of telephone support groups. No one has given me anything to cling to. I am broken. 

Hi Liz, I’m sorry that you have had a rough time with bad news coming thick and fast. Your oncologist has done everything correctly to make sure she knows the full picture. I just wanted to share my experience as I had a local recurrence under my arm 14 years after my primary. Scans showed no other mets and I was treated with the full works with the intent to cure. This was followed by a repeat performance 2 years later and again 2 years after that. It was then that I was told I had a lymph node met and was stage 4. That was 7 years ago and 11 years after the local skin recurrence.

I hope that my story will give you some comfort and positivity. All the best xx

Hi Liz, I was diagnosed with Cutaneous Metastatic Breast Cancer last November (Nov 2023) and found out about a clinical trial at Memorial Sloan Kettering Cancer Center in NYC that started this past February. I was able to get into the trial and it is truly a miracle. My nodules and lesions are healing! I’m hoping that this message reaches you because there are 6 spots left in the clinical trial so there is still space if you want to join. The trial involves a noninvasive drug that you take through an IV (the only side effect was that I was light sensitive for 3 weeks) and the next day they use an infrared laser to activate the drug. The laser then kills the tumors from the inside out. Several weeks after the treatment, scabs started forming on my skin began to heal. I met with my doctors at Memorial Sloan Kettering today and found out that they were still taking patients for the clinical trial. I want to get the word out to as many people as possible because this is truly a gamechanger. It is turning what is normally a dire prognosis into a miracle. Let me know if you would like more information. I’m happy to share all of it and to put you in touch with the clinical trial team.