Hi

It was mid axilla chest wall,to the side of my breast.

GP felt 5cm but actually in ultrasound I had two enlarged lymph nodes one at 4cm and one 3cm.

The cancer has come from the breast but didn’t show on mammogram??

at this point I don’t have a grade/stage as we haven’t found the root of the problem. There’s talks of biopsy’s once they’ve found it. There’s a lot of unknowns.

im sure you will be fine most people are by my understanding I’m a bit unusual as it has surprised everyone. 

Hooe that helps

xx

Hi there, the mammogram is really good news.  I am very reluctant to give medical information on here because I am not on here in a professioinal capacity at all.  Lymph nodes relate to different areas in the body.  A LN becomes enlarged if there is something going on in the part of the body that drains to that LN.  You have been told you have a clear mammogram which is fantastic news.  It sounds as if there is no cancer in your breast.  Mammograms are the most reliable way to pick up breast cancer, they can pick up tumours which can't be felt, this is the whole point of the breast screening programme, find malignancy before it actually makes itself known via signs/symptoms.

I can tell you - and there are always exceptions in medicine - that LNs that are not related to malignancy may enlarge but they have a rubbery texture, while those that relate to cancer are harder, and often do not move around when they are pressed.  This is called being 'tethered'.  And LNs which are palpable because of cancer are typically painless, ones that are sore are not associated with cancer.  There are always exceptions as I say, and I am talking very generally.  In the same way as breast pain is not a classical symptom of cancer, a sore lymph node is not classical for cancer either.

Obviously it's not up to me to give you any answers and I really can't but what you have said here

Hope this helps a bit. xx

Oops looks like the last sentence of the message I just wrote isn't there.  It should have said that the things you have said on here make me optimistic for you xx

Shoobeedo I have just read didnotexpectthat's post and this demonstrates my point - there are exceptions and things do not always present classically!! But there is a balance of probabilities. xx

Shoobeedo feeling like there is something in the way is what has alerted me to something amiss.  It's not because there is something in the axilla that I have this feeling, it's because the breast is bigger.  Probably unmasked by weight loss, I get Seasonal Affective Disorder, get depressed in the winter, put on about 10-14lbs, not just being less active but because I seem to hang onto weight in the winter even if I am not eating more.
In the spring the weight drops off.  I'm 12lbs less than I was in January, clocks change, I have a burst of energy, my weight plummets.  I'm not worried about the weight loss, I don't think it's sinister, it's predictable and it's been this way for years.

But breasts are mostly fat and when you lose weight, they lose volume.  I'm a size eight although I'm 5'10" which means I don't carry a lot anyway.  So when the weight dropped off over the last few weeks a disparity in the size of my breasts became apparent.  I was worried about this on its own.  I'm so paranoid about breast cancer I self examine on a regular basis.  My breasts are naturally lumpy, and when I went for triple assessment a few years ago the breast surgeon told me that some women naturally have breasts that 'feel like a bag of sprouts' and this is just normal for them.

Mine aren't quite that lumpy but they are dense and fibrocystic.  There are areas where it feels like there are palpable lumps but they feel rubbery and don't change in texture or size.  There is one in the lower inner quadrant of my right breast that has basically been there forever.

But after I realised the left breast felt bigger, or more that the relationship between the right breast and the arm, and the left breast and the arm felt different, like the left breast was slightly in the way, I had a good feel around and there is definitely a lumpy area in the upper outer quadrant of the left breast that feels firmer and more irregular than the rest, doesn't feel lumpy in a 'familiar' way, if that makes sense.

Given that I already had concerns, I really **** myself when I found this, went down to the GP surgery the next day when they released some more same day appointments in the afternoon so I didn't even have to wait another day to get referred on 2WW.

Strangely I had an appointment with a doctor I have worked with at my local hospital (where I still work).  didn't realise, it is not the most unusual name anyway.  She examined me, I told her which breast I was worried about but not which area of it and it didn't take her long to focus her examination on the same area that I was concerned about.  She said the texture was lumpier than the rest.  She also felt the LN I had found in the axilla on the same side.  Doctors are never willing to commit themselves until there is evidence that is definitive.

But she told me she wasn't that worried, particularly by the LN which was small, untethered and didn't feel 'cancerous'.  I'm trying to seek some comfort from that but the wait is appalling.  It's affected work, I have found it hard coping, A&E is very pressured and I've ended up in tears on both of my last shifts and I'm worried, I am a locum and always worry about not getting work on an ongoing basis even though I've been there for a long time.  I am really in hell, daughter is doing A levels so I am having to be 'normal' around my kids when they are here.  They are also alternating whole weeks at mine and then their dad's and I am missing them like hell and these stretches in an empty house are awful, I have all the time in the world to worry about all this and no distractions.  Normally they shuttle between our houses but it's easier this way for my elder daughter during exams.

The LN in the axilla is small, palpable but only about 1cm.  It feels rubbery, you have to dig around to find it.  I have had palpable axillary LNs before, a few years ago I had two in the left axilla, one was 2cm.  But they were benign, just reactive LNs.  I also get small palpable LNs on the chest wall lateral to both breasts which seem to come and go.  My LNs are very reactive anyway, I have palpable cervical LNs, small, that are there all the time, and larger palpable inguinal LNs that are bigger and have basically been there forever.

I've been in touch with a friend who is a breast surgeon who has been reassuring, says that because I'm on HRT and have fibrocystic breasts it is probably hormonal.  None of this helps all that much, I have been in a black hole like you and am no longer capable of rational thought.

Most of the stuff coming through the door in A&E is mundane, the worried well and people who are basically using/abusing the service because they can't get GP appointments owing to the crisis in primary care.  But we see horrible things as well.  I can't remember the exact figure but something like 10-15% of cancers first present in A&E.  I had a guy who turned up with almost classical symptoms of kidney stones the other day.  He was the same age as me.  CT to look for renal stones revealed a para-aortic mass, suspicious for a lymphoma, now confirmed.  I've had young patients presenting with a week or two of headaches, taking paracetamol for a week, them not going away, then one day they start vomiting as well, come to A&E, CT head reveals a brain tumour.  I see women, sometimes younger than me, who have suddenly fractured a hip from minor trauma, the explanation is a primary that has been 'occult' - symptomless, it is what is called a pathological fracture, owing to bone mets.  Or someone short of breath, chest X ray shows a pleural effusion (fluid on the lung) and a CT reveals a mass in the abdomen or whatever.

Also we often see people with neutropenic sepsis, having chemotherapy that knocks out the white blood cells, any sign of infection like fever they know means immediate attendance in the ED for antibiotics because it could be emerging sepsis that could be swiftly fatal without treatment because they have no immune system to fight it off.  This happens quite regularly because it's drilled into chemotherapy patients that a whiff of a raised temperature and they get themselves to A&E straight away.

All this sounds very scary and I am not trying to scare anyone.  Cancer is a disease of older people, that includes breast cancer, the huge majority of people who get it are over 70.  My mum was 72 when she got hers.  And in literally hundreds of shifts my patients have rarely been a first presentation of cancer, let alone a young presentation.  But, when you actually see this stuff it's different.  And you see many people with benign conditions or infections, common, very rarely due to cancer, but it is often a potential differential diagnosis, albeit unlikely.  So cancer is ALWAYS on my radar, my work is all about disease.  And I suppose that 10-15% of cancers that show up in A&E are not presenting classically, which is why they show up in our department, rather than being found via outpatient referral when someone expresses concerns about something to their GP.

So I am acutely aware of all the cancers that present weirdly, all the non-specific symptoms that are very rare presentations of cancer and are unexpected, masquerading as common conditions.  Every twinge I have I think is cancer.  We were never a 'cancer' family, then my mum got it (breast) and two years later my very fit and healthy dad (lung, he died).  When I had nagging shoulder pain, in my head it was lung cancer, I have a smoking history my dad never had, and I'm smoking like a train at the moment owing to all this stress... then mega-stressed that I'm smoking!

I am temperamentally completely unsuited to being a doctor because I am natural, huge worrier, which has become amplified by horrible events over the past decade.  That in itself makes me terrified of the next ambush around the corner even if my working life wasn't all about sick people.  Many of these horrible events have been 'mundane' and commonplace, like separation/divorce.  But in the past nine years two of them have been truly exceptional 'you couldn't make it up' things, one was absolutely horrific and the odds against it happening were probably in the hundreds of thousands.  Apart from this, there is the daily struggle of being a single parent, I am isolated and have little support.  And small things that ought to be straightforward rarely are.  An example - last week I finally had some decking finished in my garden.  A three day job took four weeks, which was very stressful.  So far, so mundane, but then it was all complicated by one of the workmen stealing drugs my next door neighbours' ne-er do well son had hidden in the back alley, having to tell my neighbours, the horrible man who ran the decking company getting angry with ME when the son pursued him for the drugs back or financial compensation and the decking man trying to use this as leverage to get me to pay immediately the work was finished with the implicit threat that he could accuse my daughters of taking the drugs!  And threatening to bring back the rubbish and dump it on my drive!

I mean, for ****'s sake, how many people have that happen?  It's almost a joke.

The combination of all this is a huge tendency to catastrophise, see worst case scenarios and it is a struggle to live normally when I have a fear of life...

No amount of trying to rationalise this is making it OK, it's barely tolerable.  I just want it to be over, to know.

My heart goes out to others in this position.

Sorry for the essay, guess I needed to unload!

Georgina x

Hi worrieddoctor. Did you find out what was wrong? I have very similar symptoms

Hi Worried Doctor 

How did you get on? I am nearly 34 and have a firm, smooth, fixed lump in my upper inner right breast quadrant and I can feel a small oval lump in my right armpit. The only thing that is keeping me going during the 2 week referral weight is that I've had a couple of contraceptive pill changes in the last 5 months. But still panicked - both my grandmothers had breast cancer in their early 50s, one died from it. 

Thanks so much xx