Mammogram recall - v.worried

[PuffPants]

My mum has been recalled after a mammogram. She is 72 and had breast cancer 13 years ago. Small tumour and radiotherapy. She had had annual mammograms since then and has not detected a lump.

She is so frightened and it has brought back a lot of distressing memories.

I have told her lots of women are recalled and it is probably just an unclear image they need to redo.

Am I right or does this look bad?

i know how scary these sort of things are Puff - I was Dx with Bc 4years ago, but a mammogram recall does not mean the cancer has returned, - it can be for any number of things - an area of dense tissue they want to look at again, not getting a clear view, benign lumps, calcifications - amongst other things. I know it is so frightening when you've been through it all once already, - its always on your mind, but 13 years is a long time clear, and I don't think she should panic yet.

I post on the tamoxifen thread in health - many women on there who have had BC, and some have had mammo recalls - which have turned out to be fine. If you want a chat and a bit of hand holding while you are waiting for your mums next appointment, - do pop over, you'll be very welcome. xx

Thanks Kurri, mum went back for a second mammogram yesterday and they did find a small tumour, very small is how the doctor described it - mum can't feel it - no more than 1cm, in same breast.

She gets biopsy results next week but we are assuming its malignant.

You sound like you have knowledge in this area , do you think they will advise a mastectomy this time? She had lumpectomy and radiotherapy last time (13 yrs ago) and I have heard you can't have radiotherapy twice.

She is dreading having to undergo chemo but I doubt she would have that as tumour is so small, am I right?

The doc did say that the long cancer-free period was a very positive thing and also the size. TBH I was relieved, could have been worse, right?

Thanks for your response btw

I'm sorry tp hear your mum has another tumour. After 13 years, she could have radiotherapy again, but I don't know about whether they would recommend chemo

Puff - I'm sorry to hear she does have a tumour, but it's very good that it is small and they have found it early - before she could even feel it. TBH I don't know whether they will offer mastectomy or another lumpectomy - it depends on various factors - position of the tumour for example and how close it is to the chest wall.

Once it is biopsied, they will have a clearer idea what the best way forward is, - if it is small and hasn't spread to the lymph nodes, then she probably won't need chemo, also they would take her age and general health into account before suggesting chemo. However if she does need it, it is doable - its not a walk in the park, but I think people generally anticipate the very worst, - most people get some, but not all of the possible side effects, and hospitals are very good at deal with S/E's. - But that is looking too far ahead - she may very well not need it. I'd say she has a pretty good chance of avoiding it given tumour size.

She might be a candidate for herceptin, - it is given routinely now fro early BC, if the tumour is one that is responsive, - I should think when she had her first tumour herceptin was still only being given in advanced cases. Again herceptin is very doable, - a few s/e's but not usually so bad that you can't carry on with your normal life.

Do feel free to ask me any questions you like, or that your mum would like answered - I will do my best to answer (PM me if you'd rather) - I have had a mastectomy, a lymph node clearance, chemo, radiotherapy, herceptin and tamoxifen - so know a bit about those things, And as I mentioned before the ladies on the tamoxifen thread will be happy to chat to you, - don't worry about following what's going on on the thread - we tend to go off at a tangent, but dive straight in with your queries and someone will answer you

very best wishes to your mum

I'm another from Tamoxifen thread - v.sane place to hang out if youd like some company. What Kurri's said all makes sense, but just thought I'd add that your mum must be post menopausal at 72, so that more often than not means slow growing/ less aggressive. Hope that's the case, but odds are on her side I'd say.

Thanks Smee, that's all very encouraging. From the little I know, breast tumours are fed by oestrogen, yes? I guess the older you are the less you have of it?

Kurri, the new tumour is near the front, below the nipple so away from the chest wall I suppose. It's actually in the vicinity of the original one as the doctor thought it might be scar tissue to begin with.

Do women ever have two lumpectomies? Or do you think a mastectomy is more likely this time? Even if it's small? If so, will they offer her reconstruction in the same procedure - and do they even do implants to suit a 70 yr old's bosom? Not sure a big fake pert boob on one side only would work - although mum would be v.tickled

I know we can only speculate at this stage and the consultant will give her the answers next week. He is a top breast cancer doc - she had him last time - so in good hands. I just want to talk her through the various things he might say so she's prepared. But also nice to have positive thoughts to get us through the wait too.

Thanks so much

PuffPants, do you know if they found any dcis as well as the lump? If so, she's more likely to have mastectomy as it would mean the whole breast is potentially unstable rather than just the bit where the lump is. Also I'd guess they'll want to test her nodes. Hopefully it won't have reached there, but that impacts on decision making too.

I think the majority of breast tumours are fed by Oestrogen, so yes less around to feed the little critters after menopause, which is mighty good news. Was she on Tamoxifen first time round? If so then her tumour was hormone positive last time, so I'd guess it's likely this time. 7 years on though, I'd imagine they'd call it a new cancer rather than recurrence so could be completely different type.

With reconstruction, a lot depends on whether she'll need Rads or not and also on her surgeon. Am happy to answer anything if she has to make that sort of decision. I've had two mastectomies and now have pert silicon breasts!! Please tell your mum if she is advised to have a mastectomy it's genuinely nowhere near as bad as she'll imagine. I was surprised how quickly I recovered.

Dcis not mentioned, the doctor who took the biopsies said "the lymph nodes look fine" but I expect they can't know this for sure till they test them. I think they took some out to test during the lumpectomy last time.

She did 5 yrs of Tamoxifen last time, after radiotherapy (is that what you mean by Rads?).

If it hasn't spread and isn't in the nodes, then they won't suggest chemo will they? I think she will be sad but gutsy about a mastectomy - anything to stay alive for her DGCs will be her attitude.

She was very emotionally affected by it all last time. Had a lot of time off work, sank into depression, took a lot of medication and even turned to drink for a while. It was hard for us all. I really feel she will handle it better this time though, she is at a different stage in her life: no work pressure, children married and settled, happier generally, fitter and, ironically, healthier than before. Most importantly, she is saying she is ready to fight and won't let it overwhelm her in the same way. Not to say she won't have wobbles but at least she is feeling strong at this point. At the same stage last time, she was a wreck.

Yes, if she had Tamoxifen last time the tumour must have been hormone positive. Rads, yes = radiotherapy.

From what you've said it does sounds like chemo's unlikely, but all depends on whether it's reached the nodes and how aggressive the tumour is. Poor thing going through it all again. Really is your worst nightmare once you've gone through it once. Hope this time round it's a bit easier for her to deal with. So very hard for her to be hit again.

hello puffpants- am so sorry that your mum is having to go through this again- it sounds as though you are being a brilliant support for her. Please do join us on tamoxifen thread for some hand holding as it must be tough on you.
My aunt had mastectomy for bc in her 80s (4 years ago) and chose not to have any reconstruction - she didn't feel there was much point at her age