HISTOPATHOLOGY REPORT

LL12 · February 2009

Hi, 43 years-Asian Lady.Family History-maternal grandmother and grandmother's sister died of Breast Cancer. Mother had ever removed fibroadenoma lump in Year 06 and this year follow up Mammo reported normal. I had an operation to remove bilateral lumps(except breast cysts) on Jan' 08 & Feb' 09. Suffered from hormone imbalance, now having uterus fibroids and ovary cysts yet to remove. In Nov'08 had an operation to remove endometrial polyps.

Recent Mammotome Biopsy

DIAGONSIS

A.Right Breast Lump-10 o'clock-Fibrocystic change with columnar cell alteration.

B.Left Breast Lump-3 o'clock-Fibroadenoma with adjacent fibrocystic change.

C.Left Breast Lump-4 o'clock-Fibroadenoma with adjacent fibrocystic change.

MICROSCOPIC DESCRIPTION

A.Sections of breast core show fibrocystic change featuring ductal dilation, fibroadenomatoid hyperplasia, columnar alteration with focal hyperplastic changes and mild cytological atypia, stromal fibrosis and chronic inflammation. Focal intraluminal microcalcification is noted.

B.Sections of breast cores show a circumscribed benign fibroepthielial lesion composed of breast ducts and tubules dispersed hapzardly in a fibromyxoid stroma containing plump stromal cells and a few chronic inflammatory cells. There is no stromal overgrowth, increase mitosis or cellular atypia.Features are consistent with fibroadenoma. Adjacent breast parenchyma shows features of fibrocystic change, ductal dilation, mild adenosis, focal apocrine change, stromal fibrosis and chronic inflammation.

C. Sections of breast cores show a benign fibroepithelial neoplasm composed of compressed breast ducts and tubules dispersed in fibromyxoid stroma. The lesion is well circumscribed and multilobulated. There is no stromal overgrowth, increase mitosis or cellular atypia. Adjacent breast parenchyma shows fibrocystic change featuring mild ductal dilation, stromal fibrosis, mild chronic inflammation and mild adenosis.

A, B, C - There is no evidence of insitu or invasive malignancy.

Due to my breast conditions, me, developing into breast cancer in the near future is very high right? Right now I can't relax myself in peace and have suffered from probia of breast cancer. My next close follow up Mammo and U/S will be on Aug'09

Need help to understand the report.

Please advise and millions thanks.

Anxious Lady

Kimber · February 2009

Anxious,

I have a lot of the same pathology as you and my surgeon describes it as changes that happen as we age. Sounds like you are fibrocystic, which means you are lumpy and bumpy and probably dense. It sounds like they are keeping a close eye on you, which is good. Have you had a breast MRI? It may be a good idea to go for a baseline. It may put you at ease.

Kimber

Anonymous · February 2009

Actually, from what your pathology report says, it all sounds pretty benign. I would think that your risk shouldn't really be increased that much at all--a talk with your doctor should put your mind more at ease. The only one I would question is a "mild cytological atypia" in section A, which might increase it slightly from average.

Anne

Beesie · February 2009

"Due to my breast conditions, me, developing into breast cancer in the near future is very high right?" Actually, no. I agree with Kimber and Anne. I've had those same conditions - they are all benign and for the most part, totally harmless. If there is any increase in your risk to get breast cancer as a result of these conditions, it is a very very small increase, nothing to worry yourself about. I have had breast cancer, but my breast cancer was completely unrelated to these conditions, and in fact my breast cancer was found in the opposite breast from the one where I'd had these previous problems.

Still, because you have fibrocystic breasts, it can be difficult sometimes to distinguish between a harmless lump and a lump that is of more concern. So it is important that you get regular screening. And at your age, having a solid lump in your breast such as a fibroadenoma can be a problem, not because of the fibroadenoma itself but because when you have mammograms and ultrasounds, the fibroadenoma blocks the view of any breast tissue that is behind it and something more serious could be hiding back there. So while it's quite normal to leave fibroadenomas in the breasts of younger women, once you are in your 40s, it's usually recommended that fibroadenomas be removed, just to be on the safe side.

LL12 · February 2009

Hi Kimber, AWB & Beebie, thanks for your advice and reply.

Yes, indeed I' do suffer from Fibrocystic breast disease for the past few years. Only in Year 2007 few lumps were discovered. Thereafter, few lumps were removed and recurred in Year 2008 again. I did not do any MRI but only follow up with Mammo and U/S. No hormone test, blood test and genetic test yet. Should I go for all these test? Now my daily diet I eat rolled oats, flaxseed, sometimes oat bran, so do these food help on my breast conditions ? I have totally eliminated myself from caffeine, chocolate to avoid breast pain. In year 1994/1995 and year 2008, due to my irregular mensuration and unhealthy colour discharge-red,cloudy etc, doctor had prescribed me with oral contraceptives pills. I had taken more than 1 and half years, my question is, do these pills caused my breast conditions to get worst?

I did not give birth and due to my family history, I have encountered all sort of woman related disease-breast cysts and lumps,endomertrial polyps, ovaries cysts and uterus fibroids. Just frustrated with all these problems.

Please advise and thanks in advance.

Anxious Lady

LL12 · September 2009

Hi Professional

I'm 43 years old Asian Lady without giving birth. I had removed bilateral fibroadenomas breast lumps twice in Jan'08 and in Feb'09. My maternal grandmother and grandaunt died of breasts cancer. My mother had also removed fibroadenomas lumps in Year 06.

My recent Mammography and US scan is as follows:-

Diagram puts on record a curvillinear scar at the supraarolar area of the (R) breast and laterally of the corresponding (L). A normal size lymph node is demonstrated in each axilla. Multiple benign looking cysts are demonstrated in each breast (20 in the right and 21 in the left). Shaded are complicated cysts with no solid nodule within. Two are septated sited at the 4 o'clock (L) periareolar area. These cysts range from 0.2 to 1 cm. Rest of her fibroglandular breast structures appear normal in the U/S modality. Small area of architectural distortion is observed at the upper outer quadrant of the (R) breast, infero-laterally of the upper outer quadrant of the (L) breast and central laterally of the lower outer quadrant of the (L) breast too.

Mammogram shows a fat necrotic calcifications supero-laterally in the (R) breast. There are a few scattered small dystrophic calcifications noted. There is no clustered microcalcifications/growth suggested. There is no dilated laciferous duct. Skin margins are normal in thickness. Nipples are cleary protruded.

COMMENTS:

Biphasic study shows no clustered microcalcifications/growth

Patient has multiple cysts demonstrated in the breasts. There are 20 in the (R ) and 21 in the (L). Shaded are the complicated cysts with no echogenic nodules within. Two septated cysts are recorded at 4 o'clock (L) periareolar area.

Suggest an U/S examination for follow-up in 6 months' time after your clinical review.

May I ask due to I have 41 cysts, will my cysts multiple again and then my breasts will be full of cysts and due to this will cause more breast pain? Do cut down on caffine and chocolate reduce my cysts? I also fearful of breasts lumps recurr again and what diet should I eat to prevent breasts cancer to attack me before I reach 50 as my grandmother died of breast cancer at the age of 50.

Thanks in advance for your professional advice.

Best Regards
Anxious

HISTOPATHOLOGY REPORT

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