Flat Epithelial Atypia

Lovelyface

The Microscopic Diagnosis of my Right breast reads as follows:

 Right Breast, Excisional Biopsy:

S/P core Biopsies; residual columnar cell hyperplasia with flat epithelial atypia and focal atypical ductal hyperplasia extending to the surgical margin in the 3-6:00 quadrant.  Slides A2 and A4 from the right breast biopsy were also reviewed by Drs. Ramdall and Hwang who concur with the above interpretation.

 My surgeon told me that this is nothing to worry about and that she got it all out.  It very clearly tells me that there is residual cells which as they described to me are abnormal cells which are not cancer, but like a second step out of 4 steps leading to cancer.  Since I had cancer on the left breast, how can they leave this as is, and think that a yearly MRI would be good enough to follow?

I have tried to do everything they have been telling me to do.  For instance, they told me that a roomful of doctors from different specialities will be reviewing my case and giving their recommendation as to the type of surgery and treatment.  I later read the notes and found that there were actually only 4 doctors present at the tumor board meeting.  They recommended a second lumpectomy for the left breast and an excisional biopsy of the right breast.  The left one has come with clear margins but the right one says as above.

I am thinking that maybe I should go ahead and finish the chemo and then later have another surgery to remove all this pre-cancer stuff, if possible.  My Onc. told me that this is like a breast disease and only a mastectomy could have taken care of this.  Well, why tell me now?  After I have had two lumpectomies?

Ladies, with tripple negative cancer, should I have considered a bilateral mastectomy?  Rather than two lumpectomies on the left, and a right breast with all these ugly sounding horrible cells?

Should I regret?  Should I consider a bilateral mastectomy after 4 months of Chemo?  Oh! the worst part is I am beginning not to trust my doctors anymore whereas previously I felt they will guide me step by step. I don't feel that way anymore.

shirleyinct

Dear Lovelyface - I found your post by search term b/c I just got some results back from a double biopsy on Monday for two areas that looked suspicious by MRI. This follows an initial biopsy that resulted in a IDC, <1cm, all on the right side. Pathology for the most recent biopsies reads 7 o'clock - atypical apocrine hyperplasia excision reccomended, and 3 o'clock - flat epithelial atypia. I had been considering a lumpectomy and radiation but the wait between biopsy results had me thinking about avoiding recurrence being a higher priority than minimal treatment and recovery invasion. Currently I am triple-neg too, likely Stage I, grade 1-2 (Yale and Dana Farber differ on the grade read). I am leaning towards bilateral masectomy even though the left is clean. If I can get immediate recon with skin sparing, nipple sparing DIEP Flap than I wouldn't hesitate. Even though its a major surgery, I think I'd rather not have to go through this whole mental process again. Your story adds weight to that feeling.

 Whatever you decide, I wish you all the best for treatment, recovery and moving beyond all this.