Nodules, uptake, abnormal lymph nodes

[anon07072023]

Hi all, I started feeling nodules on the upper left side of my left breast back maybe around Aug. After fighting with my doctor for 2wks to get a diagnostic breast mammogram, she finally sent over the order. I have a family history of breast cancer (mom, aunt, grandma's sister, etc) but my BRCA came back negative (which is good).

My mammo & ultrasound came back negative. I then refered myself to a breast specialist since I feel these nodules and I know they're there. They ordered a breast MRI (late Dec) & it showed 3 nodules on the left breast at the same location that I feel them and one nodule on my right breast. They're about 4mm is size each. I've been seeing an oncologist for another cancer that I may have and they ordered a PET scan. The PET scan showing mild uptake in these axilliary lymph nodes. Now I just had a ct scan follow-up from the same oncologist and it shows an abnormally high number of axillary lymph nodes on both sides.

On top of this, I have dense breasts. I think it was called something like dense fibroglandular breast tissue.  Which I should probably ask on this forum if this is great news, since the breast specialist PA that I was originally seeing told me that she wished all of her patients had this. I thought that maybe she was a little crazy & confused. That's the opposite of what I've read.

Does anyone on here have or know of anyone that has breast cancer that has spread when the nodules are 4mm in size?  The doctor doesn't seem to want to biopsy anything.

Thanks,
Kelly
  

[anon07072023]

Well the breast specialists that I see specifically treat breast cancer/disease and they are also breast surgeons.  I think the oncologists like to stay within their specialties as much as possible.  And since they're already following me, I don't think my oncologist felt like it was her place to step in.
  
The PA was saying about the biopsy that 1) she may miss the nodule during the biopsy and get the good tissue, instead.  2) even if she does find cancer in the biopsy, that doesn't mean I have breast cancer because everyone has cancer in their body every day.  So, this could just be a random place that I have cancer that my body is in the process of curing itself of and fighting it off.  ????

[japdip]

A primary tumor must be present in order to metastisize .... and 4mm is NOT too small to be biopsied IF the area is suspicious for malignancy. Perhaps the Tech. meant that a result of Fibroglandular Breast Tissue was far more desirable than actually finding something abnormal or something other than benign. As a rule Oncologists follow a patient no matter what type of cancer is suspected and I would expect him/her to be investigating the breast issue as well even though their involvement is most often AFTER the diagnosis to formulate a treatment plan.

[anon07072023]

Thanks for your response. I was actually just wanting to find out if anyone has had a malignant breast nodule the size of 4 mm that has metastasized.

I know that I have not been diagnosed with breast cancer, however that doesn't mean that I don't have it. Both of my parents died young from cancer and, actually, none of their scans ever showed their tumors.  

I fully understand what hypoechotic means - I also realize that most malignant nodules are hypoechotic.  And lymphadenopathy can be nothing or it can be cancer. I know that dense breasts are not unusual, but to say that she wishes that everyone had dense breasts makes me kind of wonder, since it makes it more difficult to see during the scans.  I'm just trying to connect the dots and being proactive - hypoechotic breast nodules in both breasts, positive uptake in axillary lymph nodes on both sides, and lymphadenopathy of axillary lymph nodes on both sides.  These are unrelated to the other cancer their looking at for me.  And my oncologist said that that size nodule would probably be too small to be picked up on the PET scan for uptake.

My oncologist says that it's a good thing that I'm already being followed for my breast nodules and that I should bring them the ct scan CD & report.  

Maybe someone else knows if that size is too small to metastasize?

[japdip]

First of all I must say that you have NOT been diagnosed with Breast Cancer and enlarged axillary nodes can be an indication of many things other than Cancer. I notice you mention "may have" in regards to another cancer .... this, whatever it is, could be the cause of the enlarged nodes as well. I think at this point the recommendation of a short term follow-up is right on .... all tests seem to have returned negative results except for the enlarged nodes. Hypoechoic simply means that the area reflected less echos than would normally be expected. I'm not sure why you are considering the spread of cancer when you have not been diagnosed with cancer. Dense breast tissue is not at all unusual ... it does make it more difficult to discover some things but you have had a Breast MRI which did indicate the nodules that you mention. It would be quite unusual to have cancer in both breasts at the same time and I notice you stated that nodules were found in both breasts. I'm not sure that 4mm is too small to biopsy .... I suppose you could get a second opinion from a Breast Surgeon since you seem to be quite concerned about these nodules. Your Oncologist should be able to do any further investigation that is necessary as well as recommending a biopsy of the breast nodules. You might discuss it in detail with him/her and go from there.  Regards ....

[anon07072023]

I probably should say that the radiologist called these nodules hypoechoic. And he suggested a short-term follow-up.

And the breast specialist seems to think these nodules are too small to biopsy.