what the hell?!

colettekathryn

Hi everyone,

New to the site. Here for some help. 

After annual mammogram, was referred back for a cone biopsy. Results came back as "histology shows DIN 1A and DIN1B" and recommendation was lumpectomy. They had put a titanium chip in at the time of the biopsy. Group of calcifications is approximately 12 mm.

My family doctor looked at the results and said she had never heard of this and she actually googled it. (!?) She said the actual name for it is:

DIN 1A = flat epithelial atypia

DIN 1B = atypical ductal hyperplasia

My question is: is this the same thing as ductal carcinoma in situ but with a different 'less scary' name or is it something completely different?

Thanks,

Colette 

Beesie

No, ADH is not DCIS but it's not completely different either.  ADH is a high risk condition; generally the breast cancer risk level associated with ADH is in the range of 16% - 25%.  Where you fall in that ranges depends on your age and what other risk factors you may have.

If ADH continues to develop, usually the next step is DCIS.  So when ADH is found in a needle biopsy, usually an excisional (surgical) biopsy is done, removing the entire suspicious area in order to ensure that nothing else is lurking with the ADH. You mention that you are having a lumpectomy; that's the same as an excisional biopsy.  Most doctors prefer the term excisional biopsy because no cancer has been diagnosed, and the purpose of the surgery is to do a more extensive biopsy.

Hope that helps.

Edited to Add:  Flat Epithelial Atypia (FEA) is similar to ADH (and might be considered a type of ADH). So the same applies to the FEA - it's not DCIS but is a high risk condition.

colettekathryn

Beesie!

Thank you!!!! You explained it in a way that no one else has been able to. You're right; it is a excisional biopsy not a lumpectomy. So it's kind of a 'wait and see' type affair...

What a gift this site is for so many. 

Warm regards,

Colette

JMH56

I am also new to the site and I was also diagnosed with FEA (DIN A1) and said the same thing.... What the....



I am meeting with an oncologist to discuss doing the excisional biopsy. They also mentioned going on tamoxifen. Which honestly I am not willing to do yet.



There is not much out there on the Internet and that worries me a bit.

JMH56

I thought the slides in this were interesting http://www.bccancer.bc.ca/NR/rdonlyres/0CAEEE33-5CEC-4C61-B835-99867F75C19D/42507/DrCeballosProliferativebreast.pdf

Beesie

To my understanding, FEA is believed to present less risk than ADH and ALH.  The DIN scale puts FEA as DIN 1A, ADH as DIN 1B, and low grade DCIS as DIN 1C.  Intermediate grade DCIS is DIN 2 and high grade DCIS is DIN 3. Generally FEA and ADH/ALH are considered to be high risk conditions, but not pre-cancers and certainly not cancer.

There is a lot of debate on this board among the women who are high risk about taking Tamoxifen.  You might want to read and join some of those discussions. 

Here is one discussion thread that is very active and current:  Topic: ADH Club