Path Report and Surgical Consult

Likeachickadee

I met with a breast surgeon yesterday to follow up on the Stereo biopsy from the previous week.  All starting from suspicious change in a micro calc cluster in my 6 month dx mammos in Sept.  They biopsied 2 areas approx 1 1/2 inches apart.  Here's some of the reports: 

Path Diag A:  Atypical apocrine lesion with focal atypical doctal appearance and nearby atypical lobular hyperplasia, with lumin secretions/necrosis, and microcalcifications. Negative for carcinoma.

Path Diag B:  Fibrocyctic changes with cysts, fibrosis, microcalficications, columnar cell changes and focal flat epithelial atypia. Negative for CA.

Then the diagnostic comment says The Apocrine differentiation complicates the interpretation of the atypical lesion.  We believe this is approaching a DCIS pattern....

 Surgeon stressed that atypia does not mean cancer and talked about the upcoming wire guided biopsy and that if the additional biopsy doesn't show cancerous cells will possibly discuss tamoxifin due to the high number of micro calc clusters in there...

I'm scheduled for the excisional biopsy on the 29th.  Trying to not stress and worry about it, but when I really sat down just now and read the path report it's a little scarry....there seems to be alot going on in both of the areas tested last week in the Core biopsy.  Anyone with similar findings?

LISAMG

You have both ductal and lobular atypical hyperplasia, considered to be pre-malignant findings, both making your breasts "busy". This is why an excisional biopsy is warranted to be sure and/or rule out a papilloma or early staged cancer is not nearby with the micro-calcifications, meaning DCIS. You are doing all u can and being very proactive. One step at a time, but do know if this turns out to be positive, it will most likely be very early staged detection. Do u have any family history of BC? Best wishes with your upcoming surgery, sending u lots of B9 vibes & keep us posted.

Anonymous

Sounds like you have ALH and ADH, and that they think the ADH may be bordering on DCIS. The excisional biopsy is to make sure nothing more serious (LCIS, DCIS or invasive bc) is in there. Praying you get good results with nothing more serious found.

anne 

Likeachickadee

Thanks - no closeby family history.  My first cousin had breast cancer in her late 40's.  Not sure what type, but was removed with a lumpectomy, and 2 great aunts. 

 I'm trying to not research or stay on these boards too much as it just makes me worry more.  Thanks for the positive vibes!

mawhinney

It is a shame you have to wait until the 29th for the biopsy. For me waiting is always the hardest part. Take the time to read all the topics at the top of the screen. Lots of helpful and informative information.

Likeachickadee

Actually considering I have to get pre-op labs, chest xray and pre op physical squeezed in between now and then and results faxed over,  I'm ok with the 29th especially considering Thanksgiving.  That makes next week short....of course I would love it to be tomorrow and get it over with, but that's not happening.

I have resigned myself that this is the beginning of a very long process.  Either way, whatever the outcome of the biopsy on the 29th, the original issues of the micro calcs and the atypical hyperplasia will still be there and will need to be monitored and I'll at least be on the follow up track for diag mammos and potentially more biopsies.  If I can't let go of wanting this to be on my timeline and trying to control this, I'll go crazy.

Since my separation and upcoming divorce, the one thing I think I can say I've really learned/worked on is patience and just letting go of wanting to feel in control.  This is how I'm trying to approach this situation too...with patience and knowing that the only person I can control is myself....and it doesn't do any good to worry about tomorrow or regret yesterday...today is what counts!  Doesn't mean I don't have my moments...but that's my goal.

Valerie

pupmom

Ahhh, patience! That is a major lesson bc has taught me. Thoughts and prayers for you to receive totally B9 results after your biopsy!  

Likeachickadee

Well, I made it through the wire guided excisional biopsy yesterday!  Now just trying to not overthink it and wait for results coming early next week.

The wire guided mammo part was pretty rough.  Not that it was extremely painful as I was injected with lidocaine, but the stress of everything, the non-stop mammos and the inability to really breath deeply contributed to a blackout mid-procedure.  It was a horrible feeling and I think I actualy fainted for a minute or two.  The tech and radiologist were great and did everything to get me back with icepacks and amonia....finally resumed the procedured and wires into the two areas of the previous stereotactic biopsies (lesson learned:  take very deep breaths in between the mammos!).  

The excisional was uneventful as I was completed knocked out for which I am very grateful.  There's a 2 inch horizontal incision that looks pretty nasty, but surprisingly doesn't hurt....it looks like it should be very sore, but it's not at this point.  I was given a script for Percocet and took one at bedtime - just in case, but nothing so far today, just a little soreness around my armpit...which makes me wonder if he biopsied something up there or if it's just a muscular soreness.

Thanks for listening - just doing a brain dump and trying to keep my "patience" hat on as I await the results.

On an amusing sidenote, I've been getting the gel-nail polish for several months my nails have never looked better.... right now I have a very festive, sparkly ruby red polish on them and I can't tell you how many compliments I got on them yesterday.  Every stop I made during my 8 hrs in the hospital, someone was complimenting me on how beautiful my nails were!  Really made me smile and took my mind off the events a little.  Too bad none of the compliments were from eligible male nurses or docs!

 ;-)

vmudrow

Likeachickadee - glad you are done - now hoping for benign results.  My daughter has gel nails - red  for Christmas - she loves them!!