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Medical Forum / Diseases and Disorders / Breast Cancer / December 2004

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2nd cancer or metastasis???

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Kaye301 - 18 Dec 2004 17:55 GMT
A couple of months back I felt something on my lower back that I hadn't felt
before.  I  showed my husband and he thought it was a skin tag.  I showed my
daughter who is in her 4th year of medical school.  She didn't think it was
anything.  It is in area about an inch above my waist in the middle of my
back--over the spine.  I can't see it--even with a double or angled mirror
(ones we have aren't large enough to angle correctly).  A few weeks later I
asked my husband to check it and he thought it appeared larger and suggested I
get it checked out.  In the past I would have just called my surgeon and had
her cut it out.  However, since I've had inflammatory b.c. I am less secure
about having any cutting done in the area of my torso.  I did call my surgeon
and she thought I should call the dermatologist since she said that she wasn't
"good with things like that."  I did call my dermatologist and left a
message--but was actually more concerned about something  else--a rash on my
chest that we were monitoring.  I called him, Thursday before last and received
a call back the  next day from receptionist saying they had a cancellation for
Monday morning.  I took it.
When I went in I talked w/him about rash and almost forgot to mention growth on
my back.  He thought it was a wart and recommended shaving it off.  I asked if
surgical removal would have any advantage.  He said he "no" and also said that
it looked more like a wart than anything and he was 100% and changed that to
99% sure it was benign.
He shaved it off and put it into a bottle.  On the report to pathology he said
"wart" and that was all.  It looked smaller (something circular about 1/8 inch
in circumerance) than what I remembered feeling--something about 1/4" in size.
However, what I felt and what was shaved or what I saw in the bottle may have
been different.  he put a bandage on it, told me to wait one day before
showering and put antibiotic ointment on it (something like Neosporin, I
guess).  I forgot all about it and never did it.
In fact I put a call into him on Thursday about my rash.  So when he called
back on Friday I assumed it was to discuss that.  We did that first and then he
told me that that growth was "superficial and multifocal basal cell carcinoma."
He told me he set me up for a procedure for cauterize? or curettage.  I again
asked him if he thought surgical removal was indicated--he didn't.  At first I
didn't think anything more about and had forgotten that when he had done the
procedure he said he had been so positive it was benign.  I then remembered
that and he had also just told me that he had never seen one like this
before--it was shinier, cleaner, and smoother than what cancers looked like.
I later told my husband and was surprised at his surprised reaction.  I never
heard him say 'what' in the way he did.  It just so happened he had put a call
into my oncologist the day before and left message to ask about something re.
appt. I'd had the day after this procedure.  (I hadn't even mentioned the
procedure to the oncologist).  Anyway, the oncologist happened to call my
husband back soon after I had told him the latest.  He told the oncologist
about it and the oncologist said he was going to call the pathologist and tell
him about my history of b.c.  (I wonder if the oncologist will remember to
mention that I had IBC...).
So, I guess now I am more concerned--and would not be if it were just a basal
cell carcinoma.  I am concerned because the dermatologist had been so sure that
it was benign and that he had never seen anything like I had being malignant.
And I am concerned because the oncologist also showed the reaction he did.  And
I am further concerned because I want to get the 'right' treatment.
Has anyone here heard of anything like this before--something thought to be
basal cell carcinoma that was something different and related to b.c.?
J - 18 Dec 2004 20:39 GMT
> A couple of months back I felt something on my lower back that I hadn't felt
> before.  I  showed my husband and he thought it was a skin tag.  I showed my
[quoted text clipped - 49 lines]
> Has anyone here heard of anything like this before--something thought to be
> basal cell carcinoma that was something different and related to b.c.?

Kaye, there's a number of posters on alt.support.cancer who have had 2 or more
types of cancers.
Skin cancers are not unusual.
As best I can tell from Steph's prior posts about basal cell "a single shot of
superficial radiotherapy.."
And that's certainly how I would want it treated, if it were me.

Steph, please confirm and if you reply, you've got one "shot at it". If she replies
and/or asks questions, she does not crosspost it/them.  She seems to wonder if
basal cell cancer is  a metastasis of inflammatory (or any) breast cancer ?
Thanks
J
Steph - 18 Dec 2004 20:49 GMT
>> A couple of months back I felt something on my lower back that I hadn't
>> felt
[quoted text clipped - 107 lines]
> Thanks
> J

I can't imagine any pathologist confusing basal cell and met breast cancer

Basal cells can be cured very easily with surgery, curettage, freezing, or
radiotherapy.
Kaye301 - 19 Dec 2004 15:12 GMT
<< I can't imagine any pathologist confusing basal cell and met breast cancer>>

What concerns me is that the dermatologist  had told me at the time of the
shave biopsy that he was 99  to 100% sure it was benign.  After he called to
tell me the results he told me that he had never seen one like I had before.
It was shinier, smoother, and something else that I can't recall.  In addition
it was in an area that has gotten very little sun exposure, it was not there
before, and it was somewhat quick growing.  My husband told me yesterday that
he had become concerned by the way it was growing--lengthwise.  He had thought
possible wart, too, and had seen something like that while in dental
school--which turned out to be some type of v.d. wart.  And as far as the b.c.
I did have dermal lymphatic invasion.
Also, when my husband talked with my onc, he became alarmed and was going to
talk to the pathologist.

<<Basal cells can be cured very easily with surgery, curettage, freezing, or
radiotherapy. >>

I had a chance to email an outside private onc we have gone to for 2nd opinion
who confirmed one of my thoughts--about need for clear margins.  There are
different types of basal cell carcinoma.  If it  is of the aggressive type,
then certain procedures are recommended over others.


Kaye301 - 19 Dec 2004 15:35 GMT
<< Skin cancers are not unusual.
As best I can tell from Steph's prior posts about basal cell "a single shot of
superficial radiotherapy.."
And that's certainly how I would want it treated, if it were me.>>

I wasn't concerned initially--had forgotten all about it but because the
dermatologist had never seen something like this be cancerous and the fact that
he was 99 to 100% sure it was benign had me more concerned.  Then the response
that I've gotten from 2 oncologists has me a little more concerned along with
fact that I had dermal lymphatic invasion at time of dx.  I have had other
weird things going on with skin on my torso/chest since dx--that are out-of-the
norm that none of the treating dr's have seen before.  Also, my dermatologist
told me has only seen one case of skin metastases and one case of inflammatory
breast cancer metastases.  There are at least 9 different types of skin
metastases.  At this point almost nothing surprises me--if something rare can
happen with this, I somehow seem to be the one who gets chosen...my reaction at
this point...so, what else is new...nothing surprises me...

As far as  treatment I hadn't even realized anything further was done after
removal.  However, the thought of clear margins popped into my mind which I am
sure could not have been gotten from a shave biopsy.  Apparently there are
different types of basal cell, some more aggressive than others.  Generally,
the more aggressive type are best treated with a more aggressive approach than
the curettage (which the dermatologist recommended).  I am guessing mine is of
a more aggressive type since I don't recall it being there previously, and in
the time between I showed it to my husband and then asked him to look at it
again a few weeks later, it had grown.  He thought it was a skin tag, initially
and then thought it might me a wart of some sort which the dermatologist
thought, also.  
•*•Annie•*• - 19 Dec 2004 05:39 GMT
Kaye...
My father had a basal cell carcinoma removed about 3-4 years ago and
hasn't had any trouble since. I know we've had breast cancer so this is
different. But I think we could probably get this anyway, despite the
fact we've had breast cancer. There are quite a few peopple that
have/had this and it's treated very simply and effectively as described
in some of the other posts here.  
I know this is on your back...but have you been severely sunburned there
at any time in your lifetime?
I've heard that exposure to the sun for long periods of time [over years
and years] can indeed have an effect on our skin in later years. I know
I'm considered "later years" ;-)

I know after what you've already been through it's terribly scary to
have to go through this...but try and stay calm till you see your
doctor, and get it taken care of and you'll be fine.  
Take care here dear/God bless
My thoughts and prayers are with you...for a good outcome on this...
annie

Ultimately.....we know deeply that the other side of every fear is a
freedom.

"Courage"...is *fear* that has said it's prayers.
akoffman@attbi.com - 19 Dec 2004 13:56 GMT
Basal is the most common and treatment is surgical incision. If if was
skin mets it would show up as breast cancer. Basal is usually caused by
exposure to the sun. Chances are you will have more and need to be
checked frequently by the dermatologist. Happy Holidays. Alex
Kaye301 - 19 Dec 2004 15:25 GMT
<< Basal is the most common and treatment is surgical incision. If if was
skin mets it would show up as breast cancer. Basal is usually caused by
exposure to the sun. Chances are you will have more and need to be
checked frequently by the dermatologist. Happy Holidays. Alex >><BR><BR>

That was my initial response.  My dad had some basal cell cancers on his
face--no big deal.  I guess I am concerned because it was found on an area of
my lower back that was rarely exposed to the sun, it is faster growing and
growing in a weird way--vertically, the dermatologist had been 99 to 100%
certain that it was benign, and he said after positive dx that he had never
seen one like this before and its characteristics were those that indicate that
it wasn't a basal cell carcinoma--shinier, smoother, not brown, and it was
described as: "pale, grayish tan."  I hadn't been concerned initially--and when
I had  my oncology appt the day after it was removed, I forgot to tell the
oncologist about it--was clearly not of concern.  However, he did become
concerned when my husband described it to him.  In retrospect, I am a bit more
concerned because of all the above and the fact that at time of dx I did have
dermal lymphatic invasion.
Thanks for your response--have a great holiday season!
Guess Who - 19 Dec 2004 23:18 GMT
I just got back from  vacation, on the plane I read about this site
http://www.findcancerexperts.com/ and thought about you/

They will review the pathology free of charge.

> << Basal is the most common and treatment is surgical incision. If if was
> skin mets it would show up as breast cancer. Basal is usually caused by
[quoted text clipped - 21 lines]
> dermal lymphatic invasion.
> Thanks for your response--have a great holiday season!
Kaye301 - 20 Dec 2004 04:30 GMT
<< I just got back from  vacation, on the plane I read about this site
http://www.findcancerexperts.com/ and thought about you/
>><BR><BR>
Thanks for the info--I was wondering about having it read somewhere--that is if
I can get hold of it.

Something seems kind of weird about the whole situation.  When the
dermatologist told me--he said he already set me up for a curettage procedure
on Jan. 6.  He seemed to gloss over the fact that anything out-of-the ordinary
can be going on.  Believe me--I do hope that is the case--but something just
doesn't sit 'right' with me about all this based on my knowledge, albeit I am
certainly no expert but from the little I do know, my husband's thoughts, the
feedback I got from a 2nd opinion oncologist, and the feedback my husband got
from my oncologist.
The dermatologist had been so sure that what I had was benign that perhaps some
protocol was not followed as it should have been and by doing a curettage
quickly, nothing further can be done or checked.
My thoughts, my husband's thoughts, and the 2nd opinion onc's thoughts is that
there needs to be clear margins which might indicate further surgical removal.
Then again, perhaps the other way is better????
Kaye301 - 19 Dec 2004 15:19 GMT
<< I know this is on your back...but have you been severely sunburned there
at any time in your lifetime?
I've heard that exposure to the sun for long periods of time [over years
and years] can indeed have an effect on our skin in later years. I know
I'm considered "later years" ;-)>>

Probably -- used to lie in the sun as a teen (before dangers were known) until
I got sun poisoning but usually tanned quite easily, although first time or two
each season did get a bit of a burn

<<I know after what you've already been through it's terribly scary to
have to go through this...but try and stay calm till you see your
doctor, and get it taken care of and you'll be fine.  >>

I guess I was more surprised my husband's reaction, concern by my oncologist,
and also of 2nd opinion oncologist as well as fact that derm had been so
certain it was benign (99
% to 100%) and has neve seen a basal cell carcinoma like this.  The gross
description stated: "single, pale grayish tan shave biopsy..."  Then again, why
should I be surprised--everything about what has been going on with me re. b.c.
has been on the rare side of the stats--like less than 1% ;-)  If only those
stats were on the positive side for something like winning the lottery! <g>

<<Take care here dear/God bless
My thoughts and prayers are with you...for a good outcome on this...
annie>>

Thanks

Ultimately.....we know deeply that the other side of every fear is a
freedom.
>><BR><BR>
•*•Annie•*• - 20 Dec 2004 04:47 GMT
Kaye...
Another thing I've heard is that if you exposed yourself to repeated sun
exposure before the age of 18 this is a risk factor for basal cell as
well..and other kinds of skin cancer. But I've read this about basal
cell alot more, as opposed to other types of skin cancer.
And "everybody's different" in the way they present with some symptoms
regarding just about every condition. My father's was on his face. I'm
not sure of his overall sun exposure, but he's had no problems since he
had it removed and was treated for it. Let us know how this turns out
for you.
Take care there dear/God bless
annie

Ultimately.....we know deeply that the other side of every fear is a
freedom.

"Courage"...is *fear* that has said it's prayers.
Kaye301 - 20 Dec 2004 08:26 GMT
<< Another thing I've heard is that if you exposed yourself to repeated sun
exposure before the age of 18 this is a risk factor for basal cell as
well..and other kinds of skin cancer. >><BR><BR>

Right.  It's just that this is in an awkward position on my back.  I am sure
that in my bikini days this probably did get some sun, but of all areas
exposed, at least cumulatively, this probably was the least-exposed.
 
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