pathology results - second opinion ????

mimi32

My name is Lisa and I have become a member of the high risk club. In June I found a lump in my right breast and went for a mammogram and ultrasound. They not only confirmed the lump I had found but also a second lump and also micro calcifications. 

I was scheduled for 3 needle biopsies. My results were fibroadenoma, fibrocystic tissue and ADH. I then had an excisional biopsy which showed more ADH and atypical apocrine metaplasia. I understand exactly what ADH is but uncertain of what apocrine metaplasia is and not finding much information to answer my questions. The tissue removed was 4mm and had no edges so no more surgeries are needed at this time. Mammograms every 6 months. 

My BS wants to put me on tamoxifen for 5 years. I am 38 with no family history of breast cancer. Should I talk to an oncologist or seek a second opinion before making this decision. 

MelissaDallas

Depending on whether you are menopausal or not, Tamoxifen, Raloxifene or Aromasin are pretty much standard of care for ADH/ALH/LCIS if you have no contraindication to taking them (clotting disorder or history of blood clots, etc.)  The therapy reduces your risk of developing cancer considerably.

ballet12

Hi Mimi, as best I can tell in my brief perusal of the literature, the atypical apocrine metaplasia is a type of "atypia" found in the ducts, and because it is has atypical features, it is usually considered precancerous.  My DCIS pathology had apocrine features, so I guess it can progress to the next stage, and I, too, had questions about the "apocrine" description.  It's too bad that we can rarely, if ever, have chats with the pathologists about the reports.  About the second opinion, that's an excellent idea. If you chose to take Tamoxifen, it would better to be prescribed by a medical oncologist rather than a surgeon.

Best of luck and be well.

mimi32

After further discussing my report it also states that I have flat epithelial atypia. I have so much to learn and a lot of it can be so confusing. 

thatgirlinok

Mimi: I too have flat epithelial atypia, which I am trying to understand. You are right, so much to learn and so confusing! I just had my excisional biopsy on 7/26. Dr. said just more atypical cells, but I'm waiting to get a copy of my pathology report. I think I'm going to take a copy of my pathology reports and consult with an oncologist. My surgeon has suggested Tamoxifen, but said we would discuss it more at my follow up appointment. Its so hard to know what to do at this point.

beacon800

I had flat epithelia atypia along with LCIS.  I think your doc is suggesting the right thing to be on tamoxifen as it will reduce your risk.  FEA conveys elevated risk, but I think the ADH is a stronger sign.  It's good you had the excisional biopsy.  Sounds like you are doing all the right things.