[dlaxague]

Hi,

I had bilaterals and no one really did any follow up exams, if you mean by feel, except me. Although I saw my onc every six months for the first few years, he was not a hands-on kind of guy. After the post-op visit, I didn't see the surgeon again. I know this varies from one area or one provider group to another. But this suited me fine (I do not like being a patient). And there isn't really anywhere for something to hide. It's pretty much bones and skin except in the axillary area. I can't imagine that there'd be something on my chest that someone else would notice before I did.

I did find something really subtle once in the shower (you know, that lub-dub feeling as your soaped hand goes across an area) and I saw the surgeon for it, but after feeling about in the area of my concern, he said "a recurrence is much more obvious that this". And that was almost two years ago so he was correct.

A local recurrence after mastectomy can happen anywhere, but it's typically in the scar tissue from the surgery, which may extend into the chest wall. Or it can be in nearby axillary nodes. I find it intriguing that it can happen in the scar tissue. Cancer is supposed to prefer vascular areas, and scar tissue, once healed, is less vascular, right? Just look at how white it appears. And it's not as if after mastectomy, scar tissue is located near the area of the original cancer in most cases. So why the recurrence in the scar tissue? What part of the healing dynamic encourages cancer cells to congregate there, and later to grow? And could we control that, so that rads could be avoided, both after mastectomy and lumpectomy? And is this question linked to the possibility that surgery encourages distant spread? So many questions ...

Debbie Laxague