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covertanjou
covertanjou Member Posts: 569
edited June 2014 in Canadians Affected by Breast Cancer

I have been diagnosed with LCIS and ADH (with stereo biopsy) and am scheduled for an excisional  biopsy in two weeks.  

My problem is that although I have been going to the same hospital for my mammos and biopsies for the past 17 years, I am debating about whether to change doctors and hospitals for my exicision.  The reason for this is because when my doctor called me with the results of my stereo, he told me I need surgery to remove "junkie cells."  When I told him that I don't understand what this means and that I would appreciate if he told me what the pathology report showed, he QUICKLY read off the report, and said, (to my ears) sarcastically, 'do you want to hear more?"  I said no, and I researched the only thing I understood (ADH).

When I went I went in for my pre-op, I requested my pathology report and that is when I really learned what the stereo showed: Lobular Intraepithelial Neoplasia (ADH/LCIS, Fibrocystic changes with adenosis, columnar cell changes/hyperplasia, usua ductal hyperplasia and apocrine metaplasia.  Calcifications present.

What do I do?  Do I delay my surgery? I have gotten an appointment with Dr. Marcogliese at JGH this coming Friday.  Does anyone here know him?  I have heard wonderful things about him, and would love to hear from you if you know him. Do I delay my surgery?

Your advice or comments would be greatly appreicated.

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  • idaho
    idaho Member Posts: 1,187
    edited July 2009

    Oh Covert- please don't be afraid to find another doc.You have time.   There are plenty of them out there that will talk with you not down to you.  It is your body- you are in charge!  I get so tired of medical PROFESSIONALS that are flippant with patients- they act like we should understand everything they are saying and if we don't then "just do what I say" .  WRONG- Nobody has the right to talk to you sarcastically!   I am concerned also that he is recommending ANOTHER biopsy- why?  If you have already had a biopsy why another?  I would think the next step would be lumpectomy or mastectomy.... I could be wrong...........just a thought- worth checking into though.   Peace and health to you,     Tami

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  • Beesie
    Beesie Member Posts: 12,240
    edited July 2009

    LCIS and ADH are "high risk" conditions, but they are not breast cancer.  The reason that an excisional biopsy is usually done after these types of conditions are found in a needle biopsy is simply to ensure that nothing more serious is going on.  Doctors aren't worried about the LCIS and ADH - those can stay in your breast - but they are want to check that there are no cancer cells mixed in with the LCIS and AHD.  In about 20% - 25% of cases, cancer is found once the excisional biopsy is done (mine was one of those cases).  Usually if cancer is found it's DCIS - Stage 0 non-invasive cancer - but in a small percentage of cases it can be invasive cancer. 

    This isn't to worry you, since the chances are very high - 75% - 80% - that everything will turn out fine and that you won't be diagnosed with breast cancer. Given all that, there is no reason why you need to rush into surgery.  So take the time you need to find a surgeon who you are comfortable with.  If it was me, I'd leave your current surgeon too.  He has an attitude that I wouldn't put up with.

    By the way, although your biopsy report listed a bunch of different conditions, the two conditions that are the most significant - the ones driving the need for the excisional biopsy - are the ADH and the LCIS.  The other conditions are common benign conditions, nothing to worry about.  So it's actually not a big deal that your surgeon didn't mention them. 

    Good luck finding a surgeon you like and good luck with the surgery.  I hope that nothing more serious that LCIS and ADH is found.  If that's the case, then you should be put into a "high risk" monitoring program and possibly, be prescribed Tamoxifen.  Although LCIS and ADH are breast cancer, you probably should see an oncologist to ensure that you are taking all the proper precautions.

    Tami, FYI, having an excisional biopsy after a needle biopsy in which LCIS or ADH is found is the normal standard of care.  Like you I don't like covertanjou's surgeon's attitude, but his recommendation of another biopsy is exactly right.

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  • covertanjou
    covertanjou Member Posts: 569
    edited July 2009

    Thank you so much Bessie.

    I really appreciate your help.   

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  • smirks44
    smirks44 Member Posts: 77
    edited July 2009

    Hi!

     Beesie wrote a great post, but I just wanted to clarify.....she wrote " Although LCIS and ADH are breast cancer, you probably should see an oncologist to ensure that you are taking all the proper precautions."  

    I think she meant to write that LCIS and ADH are NOT cancer. 

     

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  • Beesie
    Beesie Member Posts: 12,240
    edited July 2009

    smirks, thank you for catching my error and posting the correction.  Yes, I definitely meant to say "not breast cancer"!

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