concerned

am a 46 yo female who is 6 years post treatment for T1bN0M0 breast cancer. I was treated with lumpectomy followed by radiation and hormonal therapy. I have had regular mammograms since my treatment and was excited when I hit my 5 year milestone last year. This year when I went for my annual mammo there was an increased density and architectural distortion at the level of the prior surgery. I had a follow up ultrasound which showed nonlinear acoustical shadowing at the lumpectomy site and coarse fat necrosis type calcifications. I am now scheduled for a VAC core biopsy next week. The radiologist is concerned that my mammograms have remained stable up until now and implied that it is probably a recurrence. My questions are what is the likelihood that this is a recurrence, and if it is not and is found to be benign would mastectomy still be an option. I can't stand the thought of constantly  worrying about this. The fact that I was diagnosed at an early age makes for a greater concern on my part. Any advice is appreciated

[Cleveland Clinic]

Dear  barbara1016: There is no way to know how likely this is to be recurrence.  Certain features may make the doctor more or less suspicious but the only way to know for certain is to biopsy.  If this is a recurrence, then mastectomy would most often be recommended.  Mastectomy is still an option if this is not cancer but may be considered elective.  You should have a discussion with your oncologist and possibly a genetic counselor who can discuss pros and cons and determine the best choice for you.

[barbara1016]

I just got the results of the biopsy and it showed fat necrosis and dense calcifications. It did not show any malignancy. What are the chances that these calcifications and fat necrosis will become malignant?

[LindsayLee]

I dont know about calcifications but I do know that fat necrosis which is dead breast tissue does not turn into cancer. it is a result of trauma to the breast and not uncommon after breast surgery. If you haear any thing else on ths let me know. I have some fat necrosis that is how I know.
Lindsaylee

[LindsayLee]

I am sorry I just reread your post and it does not say anything about you having surgery as I previously thought. The radiation therapy however could have had something to do with causing the Fat necrosis which is dead breast tissue. Just wanted to clarify. Hope this helps.