ADH Confusion

Hi -

I think you deserve a thorough discussion of what they found, what the pathology report said, and what sort of follow-up you need in the future. For example: how large was the area of ADH in the biopsied tissue, or was it all removed in the needle biopsy?  (That would account for the 'no abnormal cells' statement). Questions include: Are there other calcifications in your breast, or in the other breast, and if so, how suspicious are they? What is your risk of a repeat, of something more serious, etc? Have they considered your family history, if any, and how does that play into your future course of action? At your age, and given this episode, how often should you have mammograms?  Clinical breast exams?  Tamoxifen? ...

The surgeon may not be the best person with whom to have this discussion --(s)he sounds like surgery is  his/her only concern. Surgeons often are like that... So you may want to talk with your primary care physician, for a start, or with an oncologist if you don't get good answers from the primary.

On another point -- the idea of having a biopsy for cells that aren't even there: that's the curse of the needle biopsy! They dont really know what's right next door until they excise the entire suspicious area. It might be a level more serious than what the needle pulled out -- and that would have been DCIS, in your case. Or, as the nurse suggests, *less*  serious - no atypical cells. That's good news! In my case, the needle found DCIS, but the excisional biopsy found invasive cancer - IDC. The uncertainty is why they do the excision. But apparently it's not usually more than one level difference: they don't seem to worry about IDC if all they see with the needle is ADH....

I was dxd with ADH last year, first a stereo needle biopsy, then excisional biopsy also showing ADH.  I was told it was benign too, but they referred me to an oncologist.  The oncologist was more thorough in his explanation of what an ADH dx means and what if any follow up should be done.  If you are dissatisfied with the explanation from the nurse, maybe request a copy of the pathology report and possibly a referral to an onc.  Depending on your risk factors, they may tell you to do nothing, or they may suggest taking Tamoxifen or just increased monitoring or whatever.  No way to tell without additional info.

I agree with Anne.  I also had ADH  on the excisional biopsy so I ended up seeing an oncologist several times, then a genetic counselor.  It's worth it just to have even one appointment so they can explain everything to you.

My surgeon's office will have the clinical staff call with the results but also schedules a follow-up appointment with the surgeon so you can ask any questions to the surgeon. I would get the path report from both the needle biopsy and the surgical biopsy. I would follow-up with either the surgeon or an oncologist like the others suggested.

Sheila

I was dxd with ADH in Feb and have a strong family history of BRCA2 with breast cancer (mom and 4 of her sisters).  Had ultrasound for lump I could not feel (B9), then had stereotactic biopsy for micro-calcification.  Dr then had meeting with all involved (path, 2 radiologists,etc)  to discussed my situtation.  Radiologist said she took a lot of calcification during procedure and felt  that I just needed to be watched, at this time. All agreed.   They told me that ADH in itself is not cancer, but you need to be watched, and watched closely.  They are treating me as any high risk patient until genetic testing is done.  Did see genetic counselor and will see my Dr in April to discuss other options.  Will have rotation of mammo's and mri every 6 mo.  Hope this helps.  Mouser, thanks for you post.  I had a list of question to ask the Dr but I forgot a couple and your list reminded me.