For Dr Lu - cording in breast after rx

dizzybuff38

Hi Drl Lu - welcome to the Board - I am sure lots of us bc survivors will have questions for you.
I was dx with invasive ductal cancer, 2 cm, 3/19+ nodes in Feb 03. I had a WLE then total axillary removal. 6 x FEC, 45 rads and 2 boosters. Now on Arimidex.
A few months ago I noticed a long lump in the top of the breast that had the tumour, which was below the nipple. Saw my GP who sent me to the Breast Care Centre on an urgent basis and I saw a surgeon, not the one who did my surgery. He sent me off for an ultrasound and the Radiologist said there were no tumours and that the lump was cording due to radiotherapy. As my original tumour was not palpable I have no way of knowing what a malignant tumour feels like. I had cording in my right arm after the axillary removal but have never heard of it in the breast itself. Have you come across this - just to put my mind at rest? I was discharged by the Oncology/Radiotherapy Dept in Feb 04 after completing my treatment with them. I have annual check-ups with my surgeon, next one due March 05. I would be pleased to hear your comments and whether or not I should seek further advice before March. I live in the Uk and really have no choice over who treats me on our socialised medical system. Many thanks, Liz.

hhmv73a · Experienced user Joined: 16 Jan 2005 Posts: 95

dear liz,

sorry i cannot give you a direct answer since that will need a physical examination and some tests (may need a biopsy too).

i am not familiar with the word "cording" but i guess they meant fibrosis or scaring of the soft tissue, which is a commonly seen side effect from radiation and is always not cancerous. fibrosis is usually firm, and by simple palpation one cannot easily tell the difference between a tumor (malignant or not) vs. fibrosis. although fibrosis is not uncommon, and i have seen many cases, it can be difficult to tell the difference.

follow up with your surgeon is extremely important for you. if you have concern about the "cording," ask him why he does not think this is recurrence, and if a biopsy is indicated. unfortunately i cannot tell you what else you need to do over the internet, but you have already brought this to your physicians' attention and it should not be difficult for them to take care of your concern.

good luck,

let us know if you have further questions.

regards,

jay

J. Jay Lu, M.D.
Diplomate, American Board of Radiology (Radiation Oncology)

penelopez · Senior User Joined: 11 Oct 2004 Posts: 165

Hi Liz,

I just saw my rad onc last week and I'll share my experience with you. I hope it helps.

I have a lumpy area just above my scar. He checked it out and said it is scar tissue. He said there were various changes in the breast from the surgery, radiation and chemo. Personally, I don't understand how chemo could change it. Anyway, he claimed he could "tell" it was just scar tissue. I expressed my concern telling him that when various doctors felt the original lump they assured me it felt like fibrous tissue and were, obviously, wrong. The radiation oncologist said I should watch for changes and if there are any changes to call him.

I'm just sharing this so you won't drive yourself nuts with worry. I understand how scary it can be. BUT....you should definitely have it checked out asap. You can't be too cautious as far as I'm concerned. And if you feel you want a biopsy, push for one. It's your body.

Take care and hugs,

Margie

dizzybuff38 · Posted: Wed Jan 19, 2005 12:19 pm Post subject: cording in breast

Margie - thank you for your posting and sharing your experience. As Dr. Lu said, it probably is fibrosis. It's funny but I don't remember either the Radiologist or the Surgeon saying "cording", but my husband mentioned this expression to me some time after the consult and ultrasound. I only remember the surgeon saying that I shouldn't expect the breast to feel the same after I had chemo and radiation. I too wondered how chemo could make the breast tissue feel so radically different to my other breast.
This "cording" happened well over a year since I finished rx and that is why I am so concerned. If it was cording I would have expected it to occur sooner, as did the cording in my arm after axillary removal. As you can feel the lump easily, I don't understand how the radiologist could say in his report to the surgeon that he knew it was not another tumour. Perhaps fibrosis and tumours look different on ultrasound. I just wish I had had the presence of mind to question the surgeon further. It never occurred to me at the time to ask for a biopsy, but when I see my surgeon in March for an annual checkup I am going to do what Dr. Lu said and ask why he doesn't think this is a recurrence and if I am not satisfied with his answer, press for a biopsy.
In the meantime I think I will make an appt with my local GP - he referred me to the surgeon when he felt this new lump but I never went back to see him after the ultrasound as I didn't think he could bring anything to the party. When he referred me he asked if I wanted to see the Oncologist or the Surgeon and I chose the surgeon because all the breast cancer machinery for diagnosis is in a specialist Breast Care Centre of Excellence, whereas chemo and radiotherapy are in an entirely different part of the hospital, quite a ways away, where many different forms of cancer are treated. I think I now need to talk to the Oncologist because I have other problems, such as hip pain (GP said it is an inflamed bursa - what, for 3 months? Methinks not) and the recent blackout and unconsciousness. I am still dizzy when I get up from a sitting or laying down position. My gastro was surprised I had not been sent for a brain scan when I was taken into hospital after the blackout - all I got was an ecg for my heart which was fine. My GP can't order bone scans, CT's or MRI's - it has to go through what we call a Consultant at the hospital, but I guess he should be my first port of call now.
Thank you sincerely for your help and support.
Liz.

dizzybuff38

Hi Dr. Lu - thank you such an erudite reply to my "cording" question.
As I think I told you, I had an ultrasound at my last visit (some 3 months ago now) to the breast surgeon and radiologist. Can the radiologist tell from the ultrasound whether the palpable lump is fibrosis or a tumour?
The radiologist categorically said to me there was no tumour and he would write a report to the surgeon. This was all done very quickly, within an hour or so, and it was the surgeon who, apparently, said it was cording. They don't normally give you copies of any reports in the UK, but I would imagine the surgeon got this dx from the radiologist and felt that no further tests were necessary. Can fibrosis occur more than a year after radiation? Thank you for your time.
Liz.

MACE1610 · Regular Joined: 27 Nov 2004 Posts: 23 Location: FLORIDA

[b]

HI I ALSO HAVE SCAR TISSUE AT THE SITE OF SURGERY. I HAVE HAD ALL MY DOCTORS TELL ME THAT IS WHAT IT IS. I HAVE HAD MAMO SINCE AND NOTHING SHOWS AS FAR AS A NEW TUMOR. I HAVE THE SAME KIND OF SCAR TISSUE WHERE MY HYSTERTOMY SCAR IS. I THINK SOME OR MORE PRONE TO DEVELOP THIS KIND OF SCAR TISSUE THAT OTHERS. AS FOR ME I AM VERY FAIR SKINNED AND WAS TOLD THAT IS ONE THING THAT MAKES ME MORE PRONE TO HAVE THIS KIND OF THING HAPPEN.

I WILL SAY THIS, DO NOT STOP ASKING QUESTIONS ABOUT IT UNITL YOU ARE COMFORTABLE WITH THE ANSWER.[/b]
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