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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Diffuse Skin Thickening , Increased Parenchymal Density In Breast With No Axillary Lymph Nodes After First Lumpectomy. Another Surgery Required?

what is parenchymal density and cystic mass? If marked diffuse skin thickening and increased parenchymal density were seen in a breast with no further axillary lymph nodes after first lumpecotomy, do the patient needs to undergo another surgery or just needs a radiation and chemoterapy process to dissolve the skin thickness?
Sat, 6 Jul 2013
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

It is evident from your history that you have under gone a breast surgery for breast cancer.
Post surgery, appearance of breast parenchymal density and thickening of the skin can be due to recurrence of breast carcinoma.
This is just one possibility and you have to be more cautious after the cancer.
However, it can be confirmed or ruled out after few investigations.
A fine needle aspiration and/ or biopsy of the thickened area and lump 9if present) may be required.
Further management- surgery, chemotherapy or radiotherapy can only be decided after the investigations.
Chemotherapy is generally given if there is lymph node involvement by the cancer cell metastasis.

Thanks and take care
Dr Shailja P Wahal
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Oncologist, Surgical Dr. Poovamma CU's  Response
Hello,

Parenchymal density, just describes the density of the breast tissue which varies from person to person, only an abnormal dense mass or asymmetrical density is of significance. Cystic mass is a fluid filled cavity which may be a simple or complex.

A physical examination and complete review of reports is necessary before deciding on further treatment. Since details of surgery and pathology reports are not stated. The need for further will depend on this. (Has the skin thickening, increased density noticed post surgery or were these present pre surgery)
The need for chemotherapy will be decided on the tumour size, grade, lymph node and hormone receptor status.
Radiotherapy is a must if you have undergone cancer surgery and the breast have been saved.

Take care
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Diffuse Skin Thickening , Increased Parenchymal Density In Breast With No Axillary Lymph Nodes After First Lumpectomy. Another Surgery Required?

Hello and welcome to HCM, It is evident from your history that you have under gone a breast surgery for breast cancer. Post surgery, appearance of breast parenchymal density and thickening of the skin can be due to recurrence of breast carcinoma. This is just one possibility and you have to be more cautious after the cancer. However, it can be confirmed or ruled out after few investigations. A fine needle aspiration and/ or biopsy of the thickened area and lump 9if present) may be required. Further management- surgery, chemotherapy or radiotherapy can only be decided after the investigations. Chemotherapy is generally given if there is lymph node involvement by the cancer cell metastasis. Thanks and take care Dr Shailja P Wahal