To have or not to have "recommended conservative excision"

GrandFlower6

Prior to being diagnosed with "...intracystic papillary carcinoma, low nuclear grade ( positive for synaptophysin by immunohistochemistry), blood clot was found in my right upper leg in October 2016, and was prescribed blood thinner medication, which I took until three days prior to my biopsy in June. I was feeling better, except for still some less painful leg cramps, when I started noticing deep red fluid leaking from my right breast. Biopsy results was provided to me July 12; My PCP arranged, and I met with the surgeon that afternoon. Am waiting to hear of surgery schedule and EKG result.

Considering the fact that I'm on blood pressure maintenance medication, leg cramp sufferer, and sometimes hip pain too... am afraid to "go under the knife", and afraid of possible complications after surgery... have a very low threshold of pain..also cannot handle pain pills.

I received suggestions not to have surgery.. exploratory is the kind I think the surgeon said it would be because they don't really know what it is under my right nipple?? .. and instead to look at alternative cure..

please help m

Moderators

Hi GrandFlower and welcome to Breastcancer.org,

We're so sorry to hear of your complications, but we're happy you found our amazing Community! We're sure others will be by shortly to offer their experiences and advice.

We look forward to hearing more from you soon! Please don't hesitate if you need any help navigating the boards.

--The Mods

obsolete

GrandFlower, so sorry you have reason to join us, and it's unfortunate that you have some complications to deal with. First, please visit the "papillary carcinoma" thread ( link below). If you read some of the articles/studies linked on the papillary thread, needling procedures (core needle biopsies included) for papillary carcinoma are not always recommended, if they can be avoided and substituted by advanced imaging to confirm papillary lesion subtype. .

https://community.breastcancer.org/forum/137/topic...

2nd, please obtain a 2nd medical opinion and further imaging (MRI, for example), if not already done so. However, please keep in mind that not all papillary tumors 5mm and under are visible on MRI.

3rd, there is usually no surer method to determine whether there are any invasions at or near the periphery of your papillary tumor other than by full wide excision with clear margins. If your tumor is believed to be located in the central region in proximity to your nipple area, please be sure your surgical & pathology team thoroughly examine cells from the nipple-areola complex tissue for occult malignant cells. If for some reason malignant cells are found, your medical team may likely wish to proceed with a biopsy of your sentinel lymph nodes to look for more cancer cells.

You did not mention the size of your intracystic papillary tumor, thus I'm basing recommendations on average 20mm (2 cm) size. You had mentioned low grade, which implies well differentiated, which is a positive attribute. The term intracystic is usually synonymous with "encapsulated", assuming your biopsy dx was correct. The one caveat is identifying whether or not there is invasion present, which might possibly involve a more conventional type of invasive cancer, which can easily be outruled by a simple wide excision.

I wish you the best in your treatment choice. Any surgery is very scary, especially with other medical complications present. Once your surgery is behind you, I promise that you will feel much better emotionally. Hugs ...