Focal Atypical Duct Hyperplasia

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  • JustmeAlicia
    JustmeAlicia Member Posts: 1,529
    edited January 2010

    Well I am sorry for allyou are going through.  I did have both of my breasts removed.  I had cancer on one side and the other side all tests came back clear.  After surgery pathology showed all typss of pre-cancer.  Atypical hyperplastia, epocrine metaplasiaa... all the stuff the cancer side started out with.  So I am glad and have no regret that they are bot gone.  BUT I will still be put on tamoxifen as I am pre-menopausal.  So not sure a mastectomy would definately be the answer but it is certainly an option.  I removed both for anxiety.  I am 42 with 2 children and just wanted to fight the fight for my life.  I am almost done with 16 weeks of chemo, and then I will be having reconstructive surgery. Tissue expanders removed implants in scar revision in March.

    Good luck to you on your decision you have come to a great, supportive, place.

    :)

    Alicia

  • goldenlotus
    goldenlotus Member Posts: 45
    edited January 2010

    I have a question about ADH - is surgical removal the treatment?

    I'm waiting to see the breast surgeon next week, my preliminary path report reads:

    1. Focal Atypical ductal hyperplasia and flat ductal epithial atypia with associated microcalcifications

     2. Focal extravascated mucin with associated microcalcifications

    3.  benign breast tissue with pseudoangionmatous stromal hyperplasia, columnar cell changes, fibrocystic changes and calcifications

    Thanks

  • Anonymous
    Anonymous Member Posts: 1,376
    edited January 2010

    golden-----the ADH itself is not cancer, but it does put you at higher risk of invasive bc in the future. The surgery is to make sure nothing more serious is in there along with the ADH (like DCIS, LCIS, or invasive bc). The general recommendation is usually for yearly mammos and twice yearly breast exams, with the addition of tamoxifen if there are other significant risk factors involved, such as a strong family history of bc. It's a good idea to talk over the risks and benefits of preventative meds with your doctor for your individual situation.

    Anne

  • goldenlotus
    goldenlotus Member Posts: 45
    edited January 2010

    Thanks Anne.  so does that mean that surgery, with or without the addition of tamox., is the typical treatment? i.e. is it likely that I will have surgery?

    thanks

  • SoCalLisa
    SoCalLisa Member Posts: 13,961
    edited January 2010

    I had a lumpectomy to have the ADH taken out...

  • goldenlotus
    goldenlotus Member Posts: 45
    edited January 2010

    Thanks Lisa - I swear......I'm not deliberately trying to be obtuse LOL - is lumpectomy/excisional bx the "standard of care"  I guess what I'd like to know before tuesday, is will I likely have surgery, or is that just for "advanced cases?  sorry to be difficuilt!

  • OG56
    OG56 Member Posts: 897
    edited January 2010

    I am assuming that the oncologist will discuss with you the benefits of Tamoxifen and give you some statitics to help you make the decision. I have LCIS and ADH plus a bunch of other junk. Sometimes when this stuff shows up in a needle biopsy they want to do an excisional biopsy to ensure that all is well.

    Wishing you the best and try not to drive yourself crazy, you will know more after seeing the oncologist. I highly recommend anti anxiety meds while in the holding pattern (:

    Hugs,

    Linda

  • Anonymous
    Anonymous Member Posts: 1,376
    edited January 2010

    golden----yes, it is pretty common to have an  excisional biopsy after ADH is found on a previous core or needle biopsy. So generally, yes, it is the next step in the process to figure out if anything more serious is going on in there or if it is just ADH. The oncologist usually likes to see you after the surgery, when the pathology report is complete, so then a plan of treatment can then be determined.

    Anne

  • goldenlotus
    goldenlotus Member Posts: 45
    edited January 2010

    Anne, thanks!  i'M SORRY TO HAVE BEEN SUCH A PAIN IN THE NECK, ASKING THE SAME QUESTION 6 DIFFERENT WAYS lol!  tHANKS AGAIN :-)

  • leaf
    leaf Member Posts: 8,188
    edited January 2010

    No problem, golden!  Some people with ADH do like to get a 2nd opinion when they get a diagnosis of ADH.  In some cases, it can be hard to tell the difference between ADH and DCIS, and they are treated differently, so some people want to get their slides re-read at a major institution (if you didn't go to a major institution the first time.)

  • KarenT17
    KarenT17 Member Posts: 46
    edited May 2010

    Hello All,

    Just wanted to update you on my status.  Yesterday I had a 6 month follow up with a mamo and sonogram.  They asked me why I was back already and I said my oncologist wanted me to do a 6 month check up.  Anyway, I have some calcifications that were seen 6 months ago but they are the same, no change.  I will now wait until the end of the year and perhaps get an MRI to follow up.  I don't want to keep being radiated either so I'll see when the time comes.  As for now, I am stable and hope that I remain that way but I will continue to update what's happening.  I'm going to touch base with my oncologist in two weeks and I'll see if they told me everything then.  Anyway, for now I'm still not taking the Tamoxifen but I'm doing everything else to stay healthy.  I wish everyone the best and to stay positive.  Time goes by so fast, make the most of it!

    Karen T. 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited May 2010

    Karen-----excelllent news! Here's to many more clear scans in the future!!!!

     Anne

  • KK0000
    KK0000 Member Posts: 1
    edited May 2010

    Hi All, I am very glad that I have found this site. I too have been diagnosed with ADH. I went and saw two oncologists and they both recommended that I go on Tamoxifen for 5 years because I am at high risk for breast cancer. I decided to start on the Tamoxifen; however, I've only been on it a little over a week and I am feeling very sick from it, nauseated, headaches every day, and increased hot flashes/night sweats. I feel like my quality of life has drastically changed. I am not feeling well at all. I am going to continue the drug a little longer to see if these side effects go away. If not, I believe I will discontinue the drug. I have been extremely stressed and upset about the entire thing which I am sure is not benefiting me either.

  • KarenT17
    KarenT17 Member Posts: 46
    edited May 2010

    Dear KKOOOO,

    I too was told I should take Tx but I declined it on several occassions.  I don't know your history but did you have a BRCA test to see if you carry any of the genes?  I did and I don't but that doesn't mean much either to tell you the truth as it only screens for certain types of BC.  Anyway if you test positive your odds increase greatly that you will get it or ovarian cancer.  Anyway, I didn't want to take the Tx becuase I too feared the side effects but in all fairness I didn't give it a chance either.  I don't like taking meds of any kind and this decision was very difficult.  After I found out that I had ADH I researched it and found that Vitamin D3 could possibly benefit me.  In addition I do all the right things as far as diet and excerise but again there are no magic potions with this F'ing diagnosis.  I was very distrought over it for a while but I am stronger now because I am going to decide my own fate.  If I made a mistake by not taking the Tx then I will accept the consequences but I do know what the risks are on both sides.  I suggest you see a third oncologist and get one more opinion.  What exactly are your risks of getting it considering your family history, I only have one grandparent on my father's side that was diagnoised with BC and she didn't die of it.  If you want to talk more you can send me a private message and I will give you my home e-mail as well.  I know how overwhelming this is becuase it's like you don't have BC but you might get it, so it's like you're always waiting for the other shoe to drop!  Talk to more people and read as much as you can.  Do your research on exactly what your diagnosis is and decide from there your next course of action.  

    Karen

  • NaughtybyNature
    NaughtybyNature Member Posts: 1,448
    edited July 2010

    Gee... here I am again... almost seven years ago my ordeal started right about now and finally on 9/5/03 I was diagnosed with BC... fast forward to this year's result, after mammogram, an ultra sound and a surgeon that was an a$$, I had my double biopsy on my good breast performed by a radiologist in his office.

    Biopsy no. 1 - fibrocystic changes including stromal fibrosis sclerosing adenosis, duct ectasia and cystic apocrine metaplasia;

    Biopsy no. 2 - all of the above and focal atypical duct hyperplasia.

    Now, this is on my "healthy" breast, and almost seven years after the first time around.

    Tomorrow, I am seeing a different surgeon (the a$$'s partner) which I connected on the phone much better.  You could think that I was imagine things if my husband wasn't present and counts as a witness to the stupidity that came out of his mouth, specially to someone that has had BC.

    Anxiety levels are running very high as the Dr. on the phone spoke about going back into my left breast and doing further testing, just like I read here regarding what some of the ladies had done.

    But to continue to live like this, every year coming along and expecting to pass with flying colors and this time around failing... not fun.  I don't want to do hormonal treatment because I hate pills (on the other hand, I see the low side effects here...and the high); I am 43 and after I finish my 4 rounds of chemo, I went menopausal, and two months later my period came back but was never the same.  On the other hand, today I woke up thinking that if I remove my breast may be I have a better chance to never have results like this... than again, the "CANCER door" was opened seven years ago and it will never be shut! 

    Have been given some names for the second opinion after tomorrow's consultation which I expect to follow up on those.

    I also had the BCRA1 and 2 tests done about 5 years ago without having any positive results. 

    I really don't know where to turn, which way to go...yet!

    Finally, I have no family history of cancer or BC... I am the history that started at age 36!

  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2010

    naughty----so sorry you have having to  go thru this again. We were diagnosed on the exact same day. PM me if you'd like.

    Anne

  • NaughtybyNature
    NaughtybyNature Member Posts: 1,448
    edited July 2010

    Today I met w/ the new surgeon and I loved him; good side manners go such a long way!

    He suggested a biopsy w/ needle localization which is already scheduled for next week... YES!!!

    We spoke more about if the results are B9, which he would suggest for me to than start a hormonal treatment; I also had  the pleasure of speaking w/ my old oncologist from NJ and he stated that he would not recommend that due to my triple negative... which I am fine with it... do not want more pills in my body... have enough as is.

    So overall, a better day, wherein in 15 days we should know if I am celebrating the upcoming 7 years of being cancer free... or not.

  • kjbrown92
    kjbrown92 Member Posts: 115
    edited July 2010

    I seem to be in the same position. I'm 41 (okay in 2 weeks I'll be 42). I've had BRCA testing last year and it was negative (though according to my doctor only 30% of breast cancer can be determined by those tests because they haven't identified all the genes responsible, etc., so it wasn't the peace of mind I thought it was going to be. My mother had BC at age 47 (premenopausal) - lumpectomy and radiation. My father's mother had BC in her 80s - found lump, ignored it for 2 years - my father had her get a mastectomy but it was already in her bones by then and she died 2 years later. I have no biological aunts or sisters. It started a few months ago, I kept having these weird "let-down" feelings in my right breast off and on throughout the day. After a few weeks, felt around. Found a lump, went to the doctor. Got a mammogram and ultrasound. Said they needed to biopsy it. The biopsy said radial scar and sclerosing lesion, so surgeon said they should take the whole thing out. Two weeks ago they did that and found atypical ductal hyperplasia. According to the GAIL model, my risk is 34%. But according to another risk calculator I found online, that takes mother's age when diagnosed into account as well as birth control use (off and on for 15 years for me), etc. it said my risk was 48.5%. So the breast surgeon wants me to make an appointment with an oncologist and a plastic surgeon to review my choices. She herself is recommending the Tamoxifen and getting MRIs and mammograms once a year, offset by 6 months. Add to that that I have chronic lyme so I already have joint pain, etc. and I have food intolerances which include dairy and corn (and two of the ingredients in Tamoxifen are lactose and cornstarch, so if I got my regular reactions to those foods - diarrhea, unrelenting back spasms, nightmares, anxiety) even without the regular side effects, I'm seriously considering prophylactic mastectomy. But I just keep doing more research. Any surgery is scary, and I've got 3 kids, the youngest is 5yo. I just read every response in this thread to see if there was THE answer, but obviously it's individual for everyone. I guess I'm looking for more opinions....

  • leaf
    leaf Member Posts: 8,188
    edited July 2010

    Well, I think the state of breast cancer prediction is in a pretty primative state.  I have LCIS, ALH, sclerosing adenoma, radial scar.  I have been given estimates of my breast cancer risk as low (or closer to) as 10% (!lower than the average woman -and this by a NCI certified center!), to in a risk calculator that has NOT been compared to populations, to up to 90% (without tamoxifen.)

    I do NOT take responsibility for a heart attack if you get extremely high values on this Dr. Hall's risk calculator - it has NOT been compared to the appropriate populations. http://www.halls.md/breast/risk.htm

    The Gail model, in the study below, does a GREAT job at predicting breast cancer  FOR A POPULATION.  It does a LOUSY job at predicting breast cancer FOR AN INDIVIDUAL.

    You may want to look at this editorial in a medical journal.  They randomly selected one woman from a group of women WITH breast cancer, and compared her Gail model score to that of a randomly selected woman WITHOUT breast cancer.  If the model worked perfectly, the woman with breast cancer would always have a higher score than the woman without breast cancer.  The Gail model and the Italian model were far from perfect.

    In other words, for 59% of the randomly se- lected pairs of women, the risk estimated for the woman who was diagnosed with breast cancer was higher than the risk estimated for the woman who was not. Unfortunately, for 41% of the pairs of women, the woman with breast cancer received a lower risk estimate than her cancer-free counterpart. Thus, for any given woman, the two models were better at prediction than a coin toss—but not by much.

    http://jnci.oxfordjournals.org/cgi/reprint/98/23/1673.pdf  (emphasis mine)

    These models assume that the factors are additive.  That may or may not be true. In many cases, we don't know if your risks are additive.  That means if you both started menstruating early AND have ADH, will your risk be higher because you add the risk of each risk factor together?  Some breast cancer risk factors seem to NOT be additive according to some authors, such as alcohol intake + some other risk factors.

  • JenPadden
    JenPadden Member Posts: 12
    edited October 2013


    I was just diagnosed with Atypical Ductal Hyperplasia by means of Core Biopsy. Surgeon then did a lumpectomy 3 weeks later to look for DCIS as a few things looked suspicious. I have two sisters who've had DCIS so the surgeon was being very careful. I am waiting for the results of the lumpectomy.


    Your posting was 2009 so how are you now?

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited October 2013


    Jen, Karen hasn't posted since June 2010.


    I hope your biopsy comes back with nothing worse than the ADH.


    Although the terms are sometimes used interchangeably, more properly you have had an excisional biopsy. A lumpectomy is an operation to remove a known cancer with clean margins. The biopsy is to explore whether there is anything more than what is known from the needle biopsy and clean margins are not the goal.


    Here is an ADH Club thread with current activity where you can get some support:



    http://community.breastcancer.org/topic_post?forum_id=47&id=773927&page=1

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