swollen breast

[robins]

I had a lumpectomy in may 2003. I was 44 yrs old.I was in stage 1 with a 1 cm lump.I had 4 rounds of AC(vascular invasion but no lymph node involvement).Then had radiation. Now I am on tamoxifen 20 mg a day. I had my yearly mammo and sono in march 2004.(due to get a sono and MRi in sept).1 week after mammo, my operated breast got swollen,hard,red and warm. Went to my surgeon and he found nothing, but performed a biopsy.Came back atypical cells.Had an excisional biopsy 2 weeks later to make sure they were atypical due to the radiation.This was confirmed. Now the breast is still swollen(strectch marks on the bottom) a little red but not warm (and noticably larger than the unaffected breast).He is not concerned.The mammo and sono came back fine.Original tumor never showed on the mammo)i felt it and showed up on the sono and MRi). Went back to radiation dr and breast imaging dr.They both feel it is nothing to worry about.This has been going on since end of march 2004.It does not hurt just uncomfortable.Was told to use warm compresses to help alleviate swelling.Never experienced any temperature.Since this began 1 week after mammo could this be due to the fact that it was still less than 1 yr after lumpectomy and i wasnt fully healed?Since i had a biopsy and an excisional biopsy in the same month is this swelling now due to those biopsies?what do you make of this?I trust all 3 of my drs.They all have spoken to each other since this began.What do you make of this and what do you suggest I do if anything?get another opinion?by whom?
thanks

[CCF-RN,MSN-rf]

Dear robins:  It is not uncommon for a breast to swell after radiation, although the delay is not usually as long as the one you describe.  It may be possible that the compression from the mammogram caused a bit of trauma, leading to fluid retention.  As you have consensus from all of your doctors, it seems unlikely that anything is seriously wrong.  For your own peace of mind, you could get a second opinion from a breast specialist, perhaps at a larger teaching facility.

[robins]

Thank you for commenting so promptly.My radiation therapy ended in Nov 2003.There has been no swelling until 1 week after my mammo(march 2004.Why do you think the breast might be pinkish now?My breast surgeon's(one of the top in his field on Long Island NY)answer to all of my questions is"I have seen everything".He is trying to calm me down.No one can give me a definitive answer.I am going to Larry Norton's seminar here at Adelphi in 2 weeks.Hopefully he will field questions from the audience.Iam taking your advice as well and goign to contact someone at Sloane in Commack LI NY.Do you feel that warm compresses might help or is this the way I might be forever?

[surgeon]

As I understand it, there was swelling before the biopsies, so I'd assume it not due to that. What you describe is not usual: sometimes after radiation the breast can be edematuous (retaining fluid), but it's unusual for it to start a year later. With all your doctors agreeing, and with the biopsies ok, it's not very likely that there's anything serious going on. And I don't have the advantage of being able to examine the area. But I do find it unusual enough to think another opinion wouldn't hurt; I'd suggest a breast surgeon, possibly at a larger medical center.

[lizziecee]

I too have a large, swollen, but very hot, right breast where I had lumpectomy for a 2 cm tumour in Feb 2003, then total axillary removal for 3/18 cancerous lymph glands in March 2003.  I had a mammo in March, NED. I have suddenly realised that some 30 yrs ago when my husband and I had an electronics company that we dealt with a Dr. (don't know what kind - research, physician, whatever, - oncologists were unknown here in the UK then) in Glasgow, Scotland who wanted to use one of our specialised instruments to monitor heat in breasts as a pre-cancer diagnostic tool. This miniature instrument was put into brassieres to monitor temperature. We made the instrument for him, but obviously didn't see the ensuing medical research. That was not part of our brief for applications electronic engineering. Do you give any credence to his hypothesis? Have you any kind of feedback on heat in the breasts, and whether if one breast has a higher temperature than the other one, this has a bearing on a cancerous tumour? My tumour was not palpable, although clearly shown on mammo and ultrasound, but I am concerned that my right breast is so hot to the touch it feels like sunburn. My right breast has a significantly higher temperature than my left one, but perhaps this is due to the radiotherapy I had. I would really appreciate any input you have on this question before I rattle pots and pans and try and see my Oncologist, who "discharged" me in Jan 2004. The NHS medical service here really sucks.