ALH dx on stereotactic...clip movement?

Sashie

 Hi There,

I hope you don't mind that I cross posted this, but I thought it would be good to post here too. 

I had a stereotactic biopsy for calcs and had a titanium marker placed. At the time of placement it immediately moved 2 centimeters. They found ALH and wanted to do an excisional. I read the literature which seemed to be wishy washy on whether it area should be excised and I did not have it done. Anyway fast forward 14 months since the stereotactic. I had a repeat mammo in January and everything looked fine. But now I am questioning my decision to not have it biopsied further. I keep thinking maybe there are precursor cells in there. I would like to have the area taken out and examined but now I am afraid it is too late and they may not get the right place. Hence my question about clip movement ...do they continue to move around as time goes on?

I went to see the surgeon a couple of weeks ago and he said I wish you would have done this a year ago... your clip has moved (which I think he meant originally). Anyway he said the procedure was still recommended but I got the feeling from what he was saying that he didn't think it was all that good of an idea still.

I am totally confused once again as to what to do. Please give me your opinions.

Thanks so much for you input,

Sashie 

 

idaho

Could you get your mammo films from when you had your biopsy?  Do you mean it immediately moved (like right after biopsy) or a couple days later?  If it was a couple days later they could look at the mammo and maybe do another biopsy from where the original was done.?  If your mammogram looked ok I would think you are ok.  If you are really nervous you could have an MRI done, or an ultra sound, they can sometimes see things that mammos miss.  Peace to you, Tami

leaf

Did they remove the calcs during biopsy?  Sometimes they miss. If you still have the calcs in, that would be a 'natural marker' for them to use.

I would imagine they may have to take out a bigger area than they would have otherwise.

But they may go all over your breast in an excision anyways.  I had my excision almost 2 months after my core biopsy.  (They did not put in a clip at that biopsy.)   I had a biopsy for ultrasound abnormalities a year later.  This 2nd biopsy ended up being scar tisse.  The place they biopsied was an inch or more away from my original core biopsy.

One person posted here and said  her surgeon told her the wire insertion (they inserted a wire into the area of the calcs a few hours before her excision) did NOT help in finding the area.  

Some of the factors that may go into making your decision include:

a) potential external shape changes of your breast - if this happened, how would it affect you?  It may be much less notable, or invisible if you have larger breasts (vs smaller breasts).  (I have almost no change in shape - I am a B cup.)

b)  internal scar tissue created (making it harder to read subsequent imaging)

c) How well do you handle uncertainty - what are your feelings about missing an area of higher risk vs risk of getting the wrong place and the factors above.

Another factor is that it is good that, as far as you know, you have not developed breast cancer in the past year.  Also, the ACS has opined that in SOME cases, they do not feel an excision is needed. 

You may find this thread interesting. http://community.breastcancer.org/forum/95/topic/702563?page=2#idx_40

I have LCIS and ALH, so LCIS women are at higher risk than ALH alone. I am glad I got excised.  Its hard to make these decisions.  There is no Right Answer for everyone.