Looking for a BS in Inland Empire of California

Dustysmom

I had stereotatic Biopsy for clustered microcalcifications pleomorphic < 9mm.  Dx came back atypical ductal hyperplasia with microcalcifications and columnar cell hyperplasia. My primary has referred me to a general surgeon for 2nd opinion and follow up mammogram in 6 months.  My maternal grandmother had BC.

I am not chasing ghosts or anything but don't I need/want a excisional biopsy?  I have PPO insurance so I can go pretty much to anyone.

Any suggestions and/or infor is appreciated.

car

Dustysmom--I shopped and shopped and finally drove to Hoag for my mx. I did check into Loma Linda, but wasn't thrilled about the options available and they're notoriously bad about waits. The BS I consulted w/locally said that the skin-sparring mx that I wanted and recon just wasn't available in the IE and I should go to Hoag in Newport or City of Hope (I think that's Duarte). I've been very happy w/Dr. Lincoln Snyder at Hoag for my BS and Dr. Neil Barth (also Hoag) for oncology. As for my recon...UCLA!

I have PPO and am very happy w/my treatment.

janeinca

Janet Ihde, MD, FACS, in the Palm Springs/Rancho Mirage area, has an excellent reputation. 

Dustysmom

Thank you so much.  I will look her up and see if I can get an appointment.  This is a great time of the year to visit there too.

Anonymous

Dusty--usually they do an excisional biopsy after a finding of ADH on core biopsy to rule out anything more serious--such as DCIS or invasive bc. I would ask your surgeon about it. It's highly likely they won't find anything else other than the ADH, but it's good to check for peace of mind.  Praying your diagnosis won't change from ADH. Keep up with regular mammos and breast exams.

Anne

hbcheryl

Hi Dustysmom - I agree with Car.  I have an HMO but came out of network and paid for a consult with Dr Snyder at Hoag, he was fantastic he went through all of my reports and looked at my MRI and explained everything to me so that I understood and didn't make me feel like an idiot (as others had).  I was being totally cared for through my HMO but I just wanted to make sure because I didn't know a thing as I was new to this club. 

Cheryl

car

Dustysmom--another plug for Dr. Snyder at Hoag. From where I am  it's less than an hour's drive.I was very unhappy w/the diagnostics here in town w/my ADH dx and still having to wait 6 weeks for a stereotactic biopsy and then Redlands Community wanting me to return for the 2nd spot. I flat out refused to leave the table and told them to keep going. Hoag's comprehensive breast care center has available right there ultrasound, MRI, digital mammograms, etc. I've never gone back to my MDs in town since my experience at Hoag. My DCIS was found 6 months via stereotactic biopsy after my ADH dx--not to scare you, but to emphasize the importance of vigilance and high quality care.

Dr. Snyder now performs my annual mammos and either he or my onc orders an MRI either every year or every other year, depending on how things are going. I get all of my breast care out there, though I still get an annual w/my family practice guy here.

Another thing about Dr. Snyder is that he is very, very good about discussing options especially in cases like ADH and DCIS that are very complicated. Feel free to PM if you'd like.Frankly, w/PPO I won't deal w/treatment in the IE for this.

Dustysmom

Well, thank you CAR and everyone!

Today, I went to the surgeon that my Primary had referred me to for a second opinion.  First off, it is rather disconcerting to visit a MD that seems young enough to be my son, I know off the subject but I thought that he was nice, but he didn't actually understand thaf I had a pretty good handle on what was going on. 

He said that he was going to personally go to the hospital to review the digital films with the CAD and to spend a few days thinking about what to do before he proceeds.  He says that he doen't normally do an excisional bx at this point and then he educated me that ADH is not cancer, and that DCIS isn't really cancer...blah, blah, blah. 

He asked if I had a hx of bc in the family and I said only my maternal gm who was 86 yrs old when she had a mastectomy.  However, my mother, never had a mammo so we really can't determine an adequate hx.

He then does the physical exam and leaves the room.  When he returns, now he is saying that perhaps I should consider Tamoxifen and that he was possible going to refer me to an ongologist to determine the need for Tamox.  I just feel that he was consulting a "book" while he was out of the room and this makes me concerned about his experience.   First he is making "light" of it and then he seems more concerned.  Maybe I am reading too much into it, but it certainly makes me wonder.

I am going to contact Dr Synder @ Hoag and get a more experienced second opinion.  I feel like I appear to be chasing ghosts or something like I am looking for cancer, but I am just scared that it is only a couple of mm away and we just don't know it. 

The doctor I saw today summarized it like this...if you took a solid loaf of raisin bread and took a core sample, you might miss the raisins, but you would still have raisin bread regardless.  Hmm...I wonder who told him that?

Trying not to sound paranoid,

NIKKI

car

Nikki--I think that you're making the right choice. You are not the first woman w/ADH to whom tamoxifen has been suggested. The research has only assessed its effectiveness w/women w/DCIS and higher grades of cancer. That's more of an onc's judgment call than a surgeon. And, BTW, my onc and I decided not to go w/the Tamoxifen.

You're not paranoid--you're vigilant. You'll be amazed at the technology at the MD's fingertips at Hoag. It really is worth the drive. And again, feel free to PM.

Cheryl R.