Atypical Hyperplasia

rbcrhodes

Atypical Hyperplasia

rbcrhodes

yesterday I had a follow up visit with my surgeon following and excisional biopsy. Although it turned out B9 - he said I have something called atypical hyperplasia.  He said this will cause me to have to have mammos every 6 mos and they will keep a very close eye on any changes at all. He asked if we had breast cancer in the family and I did not think we did. However, after some investigation I've found that I have two first cousins on my mothers side  who had masectomys and my dads mothers  sister had a double masectomy. 

Can anyone tell me about atypical hyperplasia and if this new family information I have found is significant enough to call my sugeon to let him know. My path report said this "fibrocystic changes seen in the sections include fibrosia, microcysts, apocrine metaplasia, adenosis inlcuding sclerosing adenosis, and ductal epithelial hyperplasia including focal atypical hyperplasia. involvement of the biopsy margin by atypical hyperplasia is not seen. There are scattered intraglandular microcalcifications"

lvtwoqlt

Atypical hyperplaysia does increase your risk of developing BC. My history is similar to your except my mom had bc in 2001 and her sister had OC in 1978. Breast cancer and Ovarian cancer both run in the same set of genes. My mom was tested after her dx and she was negative but the family history is important. I was dx with ADH in jan 2005 in the left breast and put on the 6 month mammo. 18 months later (aug 2006) ADH in the right breast. After the second dx for me the surgeon put me on tamox but last year I was dx with DCIS. It was found early, no invasion into the breast or lymph involvment,  so the bilat mast I went through was all the treatment I needed.

As long as your surgeon is ordering the mammos every 6 months, you are in good hands. You can wait to tell him the history that you have uncovered at your next appointment. The close monitoring is good in detecting any changes and if it does change they will find it early.

Sheila

Anonymous

I had an excisional biopsy earlier this month, and I was diagnosed with atypical ductal hyperplasia (ADH). Having ADH does increase your risk of developing breast cancer.

I have family history too, and my surgeon referred me to an oncologist for follow up.  The oncologist ordered a breast MRI, to make sure there is nothing else going on at the moment (I'm waiting for the results now).  I will also have mammos every 6 months, and the oncologist wants me to see both her and the surgeon annually, but to alternate the appointments so I see one of them every 6 months (for a clinical breast exam and to review the mammograms).  I'm also a candidate for Tamoxifen, but I'm going to wait and see if the MRI shows anything before I make a decision. 

I agree with Sheila, you can certainly wait 6 months and tell your physician about your family history then.  The only thing he/she would do differently at this point would be to refer you to an oncologist to discuss taking Tamoxifen.  While Tamoxifen has been shown to be effective in cutting the risk of developing breast cancer in high risk women, it can have some potentially serious side effects. 

Dukemom

Beth1128

I too have been dx w/ADH after having a core needle biospy on a lump that had changed over the last few yrs (it was biopsied yrs ago and it was ok...then) now they are taking it out to biopsy the whole thing June 17th...do u think they suspect to find DHIS? or is it just routine because now Im wondering why didnt they just say..ok u have ADH we will keep an eye one it...altho I totally agree w/the only good lump is in the jar ....when in doubt take it out!

lvtwoqlt

Beth, for me it was standard procedure to remove the area surrounding the core biopsy showing ADH just to make sure that they didn't miss anything with the needle biopsy. I was through the needle biopsy/lumpectomies 3 times in just over 24 months. I told the ladies in the radiology dept who did the sterotactic biopsies the second time, 'been there, done that, got the t-shirt. The third time, 'I'm looking for Bill Murray and singing I got you babe.'

Sheila

Beth1128

Sheila, thanks for the response and I love that song! I got you Babe!! 

othershoe

Hi, DukeMom2 - I had the same this past month - excisional biopsy with ADH (and also LCIS).  I had a Gamma test to look at the breasts more closely (also called a "nuclear" test), and will probably have a core biopsy on the other side now.  But... anyway... I will also consider Tamoxifen, once I have all the info in front of me. I will look forward to seeing what you decide to do, given your own circumstances.  It's interesting to know someone somewhere going through something similar... (by the way - where did you get DukeMom2? Did you go to Duke U?  I did.)

Thanks for sharing your story.

3girls4me

Hello!

Just concurring with the others here, and wanted to add that when ADH is present, 30% of the time DCIS will be as well.  In your case, it sounds like they didn't find DCIS, which is good.  In the progressive breast cancer charts, if you've seen one, ADH is just one step below DCIS.  No one knows for sure if ADH develops into DCIS, which then develops into invasive cancer.  So your doctors' choice to monitor you is a good one!  ADH and DCIS can look very similar under a pathologists' microscope.

In my case, I had a benign lump that was biopsied.  Upon the biopsy, they found ADH incidentally in the same area, so I had to have another excisional biopsy to rule out if there was DCIS as well.  Unfortunately, my ADH was DCIS.   Ultimately, I decided to have bilateral mastectomy.   And in my "good" breast, the pathology report showed an "area of ADH approaching DCIS stage".   So I'm thankful for my decision.  I have no history at all of breast cancer in my family.

leaf

Hi there! There are 2 types of atypical hyperplasia, ADH and ALH. (I have ALH as well as LCIS.) Different doctors or places have different protocols for following higher risk people.



Some places have more frequent monitoring for 6mo-1 year after any biopsy, then if they turn out clean the follow them less frequently. But this differs from place to place.

rbcrhodes

Thanks you guys for so much feed back. The biggest problem I'm having is not being able to take hormones and all the hot flashes are coming back. The doc said not even homeopathic! Someone said eating a sweet potatoe each day helps! I'm ready for anything. 

I have to admit I think knowing this could be a potential problem has me a little on edge. I've been doing weight watchers and have lost 27 lbs. I'm eating better. However, I have a lot of stress in my life (just life situations) so I know I need to calm that next.

Any other suggestions?

Peaches70

rbcrhodes,

I hear you about the hot flashes. Last summer, between the heat and the Evista and menopause, I was miserable. Hopefully this year will be better.

I have found a few things that seem to help with the hot flashes. I use cold packs on my neck. At night, I take an actual little cold block (like you use in a cooler) and wedge it behind my neck, scrunching up the pillow to help cushion the edge. I lay on my back as long as I can stand it. I also put a glass of ice near the bed to sip when I wake up. I tend to wake up just before the hot flash hits. We have a fan at the foot of the bed, even when it's not hot. I wear the lightest nightie I can find - plain cotton or blend. I keep my feet out of the covers.

During the day, I take the cold packs you use for pain relief and wrap them around my neck or tuck them into a neckline. This and cutting back on caffiene seem to make a difference, albeit it small. The other thing that I have read about recently in more than one place is that exercise helps for most people. I do exercise a lot. I have to admit that days when I do seem a little better than those when I don't or can't.

Oh, for the time when I could take HRT. That really worked.

Anne

leaf

Historically, Mexican yams were used as the source to make norethindrone, an ingredient in traditional birth control pills. http://www.ncbi.nlm.nih.gov/pubmed/1481227



The ingredient in yams, diosgenin, could possibly have an effect, but I'm sure much more study needs to be done on this.



http://www.ncbi.nlm.nih.gov/pubmed/18022396



http://www.ncbi.nlm.nih.gov/pubmed/15913148





For me, I found biofeedback helpful for stress reduction. We are all different though, so what works/appeals to one person will not be the right thing for the next person.