ALH, PASH, Sclerosing Adenosis - Remove?

blaketots

I am 47 years old and high risk (27.2%) and have MRI and mammo screens rotating every six months. I also had a breast reduction in 1995 so I have quite a bit of scar tissue and I also have dense breasts - my mother had DCIS removed at age 63.

I had a prior biopsy in 2015 that was a ruptured cyst with fibroadenomatoid change. Fast forward to October 2021, a new enhancing mass was found on my MRI. I had my biopsy last week which is within a few centimeters of the prior 2015 biopsy. The results are as follows:

Atypical lobular hyperplasia involving nodular sclerosing adenosis.

Additional findings of microscopic fibroadenomatoid nodule,
columnar cell change and pseudoangiomatous stromal
hyperplasia.

Is it reasonable to ask that this area be surgically removed in case there is cancer nearby? I'm concerned about how many benign things they found, but maybe this is common and I'm worrying for nothing?

My doc has only suggested Tamoxifen so far, but I am meeting with her next week to discuss all options. I also have a genetic counseling appt next week as well.