Just diagnosed and confused ??

ShirleyFaye: I just remembered something about LCIS which I want to share with you. Women can have LCIS for years and years and it's never discovered. It's often only discovered when an invasive lump is found. So that shows you it's not really as threatening as DCIS.

Leaf: We can't help being intelligent. My surgeon didn't like it when I asked too many questions - the prick. I have since dumped him and am now seeing a female one for follow up. I made sure she got the message that I was very informed and didn't like being treated like an idiot. I used to work in medical software so a lot of terms are very familiar to me (I'm a software engineer).

Sue

Suepen: No doubt you are very smart.   I do have to be careful about the 'bigger picture' though. We're probably read more academic papers than most of our general docs, though.

Most LCIS (and nothing worse) does not present with a lump.  LCIS (and nothing worse) is usually an INCIDENTAL finding at a biopsy.  It often (but not always) is present not *at* but *adjacent to* the 'region of concern' (action at a distance.) I think that if an LCIS woman goes on to get invasive breast cancer, it often happens in an area that was previously thought to be normal.  Its hard to tell though, since if it was biopsied and removed, then it would be gone, of course.  In a 'small' number of cases, classic LCIS may be a *non*obligate precursor to breast cancer.  No one wants to define 'small'. 

LCIS (and nothing worse) patients, IF they go on to get invasive breast cancer, get more IDC than ILC (as is the case with the usual population), but many more of the LCIS (and nothing worse) patients get ILC than in the general population. 

ILC often presents as a thickenening.  It is thought that this is due to the lack of E-cadherin.  (Think E-cadherin.)  The E-cadherin is thought to be part of the 'glue' that holds a tumor together, making a lump.  ILC more often presents as a 'web' or 'layers', and often (not always of course) not as a discrete lump.

Since LCIS and nothing worse is normally found as an incidental finding at a breast biopsy, and of course not every women gets a breast biopsy, we don't know how many women are out there who have LCIS.  The number of LCIS cases has increased over the years http://www.ncbi.nlm.nih.gov/pubmed/12353815 , partly because there are more mammograms, and more biopsies than in the past.http://www.ncbi.nlm.nih.gov/pubmed/16604564

In the Li paper, they find that the LCIS and nothing worse patients actually had a higher rate (adding the risk of both breasts together) of subsequent invasive breast cancer than DCIS patients during this period (1988-2001).  I think more DCIS patients were caught at a more advanced stage, though.

Among DCIS patients, incidence rates of ipsilateral and contralateral invasive breast cancer were 5.4/1000 person-years and 4.5/1000 person-years, respectively; and among LCIS patients, incidence rates were 7.3/1000 person-years and 5.2/1000 person-years, respectively. http://www.ncbi.nlm.nih.gov/pubmed/16604564

ShirleyFaye: That's great news!!! Makes your original doctor sound really stupid.

I double checked with my new bs yesterday about the LCIS I have left in my breast and she is adamant it's ok to leave it there.

Sue

Good for you, ShirleyFaye! I echo patoo's post.  

There you went and did it ShirleyFaye - mentioned that illegal word "diet"! 

Oh, you can get on that bike.  Come on over to the exercise thread and join us - it will get you going.

bumped it to top a few minutes ago.

http://community.breastcancer.org/forum/58/topic/741082?page=69#idx_2048

We have fun.

Hang in there, Shirley.  We're all hoping it all comes out as something benign and uninteresting like fat necrosis.  We're all reaching out our hand to you.

For the needle localization, you may want to have some sort of backup plan in case you do have pain.  You may want to consider slathering your breast in Orajel about an hour before.  Messy, but may help.  You can wipe it off just before you go in. You may want to have a plan in place with the doc in case you do have pain.  I had several hours between my needle insertion and my surgery (my surgeon was in a family emergency), so I'm glad I brought something to try to distract me.

I had no pain during the procedure once an anesthesiologist got involved.

Do whatever may calm you to get you through these days before the surgery.  We're here whenever you want to vent.

I don't know why they are ordering no tea or coffee x 7 days before (assuming you are fairly healthy otherwise.) I know the regulations differ from hospital to hospital, but this is quite stringent from my own personal experience and what I have read.  (I assume you are not on anticoagulants such as warfarin (Coumadin) or have reflux problems,etc.) The standard I've heard is 'nothing by mouth after midnight', no aspirin or nonsteroidal antiinflammatories x 1-2 weeks before, stopping anticoagulants (such as warfarin, heparin).

There was no evidence to suggest a shortened fluid fast results in an increased risk of aspiration, regurgitation or related morbidity compared with the standard 'nil by mouth from midnight' fasting policy. Permitting patients to drink water preoperatively resulted in significantly lower gastric volumes. Clinicians should be encouraged to appraise this evidence for themselves and when necessary adjust any remaining standard fasting policies (nil-by-mouth from midnight) for patients that are not considered 'at-risk' during anaesthesia. http://www.ncbi.nlm.nih.gov/pubmed/14584013

Some of the surveys were asking about a breakfast of plain toast and tea 7 hours before surgery.

Gesh, maybe they're worried about A boy presented with the classic triads of acute onset altered mental state, respiratory depression and small pupils following consumption of a bottle of presumed "green tea", which was subsequently found to contain methadone.http://www.ncbi.nlm.nih.gov/pubmed/19347668

I'm sure you heard correctly, but maybe it would be good to call and ask another person (if you weren't told this by your anesthesiologist directly).  

I'm so sorry you had a bad time with anesthesia.  I hope you never need any more surgery, but if you do, they can 'pre-med' you with anti-emetics.  With my first general anesthesia, I threw up several times, but they've done a good job in my subsequent surgeries - haven't even felt nauseated.  On my first surgery, even a week later, when I turned my head it felt the world was spinning around, yet I was able to walk 8 miles.

I didn't have any chest or back pain, but some people have a horrible time even with biopsies-lots of neck/back pain.  So you are definitely not alone.

At least its behind you and  I hope you never have to go through anything like this again!

Best wishes as you wait for your results.

I am so glad you have 'nothing worse' than LCIS and ADH. 

Some people with ADH choose to have their slides re-evaluated to make sure they don't have DCIS.  (Of course, not everyone does. When I had my slides re-read at a major institution, it was $300 out of pocket for each biopsy, and they just sent 1 slide for each biopsy.  This money was later re-imbursed to my by my insurance company. My diagnosis only changed from 'LCIS + some features of ALH' to 'LCIS with ALH'.)

If you are post-menopausal, there are other anti-hormonals.  But its a discussion you will need to have with your onc.