Lymphoma presenting in the breast?

[Mochadelicious]

In March I discovered a swollen lump about the size of a grape on my left breast.  It is on my aereola next to the nipple.  It is a little red, swollen and warm to the touch.  It somewhat resembles a swollen bug bite.  It does not hurt and is not tender.  About a week before I discovered the lump I found a swollen lump under my left armpit but it went away after a couple of days.  I went to my doctor who thought it was probably mastitis because it was so close to the surface of the skin.  He recommended warm damp compresses on my breast several times a day for two weeks.  He said if it didn't help then I should see a surgeon.  It did not go away so I went to see a general surgeon.  He too thought it may be mastitis or some sort of infection and tried me on a bout of strong antibiotics for a week.  The antibiotics didn't work either so he did a punch biopsy of the lump and was told to come back in a week for the results.  On Monday I went in to see him for the results and was told that they think it may be Lymphoma but they still are not 100% certain.  He said they are wanting to send it off and run more tests on the sample.  He said it still could come back as a very resistant infection but to be prepared as it may not.  He informed he that he was putting me on their "cancer board" where other cancer specialists and pathologists will discuss my case.  He also said he was basically stumped because this is not breast cancer but it is presenting on the breast.  He said he has never seen this before.  Has anyone heard of lymphoma presenting on the breast?  From what I have read lymphoma is not easy to diagnose.  If this does come back as lymphoma, how certain can they be that the diagnoses is right?  Is there a lot of room for error?   Should I get a second opinion?

[Ken_PA]

> they think it may be Lymphoma but they still are not 100% certain.  He said they are wanting to send it off and run more tests on the sample.

hi, probably it went like this: somebody looked at the cells under a microscope, The cells look unusual, in a way that cancer cells look unusual. But the cause still might be something else.

So then they might use a complicated lab test called Flow Cytometry to get further clues, regarding tiny proteins that are on the surface of the cells. Then they might send away for another even-more-complicated method called FISH to be more certain, which can only be done in certain regional labs. In the end, most diagnoses are pretty sure - though it is true that in some cases the nature of the cells is on the borderline. E.g., a lot has to do with how many of the surface proteins exist as opposed to how many of another type, it's not all-or-nothing. So how much is "a lot" or "a little" is not always clear if the number is really in the middle.

You can get a 2nd opinion on the reading of a test. Whether to ask for that would, I suppose, come down to how certain or uncertain the first reading was.

On the plus side, every doc there seems to have thought it was not lymphoma (such as Subcutaneous T-cell lymphoma).

Anyway, I just noticed the original date - so you'll know by now. I hope it turned out well for you.

[cleelymph]

MALT lymphoma often appears in the breast. I have had it there several times. For more information you might want to go to yahoogroups.com and join the nhl-MALT group. If the diagnosis is low-grade MALT lymphoma, you may just be put on Watch & Wait; that is, if you have an oncologist who has treated MALT nhl before. It is not handled at all like other cancers, so a general oncologist may not be able to give you the best advice. DO DO DO get a second opinion.