CSL/Radial Scar plus AHL

ltrinidad

I have an appointment with a breast surgeon on April 15. I received a BI-RADS 5 diagnosis two weeks ago and my pathology report came out "benign", though they did find at least a couple high risk lesions. I am sure they will want to excise the mass, not so sure about taking hormonal therapy if they do prescribe it. I would appreciate any tips or thoughts.

Breast, right, 11:00, 4 vm from the nipple, ultrasound-guided core biopsy:

- Complex sclerosing lesion / Radial scar

- Atypical lobular hyperplasia (ALH)

- Fibrocystic changes with stromal fibrosis

Comment: Immunostains for p63, calponin and E-cadherin confirmed above diagnosis.

Clinical History

Rignt breast, 11:00, 4 cm from the nipple, 1 cm irregular mass with high suspicion. BI-RADS 5

Received in formalin are three cores of yellow-white soft tissue ranging from 1.7 cm to 1.9cm in greatest dimension.

sasamat

I recently had an ADH diagnosis, found with core biopsy, confirmed via surgical excision. Together with other risk factors (a 2nd site needing biopsy, mom with triple-negative bilateral BC, BIRADS D, 50 yrs old, first full-term pregnancy at 33), this puts me in a high-risk category (40-45% cumulative risk). You can look at my previous posts to see the pathology report.

I was referred to an oncologist and we reached the joint decision for me to try low dose tamoxifen, 5mg/day. I think I either have no side effects or very moderate and tolerable side effects. I'm 2 months in. If this reduces my risk by 40%, it is a bargain I am willing to make!

This paper might interest you:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC66014...

sasamat

Hmm, I guess De Censi, et al doesn't directly address ALH, so not sure where that falls in the "benign but high risk" landscape.

ltrinidad

Hi sasamat, thank you so much for your response. I am talking today to an oncologist. I will keep posting and updating.

LivinLife

ltrinidad you likely spoke with your oncologist already... I do not know about some of what you listed above. Around here the radiologists want radial scars removed considering them a cancer risk.... I know other places leave them alone/monitor for a time.... Please let us know what you're onc said and are you ok with recommendations?

ltrinidad

LivinLife, I did talk to the oncologist, thank you for checking in with me. He basically confirmed what I had been reading these days, here in the forum and elsewhere. When there are several high-risk lesions (in my case, the radial scar and the ALH), they excise the mass and biopsy again to rule out any occult cancer cells/cancer. He recommended that, no matter what the results are, I should probably be on hormone therapy (suppressing estrogen) for 5 years, which scares me after reading the side effects others had on this site. He also talked of ALH increasing by 20% (?) my chances of developing breast cancer or cancer anywhere else in the body. I will see the surgeon on April 15 and post her recommendations then.

ltrinidad

I am now realizing I should maybe post this under "High Risk for Breast Cancer"??

MinusTwo

trinidad - see Bessie's note on your other thread. See if the mods can help so you don't have yet another thread.

ltrinidad

Thank you, MinusTwo.