Possible treatment for internal scar tissue

[SueM]

I finished lumpectomy/chemo/radiation June 2001. My always-very- dense breast is still somewhat red, definitely inflammed, sometimes very painful and itches. I take 75 mg of vioxx a day. My surgeon, radiation doctor, and oncologist have come up with a variety of treatments, none of which have helped. For instance, it did not respond to large doses of antibiotics. Mammograms are unbelievably painful and inconclusive, a CAT scan was inconclusive, MRI confirmed an abundance of internal scar tissue. My surgeon referred me to a Rehabilitation doctor who declined to treat me stating that I need to see a Plastic Surgeon. Before I call my cancer surgeon back, can you give me any idea of what a Plastic Surgeon can do inside my breast? Do you have any other ideas how to treat this condition? If I must live with my breast the way it is, then that's the breaks, but I hate to give up only to find later that there was a solution. My doctors all stress how unusual and rare this is, which is, I suppose, statistically interesting, but does nothing to relieve the daily discomfort.

[CCF-RN,MSN-JS]

Dear SueM, I am not sure exactly what the plastic surgeon could do inside the breast, but they may have a surgical answer to the discomfort you are feeling.  They would evaluate the information available from the testing you've had done, physical examination, and make recommendations as to what they might be able to do to help.

[surgeon]

One issue that comes up is whether the area needs biopsy again: that is a difficult issue, because healing could be slow. However, a core needle biopsy would be a consideration. The plastic surgeon would likely not have much to offer other than a major reconstruction; ie, removing the remaining tissue, and replace it by transferring tissue from another part of the body. So there are two issues: first, how best to be certain that there's no tumor recurrance, and second, how to deal with the chronic changes. If there's no worry about recurrance, then most likely your choices are between enduring the discomfort, or having a major reconstruction.