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Fat Neceosis-Scar Tissue

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    Posted: May 30 2020 at 4:35pm
My concern du jour is continuing change in my breast.  It’s been 8 months since the end of chemo and subsequent lumpectomy, five months since end of radiation.  All clear according to scans and pathology.  I quickly developed hard ridges and lumps in my breast, which is believed to be from trauma to the tissue.  Fat necrosis or scar tissue.  In recent weeks, I’ve experienced mild pain in the affected breast, but in a different area from my tumor and surgery.  Of course, this is worrisome.  I have my first post treatment mammogram and ultrasound in about two weeks and am very nervous.

I should note that at the recommendation of my breast surgeon, a plastic surgeon was brought in to move tissue from the outer portion of breast toward center to fill in the golf ball sized amount to be removed so that I wouldn’t have a “divot”.

Anyone else have changes this long after treatment?  Thank you, Cindy
66 at diagnosis. 3/2019, AC/T, lumpectomy, 30 radiation. Complete 12/19. IDC, grade 2-3, 4 cores .2-1.5cm, yellow lobulated fibroadipose, stage pT1b, NO
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Lisa s Quote  Post ReplyReply Direct Link To This Post Posted: May 30 2020 at 7:23pm
I am 2 years out from radiation.  Although I know longer have pain my breast is very lumpy and I can feel what can be described as ropey\lumpy tissue.  I have had my routine scans and it was just tissue damage.  What helped me stress less was a conversation with my surgeon about how much tissue he actually took out during lumoectomy.  When he drew me a pic, it totally made sense and WOW had no idea we had so much tissue :). I hope this helps
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Post Options Post Options   Thanks (1) Thanks(1)   Quote Plume Quote  Post ReplyReply Direct Link To This Post Posted: May 31 2020 at 4:52pm
I don't know what the recommendation is in the US but I can tell you my experience here in France.

To go straight to your question about lumpy and hard scar tissue, my answer is "yes" and I am nearly 3 years after surgery.

A month after surgery, I had to go to a physio for massages.  When the surgeon saw me again 4 months afterwards, he was quite upset because the massages were too gentle.  So I had a new prescription that said massage the breast "actively and profoundly" like bread dough!!!

Then followed a year and a half of fierce and painful massages weekly and 20 sessions on a machine that is normally used for cosmetic purposes and which gives deep tissue massages.

I was told I had to wait 2 years before any reconstruction after radiotherapy finishes.  I was due to go for my first operation mid April but Covid put paid to that and so I am now waiting for another date.

What he's proposed doing is to cut away the hard tissue, make 4 holes in my abdomen and do liposuction.  The fat extracted is then put in a centrifuge to separate the blood from the fat.  Then the fat will be injected into my breast.  Apparently, according to how my body absorbs the fat, this might need to be done 2 or 3 times.

The lumpiness can be painful and, of course, the nipple has been displaced so that needs to be "straightened" out and the other breast lifted slightly so that I should have breasts that match in the end.

The surgeon has promised that the procedure will make the breast more comfortable as well as for aesthetic reasons.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CMDW Quote  Post ReplyReply Direct Link To This Post Posted: Jun 01 2020 at 7:58am
Thank you for that comprehensive response.  I will be 68 next month and am not as concerned about appearance as I once was, but am most concerned about future health.  Your post addressed several issues and I’m sure it will be helpful to many others as well as myself.
66 at diagnosis. 3/2019, AC/T, lumpectomy, 30 radiation. Complete 12/19. IDC, grade 2-3, 4 cores .2-1.5cm, yellow lobulated fibroadipose, stage pT1b, NO
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Plume Quote  Post ReplyReply Direct Link To This Post Posted: Jun 01 2020 at 3:48pm
Hi Cindy

Your post just shows how differently we all think and react about our bodies after breast surgery and cancer treatment.  I am older than you, 71 in May, and the thought of having my breast put "right" again has kept my spirits up through some very low moments.

I just want my body as much as possible the way it was.  It's not as though I had great boobs or my body was special or beautiful.  But it doesn't feel "whole" somehow and I think the corrective work will help me a lot psychologically.

To me, it's bad enough that my hair has never grown back strong and shiny like it used to be.  It is now very fine and on the top of my head, the hair is so scanty that it barely covers the scalp.

Don't get me wrong, I am grateful to get my life back and, in fact, I feel just as well and strong as before.

For you, it's still early days, the lumpiness does reduce a bit and the breast will become less painful.  All the best! 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CMDW Quote  Post ReplyReply Direct Link To This Post Posted: Jun 02 2020 at 8:27am
Thank you!  I am with you regarding gratitude-continuing good health is the most important thing.  

Hair is an issue though too, now that you mention it.  I had chin to shoulder length dark brown hair most of my life.  Grateful that my hair is coming back, but it is salt and pepper, curly and short.  People say it cute, but I don’t recognize myself.  In conclusion, I think we just want to go back to our prior selves.

Stay well and best wishes with your procedure.
66 at diagnosis. 3/2019, AC/T, lumpectomy, 30 radiation. Complete 12/19. IDC, grade 2-3, 4 cores .2-1.5cm, yellow lobulated fibroadipose, stage pT1b, NO
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