Post-Surgery Changes: Hard Lumps After Breast Cancer Treatment

After surgery and radiation therapy for breast cancer, a hard lump has been felt?

Hello Doctor, I was diagnosed with ductal carcinoma in situ in April this year, underwent a partial mastectomy in May, and completed 16 sessions of radiation therapy by July.
However, after the treatment ended, I noticed that the area around my breast and the areola feels firm, and I occasionally experience sharp pains in my chest.
I had a follow-up appointment in August with an X-ray examination, which showed no issues.

Yesterday, I discovered a hard lump in the area where I had surgery, which feels about 1 to 2 centimeters in size.
The area around the lump also feels firm, and the surrounding breast tissue and areola remain hard.
There is no pain when I press on it, and the appearance seems normal.
I have been taking my medication as prescribed, and I feel the same as usual.
I weighed myself at the end of September and noticed I gained 1 kg.

Doctor, is this phenomenon normal? Is it possible for a lump to develop so quickly, just five months after surgery?

Lu Mei, 50~59 year old female. Ask Date: 2022/10/13

Dr. Yuan Tianmin reply Breast and Thyroid

The likelihood of recurrence in such a short time is generally low; however, it is still advisable to recommend an ultrasound examination.

Reply Date: 2022/10/13

More Info

After undergoing breast cancer treatment, including surgery and radiation therapy, it is not uncommon for patients to experience changes in their breast tissue, such as hardness, lumps, and occasional pain. These changes can be attributed to several factors related to the surgical procedure and subsequent treatments.

Firstly, the hardness you are feeling in the breast area is often due to the formation of scar tissue. After surgery, the body naturally heals by forming scar tissue, which can feel firm or hard to the touch. This is particularly true in the case of breast surgeries, where the removal of tissue can lead to changes in the surrounding areas. The firmness may also be exacerbated by radiation therapy, which can cause fibrosis (thickening and scarring of connective tissue) in the treated area. This is a common side effect of radiation and can lead to a sensation of tightness or hardness in the breast.

The lump you have discovered, measuring 1-2 cm, could also be a benign condition known as a seroma or hematoma, which are collections of fluid or blood that can occur after surgery. These can sometimes feel firm and may take time to resolve. However, it is essential to monitor any new lumps or changes in your breast tissue closely. While many post-surgical changes are benign, any new lump should be evaluated by your healthcare provider to rule out any potential complications, such as recurrence of cancer or other issues.

The occasional sharp pain you are experiencing is also not unusual. Nerve endings can be affected during surgery, leading to sensations of pain or discomfort as the nerves heal. This can take several months and may persist for some time after surgery. The fact that you are not experiencing pain when pressing on the lump is a positive sign, but it is still important to keep your healthcare provider informed about any changes.

In terms of your weight gain, a 1 kg increase is generally not significant and may not be directly related to your treatment. However, it is essential to maintain a healthy lifestyle, including a balanced diet and regular exercise, to support your overall well-being during and after cancer treatment.

To summarize, the hardness and lump you are experiencing could be normal post-surgical changes, but it is crucial to have them evaluated by your doctor. Regular follow-up appointments and imaging studies, such as ultrasounds or mammograms, can help monitor these changes and ensure that they are not indicative of a more serious issue. Always communicate any new symptoms or concerns with your healthcare team, as they can provide the most accurate guidance based on your individual situation.

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