I had a breast reduction on year ago and just found a lump

Last July I had a breast reduction with no complications (anchor incision).  I'm 38 with a paternal grandmother that was diagnosed with breast cancer in her 70s. No female in my immediate family with cancer. I DON'T have cystic breasts. Recently I found a lump which was difficult to find because it was under alot of other breast tissue. It is in the lower, middle section of my breast, but about 1 inch above the bottom incision line.  My OB felt it and said it was approx 3 centimeters and ordered an ultrasound on that breast. The ultrasound showed only normal breast tissue, but no lump. I didn't have a mammogram.  OB seems comfortable with the results of the ultrasound, however, I'm not.

I called my plastic surgeon about this and he sent me to a breast specialist. I go next week. In the mean time, I can't sleep and was just wondering how often, if something IS cancer, does it show up as normal breast tissue on an ultrasound? Does scar tissue show up as normal? Is it possible, because of the location and breast density that the lump wasn't detected? Any input appreciated.  Thanks.

[CCF-RN,MSN-JS]

Dear Elfey, An ultrasound is used to help to differentiate between a solid and a fluid-filled area (cyst).  It can not distinguish between something that is cancerous or not.  With the ultrasound results being read as normal that lessens suspicion of a cancer problem, however, it doesn't rule it out completely.  It makes sense to see the breast specialist to evaluate this lump, to be on the safe side.

[surgeon]

All ultrasound really does is determine whether it's a cyst (fluid-filled) or solid. It really can't rule cancer in or out otherwise. In most cases, cancer will show as a separate shadow on sonogram because typically it's harder than the surrounding tissue; so when the sono shows nothing, it's reassuring; but it's certainly not absolute. When there's a lump, it boils down to two choices: if everything suggests it's ok, and you're comfortable, then careful followup is an option. Or, it gets some sort of biopsy. Seeing the breast specialist sounds like the right move. Meanwhile, it sounds like the suspicion is low.

[Elfey]

I went to breast center, had mammo and ultrasound and the specialist saw me one month later for a follow-up.  The specialist (which may be you because I'm at CCF) told me the mammo didn't show lump, but he can feel it. I'm having a revision to BR and the specialist asked the PS to biopsy the area during the revision.  I'm grateful for the proactive response and no waiting for months and months.  I don't have revision scheduled yet, but was wondering if scar tissue shows up on mammo?