Local or Regional recurrence - Help

Hi Ladies

Has anyone had a BC recurrence in the pectoral muscle??

My history is as follows;
Dx 2007 Invasive Lobular Cancer in right breast at age 45yrs. Tumour size 3,5cm
Grade 2
No lymph node involvement ( following sentinel lymph node bx)
No vascular invasion
Er Positive (moderate)
Her 2 Neg
Score 3.7 on Nottingham Prognostic Index (moderate risk of recurrence)

Had WLE but margins unclear. Tumour close to skin and also touching chest wall.
Had Skin and Nipple Sparing Mx with chest wall shaving. Clear margins on this occasion.
Had FEC - No Rads - Initially Tamoxifen but too many nasty side effects so now taking Arimidex.
Reconstruction with sub pectoral expander implants 2010 - No flap reconstruction as I’m too skinny and therefore not a suitable candidiate.

All going well until Aug last year when found a large swelling high in the neck on the left side (just below left ear and on the jawline)
All medics said swelling was a lymph node
Had USS - radiologist said lump was cystic and definately not a lymph node. Had FNA. Results clear but USS could not see where the lump was arising. Had MRI scan - all clear - said lump had disappeared!!

All well until early March when neck lump reappeared quite suddenly.
Had 2nd MRI which showed a cystic lesion with atypical features in the Parotid gland (Salivary gland).
Listed to have Left Parotidectomy on 6th May.

2 days later found small pea like lump in reconstructed right breast.
Had USS - Consultant Radiologist said reactive lymph node!
Breast Surgeon said - not a lymph node. Could be fat necrosis or fibroadenoma.
Listed to have excision biopsy on 6th May alongside Parotidectomy.

As you might well imagine, I am beside myself with worry. I really don’t know which lump to worry about first or indeed, worry about the most.

I have read reports of BC recurrence in the Parotid gland though this is very rare. Surgeon said good sign is that the Parotid lesion is in the opposite side to the BC. Of course this could be a new primary malignancy of the Parotid gland and may not be connected to BC at all.

My worry is that the breast lump is a recurrence of the original BC. It does not feel in any way connected with the implant nor is it in the skin as I can pinch a good amount of skin and cannot feel the lump. It feels quite prominent and I think it is in the pectoral muscle which overlies the implant. I must add the the lump is in a completely different area of the breast to where the original BC was found. The original BC was at the 9 oclock position. This new lump is at approx 6 o clock.

Has any one had recurrence in the pectoral muscle? Is this a local or regional recurrence? Does anyone know what treatment is offered?

Any comments - good or bad - greatly appreciated.

Love and Peace to all

I had a mastectomy in May 2009 followed by chemotherapy. Diagnosed invasive ductal cancer grade 3 and triple negative. Had local recurrence in November 2010 - a 6 mm lump just above the implant. Had this removed and started radiotherapy on 1st March. During treatment noticed another swelling on pectoral muscle - had 2 nodes removed on 7th April. These are apparently Rotter’s Nodes - same diagnosis. I’m awaiting CT scan and then further chemotherapy.
Cath

I had a recurrence (local or regional I was never told which) in the lymph nodes within the pectoral muscle in 2008, following initial dx in 2004, with mx, chemo, rads and tamoxifen. They said at the time that it was probably some “stray cells” left over from the original tumour - but my surgeon said he’d never seen it there before! They took out the pec muscle, and i had the whole caboodle of treatment again, chemo, rads plus herceptin as apparently my tumour had changed her2 status. Now on arimidex. I have never heard of Rotters nodes - interesting. Apparently it used to be standard years ago with mx to take out the pec muscle - but they don’t do it now with a normal mx.

Best wishes , Mo

Can’t help you with the pectoral muscle recurrance but just to let you know prior to BC I have had a lump removed from the Parotid gland twice and each time it was a benign growth. It first appeared when I was 20 and everyone thought it was a cyst so were very surprised when it wasn’t. It then reappeared 10 years later in the same place, again benign.
The only problem I had was after the 2nd surgery, I had some temporary facial paralysis, as the main facial nerve runs alongside the Parotid gland. However this resolved itself after a few weeks. The only permenant effect is when I eat, a small area on my cheek sweats! It has a medical name which I can’t think off, but it was to do with the nerves connecting wrongly after the surgery.
Hope this helps.
Good luck with your surgery.
cat

I am already at stage 4 ( I have a couple of bone mets) and I had surgery for what we thought was a local recurrence just under the skin last month but it turned out to have pectoral muscle involvement too, and so was not completely removed. I asked about further surgery but was told it was definitely not an option for me (and neither is radiotherapy as I had that when I had my mastectomy). I asked if the answer would have been the same if I wasn’t stage 4 and my onc said yes probably. So I’ve just had a change in systemic treatment (to another aromatase inhibitor) for now and we will review this in a couple of months. Not really happy but my onc seemed completely sure on this occasion that this was the way to go.

Dear Girls

Thanks so much for your replies. So sorry to hear that you are going through this for the 2nd time. I am still in the dark as to the nature of my lumps and bumps but at least the surgical stage is over. I had total parotidectomy along with excision of the breast lump on Friday 6th May. Am making a good recovery on the whole- apart from what looks like a collection or haematoma around the incision on my neck. Will be making a telephone call to the ENT cliic tomorrow for advice.

Cat 107 - good to hear you’re fully well from your parotid experiences. I have some damage to the lower branch of the facial nerve which means I cannot open my mouth fully and have developed something of a lisp! Am hoping this is something that will resolve in time - like yours. Not experienced the sweating yet - I belive this is called Freys syndrome but not absolutely vertain.

Get breast bx results on the 19th and have yet to hear when I will find out about the parotid lump. ill keep you posted.

To you BC ladies may all good things come your way
MG x

Hi just seen this thread although my experience is a bit different thought I would share anyway In 1996 was dx with stones? in my saliva gland (Parotid)had it removed that year then had further stone! in saliva gland underneath parotid this was removed in 2001. Both on right side. DX with bc in left breast in Jan this year had WLE and 4 nodes removed all clear grade 3 TN Am having chemo now BUT when I went to see onc he asked if I had had chemo before??? Replied no and he said my records showed they had seen me in 2001??? Now am thinking they may have sent sample to onc from the saliva gland they removed that year?May ask when I see him next week.

Cat I also have the sweating from next to my ear every time I eat very attractive isn’t it my maxo surgeon suggested putting vaseline over the area!!! Or did suggest botox but would only do the one side??

Good luck to everyone

Jill