Sclerosing adenosis and usual ductal hyperplasia

Laura2019

Hi,
I received these results from the biopsy:

The pathologic diagnosis of complex sclerosing lesion (radial scar) with

prominent sclerosing adenosis and associated microcalcifications, fibrocystic

changes with columnar cell alteration and focal usual ductal hyperplasia with

assocated calcifications. This is concordant with the imaging findings.

And the doctor suggests surgical consultation and excision

I am worried about it, but on the other hand i don't want to have any surgical operation

Can you please give advises about this?

I'll apreciate any opinion
Thank you
Laura

Moderators

Dear Laura,

Welcome to the BCO community. We are sorry that these breast changes have brought you here but glad that you reached out. While you are waiting on some others to offer their experiences you may want to check out these two links Common Questions and more information about radial scars. Keep us posted on what you learn and decide and let us know how we ca be of help.

The Mods

Lea7777

Hello Laura, Sorry about what you are going through which is stressful. Your pathology report looks very similar to the one I received, and the advice to have an excision is also the same. I even went to another doctor and got a second opinion on the biopsy results and whether excision was warranted. Both opinions agreed on the pathology as well as the recommendation of an excisional biopsy and both agreed that there was no rush.

Here are some reasons I was encouraged to choose to have an excisional biopsy:

1) While odds are great that there is no cancer hiding in a radial scar, there is a 15%-20% chance it could be there and an excisional biopsy can tell. Early detection is key to survival.

2) My surgeon explained that the first needle-core biospsy that showed the radial scar, sclerosing adenosis (and other atypia in my case) was the equivalent of looking through a knothole in a fence and seeing no cancer. But the knothole view is limited and you can't see the entire affected area, whereas the excisional biopsy gives a full view so you can be assured you have no cancer lurking and you can have peace of mind.

3) Removal of lesions such as a radial scar, and perhaps your microcalcifications, reduces the risk of these things becoming cancerous in the future. It was explained to me that just like you'd remove funny looking moles, certain benign lesions and abnormalities are best gotten rid of.

Usual ductal hyperplasia, on your report, is better/much lower risk than atypical ductal hyperplasia. Sclerosing adenosis slightly increases future risk of breast cancer but far less than other benign conditions. The mention in your report of "concordant with imaging" is good because what was found from your biopsy is explained by the images. More worrying is unconcordant/discordant/ non-concordant imaging which means the images don't explain what the biopsy found.

Perhaps you'd feel better with a second opinion regarding surgery. If you do ultimately choose the excision surgery, I'll mention that mine was nearly painless (levels of 1, maybe 2 at the worst during the wire insertion and for healing). I underwent a wire placement biopsy where the area to excise is located by wires inserted into the breast, under local anesthetic. Some procedures use "seeds" instead of wires. The wire business sounds scary, but it was no big deal. I did not look down at the wires because I thought it would be upsetting, but they did not really hurt. The actual surgery, in which I was completely anesthetized, and the brief recovery was also no big deal. Even less pain than the needle biopsy. My excisional biopsy result was various types of atypia, meaning a higher risk for breast cancer, but no cancer. Hopefully you too are part of the 80%-85% of women undergoing biopsies who confirm they do not have breast cancer.

Good luck to you.

Laura2019

Hi Lea,
Thank you so much for the information you gave. I appreciate it very much. Next week I'll have the consultation visit to the surgeon, and let's see what she has to say.

Thank you again,
Laura

cattledoglv

I have to say some people thought I was overreacting to having a fibroadenoma removed. The lump was painful and my surgeon said it’s best to get them out since it was symptomatic. I’m so glad I did because it was harboring several focus of ADH, or atypical hyperplasia. Some was also found in my other breast after I had my implants removed. Now I’m in a high surveillance group within my breast drs office. Imo, it’s best to know the whole picture so you know what you’re dealing with. Surgery is scary I know and you have to do what’s best for you. Good luck!