Question: In 2011 I had a double mastectomy for Stage 1A Brest Cancer. I had extensive DCIS, some LCIS and multifocal invasive cancer, the largest focus was 2mm. The margins were negative for both DCIS, LCIS and invasive cancer. The muscle and deep margin were negative. The DCIS was Intermediate and the invasive was Grade 1. My concern is one year ago I found a pea sized lump in my reconstructed (silicone implant) breast. It is on the cancer side, but not near the cancer location. I had 1 MRI and 3 ultrasound follow ups since. The imaging is all negative. See attached most recent ultrasound report. You can feel the lump, but not see it on imaging. My concern is could it be a low grade cancer that is not showing up or could the lump be in the muscle and not showing up? You can feel it more when I am standing vs. when I am lying down. Both my breast surgeon and oncologist feel it would show up due to the mastectomy and lack of breast tissue. They do not recommend removing it. I am unclear whether I should insist on an open biopsy. Please give me your opinion.

Thank you for your reply. Would a breast ultrasound reveal any type of malignancy even if small, due to the mastectomy? The radiology tech stated there was just implant and skin and nothing showing. Would a soft tissue know feel smooth and round/oval? This is how the lump feels.