dx

You have ADH and ALH.  Columnar cell changes are changes that don't qualify as ADH or ALH.  Columnar cell changes are NOT atypical.  http://surgpathcriteria.stanford.edu/breast/columnar_cell_change/

It is the 'atypical' description that puts you at measurable higher risk of breast cancer.  (Columnar cell change may put you at higher risk, but, if so, its so small of an increase its probably not measurable.)

 E-cadherin stain is used to try to differentiate lobular from ductal.  E-cadherin is thought to be involved in adhering cells together.(E-cadherin contains the name ADHERIN - molecular biologists like to have plays on names like this.  Here's more from Wikipedia which I know is not always the most reliable. http://en.wikipedia.org/wiki/Cadherin) .  It is thought that IDC, that is usually E-cadherin +, is more apt to make tumors because the cells stick together.  ILC, which is normally E-cadherin negative, is thought to more often make sheets because the cells don't stick together. LCIS is normally E-cadherin negative also.

Lobular neoplasia covers the spectrum of ALH and LCIS.  

I also do not see any mention of DCIS.

Some women with ADH choose to get their slides re-read to make sure they are not DCIS. (Perhaps you did this already, or you choose not to do this.)

The ducts and lobules are lined with epithelial tissues.   Apparently (?) you don't have lobules as a fetus/in early childhood. Epithelial means the skin, and the (often mucous) membranes that line cavities (like the mouth, nose etc.) 

Proliferation means more cells are growing there.  So in lobular or ductal hyperplasia, you have more cells lining  the ducts or lobes (respectively). 

This site seems to explain things better in the introduction. Sounds like the innermost cells are epithelial, and the next layer in is myoepithelial.  The innermost epithelial cells tend to be cuboidal, and the next layer, myoepithelial, can be more triangular in cross section.   http://www.breastdiseases.com/benignb2.htm

I'm learning things here too - I'm not posting from previous knowledge.  I do know that some categories and descriptors can change in pathology over time.

Question for leaf or awb or any other LCIS women:  Does having ADH plus LCIS/ALH increase your risk of breast cancer more than only having LCIS/ALH?

Thanks leaf--as always--much appreciated!

Thanks Anne:  I thought LCIS was 25% and I'm sorry if we've already had this conversation.

Patricia

Predicting breast cancer is very problematic, as the paper I referred to states. For a full copy of the article, follow the links that are colored brown at the right of this citation. http://www.ncbi.nlm.nih.gov/pubmed/17148763

If you have multiple risk factors A and B, and a model that predicts breast cancer from risk factors A and B, then your risk may be A, B, A+B, smaller than A and/or B, larger than A and/or B.  You need to compare what your model predicts to the group of people that has risk factors A and B.

Even then, predicting whether or not YOU will get breast cancer is a different story.  As the paper says, because none of the risk factors (except perhaps BRCA and radiation therapy to the chest) can sharply identify the people who will have breast cancer, your Gail model (or other models that add more risk factors than the Gail model) score is a very POOR predictor whether or not you will get breast cancer. 

Nearly half the time, the person who did NOT get breast cancer got a HIGHER Gail model score than the person who DID get breast cancer.  Adding other risk factors such as breast density improved the model very, very slightly (a few percentage points.) In other words, as a concrete example, almost half of the time, the patient with breast cancer had a lifetime breast cancer risk of, say, 25%, and the person with NO breast cancer had a lifetime breast cancer risk of,say, 30%.  So this model was NOT very good at predicting which person would come down with breast cancer.

There are other models for people who do have BRCA mutations or a heavy family history.  But for those of us who do not,  there are a lot of unknowns.  In the Gail model and other models, they specifically say that you should NOT use these models to make therapeutic decisions. 

Once again, you all are so very helpful. As a 50 yo with LCIS/ALH/ADH, family history, dense breasts and other risk factors I appreciate any and all insights you have provided during the past year as I have struggled with my "options".