So, I saw the Breast Surgeon yesterday....

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goldenlotus
goldenlotus Member Posts: 45
edited June 2014 in High Risk for Breast Cancer

I really like him, no need, at this point for a second opinion.  I was very comfortable with him

He is scheduling a wire located excisional biopsy.  the bad part is, it won't be for another 3 weeks!  he only does 3 of these procedures a week, on a friday.  this friday is too soon to get preop etc done, next friday he is booked, then he is out of town the 12th so it is scheduled for 19th.  i'm bummed i have to wait so long.....

one interesting this is that when i went in, he had all my papers on his desk, he gave me a copy of the path report, he also gave me a book about breast cancer?!  he would not give me stats on whether or not my dx would stop at ADH upon excision..... so it makes me wonder if they 'suspect' something.

anyway, all that said - i was really comfortable with him, he was kind, very explanatory, and was not in a hurry.....  i just wish i could get this over and move on. sooner.

thanks for listening :-)

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  • redsox
    redsox Member Posts: 523
    edited January 2010

    ...so glad you are comfortable with the surgeon! That is important.  Three weeks seems long, but it is actually pretty fast.  His schedule sounds typical.

    Giving you a book on breast cancer probably does not mean they particularly suspect more.  They just do not know the worst diagnosis you have until after a biopsy with clear margins in all directions.  Out of all patients they see in such a situation some % will have something worse after biopsy.  They don't know what category you are in until they have the results.  ADH alone does put you in a higher risk category for breast cancer and they are helping you on the path you are already on, learning more about it than you would have dreamed of wanting a month ago!

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

    Different studies differ.  Results may differ with the way the core biopsy was taken, the lesion that prompted the biopsy, the study date, etc. etc.  These studies are also small, often with <100 subjects.

    I think the wording in this abstract is confusing, but

    A total of 56 (45.5%) of 123 were categorized as focal ADH, and 7 (12.5%) of 56 were upgraded to carcinoma. A total of 49 (39.8%) of 123 were categorized as ADH not otherwise specified, and 11 (22.4%) of 49 were upgraded. Eighteen (14.6%) of 123 were categorized as suspicious for ductal carcinoma-in-situ, and 8 (44.4%) of 18 were upgraded. http://www.ncbi.nlm.nih.gov/pubmed/18696163

    Of 39 ADH cases, eight (20.5%) were found to have malignancy on subsequent excisional biopsy. The majority of these were ductal carcinoma in situ (DCIS) (62.5%). http://www.ncbi.nlm.nih.gov/pubmed/16146248

    Ninety-six patients with either ADH (61/96, 63%), ALH (19/96, 20%), or LCIS (16/96, 17%) on image-guided CNB proceeded to excisional biopsy. Malignancy was detected on excisional biopsy in 31% of patients with ADH, 16% of patients with ALH, and 25% of patients with LCIS. http://www.ncbi.nlm.nih.gov/pubmed/16978969

    Of the 65 patients who underwent excisional breast biopsy, 11 (17%) had their condition upstaged to a breast cancer diagnosis. http://www.ncbi.nlm.nih.gov/pubmed/12799332

    I didn't look at every study in Pubmed, either.  

    So different studies differ, but it sounds like in roughly 80% (say a range of about 70-90%)  of cases the diagnosis is NOT upgraded to something worse.

    Of course, I hope you have Nothing Worse.

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