New Lump Seven Years After Lumpectomy and Radiation

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QUESTION: I am a seven-year breast cancer survivor (lumpectomy, 7-mm tumor, invasive ductal carcinoma; clear nodes; and full course of radiation). I recently felt a new lump near my old tumor site. The mammogram shows scarring over a surgery clip, so it feels like a tumor and looks like density on the X-ray. Should I insist on a needle biopsy? My oncologist doesn't think it's necessary, and my radiation oncologist has relocated, and I don't follow with the surgeon. What should I do?

ANSWER: Of course we can't give personal medical advice, but we can support you with general guidance. Scar tissue commonly forms at the lumpectomy site, and tends to heap up around a clip or suture. Usually the scar tissue stabilizes within the first year after treatment. As the surrounding breast tissue heals and softens after treatment, the firm scar tissue may become more noticeable. But at seven years beyond your initial treatment, if you feel what you think is a new lump and the mammogram also shows a "lump"—then go to a surgeon who specializes in breast health. A biopsy can be done much more easily now relative to even a few years ago, and it may the fastest and surest way to resolve the uncertainty that you're struggling with. Good luck with this process. Trust your instincts!

—Marisa Weiss, M.D.

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