TNBC: Pain in armpit, how do I ensure it's not cancer coming back?

Posted by maryk65 @maryk65, Jul 12, 2022

I am 6 month survivor of TNBC. I had chemo, lumpectomy and radiation. All my biopsies were negative. I’ve been having pain in my armpit and area of tenderness near armpit. They did diagnostic mammogram and ultrasound and did not see anything suspicious. I have dense breasts and my cancer did not show up on mammogram. I’d like MRI every 6 months but my doctor won’t do that. I’m terrified this tenderness is recurrence. Any advice appreciated!

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@lcr2017

There is also something called lymphatic cording. Thin little cords form and pull. Most doctors do not know what it is and some PT clinics don’t know because they don’t have a specialist in lymphedema or breast cancer. I went to a PT lymphedema specialist in the hospital as an outpatient. They said they had to break up scar tissue and that I had a lot more “cording” than I realized. Lots of exercise involved. Hope it’s as simple as that and be persistent about being evaluated for lymphatic cording. It’s a real thing.

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@lcr217
You are spot on. Besides lymphatic cording, it is also called axial webbing. I could barely lift my arm at one point and you could actually see the lymph cords from my armpit down to my wrist. Luckily, our PT department are highly skilled in treating breast cancer patients. It took about 6 appts to get mine under control. I learned how to put pressure on the pressure points from my wrist upward through the armpit and then breast. Part of the problem @maryk65 also may be from radiation which can cause the area in your breast to become scarred and harden. Mine felt like blocks of cement which caused a lot of pain and I still have a bit to this day but not as bad. The PT specialist has me using a "swell spot" for a week or two under my bra which helps break up the lymphedema and it also helps to soften the area. In addition, I do the exercise program which they teach breast cancer patients (at Kaiser) that include stretching, weight lifting, and core strength training. One bit of advice is if you drink caffeinated drinks or eat chocolate, caffeine can cause inflammation of lymph nodes which can also cause pain. My best advice -- see if PT in your area are educated in helping breast cancer patients. It really makes a difference.

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Great explanation Trixie1313!

MaryK65, I got a lump in my armpit a day or two after my first covid shot. I freaked out thinking it could be cancer again. I called my doctor’s office, her nurse said that it’s common for lymph nodes to swell with flu/virus shots. It took about 2 weeks for the tenderness and swelling to go away.

Your armpit pain could be something very simple too. Keep in touch with your doctor for your individual situation, and keep us posted about your progress. We all care about one another!

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@maryk65

The pain comes and goes and I haven’t noticed any swelling. The tenderness is always there.

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I was diligent about doing my PT for cording and lucky to have found 2 therapists whose specialty it was. They told me that most of their patients didn’t work as hard as I did (meaning I did the exercises at home also) and took the time to print out a booklet of the exercises that seemed to help me most. ( some centers also have video that can be downloaded.) I continued to do that when I discovered yoga and so many stretches and twists were similar. I have switched to that for 2 years now. My lymph nodes do bother me but in my day to day I realize it’s worse after being with my granddaughter who is only 23 lbs at 2yo! So I pick my battles. I will not give that up! She still says “I hold you Nettsie,” when SHE wants to be held! Then I do some yoga. Lots of good apps and YouTube. I landed on Sara Beth Yoga (good instruction for newcomers) and choose the body part that needs attention. My cancer center also has virtual yoga which was in person before Covid but I haven’t done that because it’s easier to workout when I feel up to it.

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Can I ask what the reasons are that your oncologist won’t order a breast MRI? Especially given that you have dense breasts. ♥️

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@lisakinpa

Can I ask what the reasons are that your oncologist won’t order a breast MRI? Especially given that you have dense breasts. ♥️

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She said it hasn’t been proven to increase survival. It’s the hospital’s protocol. They also fight me on doing ultrasound saying they don’t use those for screening.

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@maryk65

She said it hasn’t been proven to increase survival. It’s the hospital’s protocol. They also fight me on doing ultrasound saying they don’t use those for screening.

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I know my suggestion may be difficult to do but I would call my insurance company to see if I can see another oncology practice for a second opinion.

Perhaps your breast surgeon can weigh in? ♥️

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@lisakinpa

I know my suggestion may be difficult to do but I would call my insurance company to see if I can see another oncology practice for a second opinion.

Perhaps your breast surgeon can weigh in? ♥️

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That is my breast surgeon’s recommendation. My oncologist left and I see new one in September. I’m going to ask her what she thinks when I see her.

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I would second getting a different team if you can. I too have dense breasts and TNBC, and my standard monitoring after my expander came out was a MRI and Mamagram every year staggered so I get one every 6 months.

Well, my first MRI found something against my ribcage on my side where no breast tissue should be, so we had to follow with a Mammogram and Ultrasound, then a biopsy and clip. It's benign, but that now has escalated all three screenings to be done every six months.

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@maryk65

She said it hasn’t been proven to increase survival. It’s the hospital’s protocol. They also fight me on doing ultrasound saying they don’t use those for screening.

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I am in NJ and I was under the impression that dense breasts= mammogram + ultrasound because a law was passed in 2014. I thought it was every state. If it weren’t for the ultrasound, they would not have found the cancer in the second breast which was invasive. My gyno would always write the script. My insurance covered it. Now I alternate ultrasound and MRI, but if I have discomfort, they will seek approval for MRI. It’s my surgeon’s decision and not the oncologist or the hospital where he is. My sister, who sees a PCP, has to argue every year and it’s written “if needed.” I always tell her that they can’t always tell when it’s needed. The second cancer didn’t show up on the mammogram. Mammogram detected one breast, ultrasound, the other.
I think there’s a difference between detection and survival.

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@maryk65

That is my breast surgeon’s recommendation. My oncologist left and I see new one in September. I’m going to ask her what she thinks when I see her.

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@maryk65 May I suggest, when the new oncologist gets there, if prior to your September appointment, you call for a phone consultation or better yet a telehealth to discuss your upcoming appointment. This way she will be familiar with your case and recognize your face. It will give her a heads up about you and maybe she will actually look into the situation prior to your appointment. We have to advocate for ourselves and be proactive. Good luck. My tumor was found by a MRI , not by the Mammo. Blessings to you. Please come back and let us know how you’re doing. Hang tough. 💪🏼

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