ADH on core biopsy - what to expect from surgical biopsy?

Well, studies may give you a more complete view, but they won't give you the emotional support you need.  I don't have ADH, but I have LCIS, ALH, ductal hyperplasia, and sclerosing adenosis, and a weak family history.

Different studies give different numbers, but this recent study says Previous studies have shown that 4-54% of breast lesions reported on core biopsies as atypical ductal hyperplasia (ADH) are upgraded on further excision to ductal carcinoma in situ (DCIS) or invasive carcinoma. We evaluated the rate of upgrading ADH to carcinoma at surgery for ADH diagnosed by percutaneous biopsy, and examined characteristics associated with malignancy. We identified 13,488 consecutive biopsies conducted at one center over a nine-year period. A total of 422 biopsies with ADH in 415 patients were included. DCIS or invasive carcinoma was found in 132 cases (31.3% upgrading). http://www.ncbi.nlm.nih.gov/pubmed/20619647  

So this study says that 4-54% of ADH were upgraded in previous studies, but in this particular study 31.3% were upgraded.

We will be here no matter what happens.  Crossing my fingers  for Nothing Worse for you.   I'm sure others will be along shortly to share their experiences.

Oh Lana, I'm so sorry you are going through this.  This must be soooo hard to go through.

No you aren't crazy.  I didn't understand until I was diagnosed with LCIS either.  Before I was diagnosed, I thought the only women who get breast cancer are women who ignore their lumps (and I'm a pharmacist.)  I didn't even understand why cancer patients get upset when they go to get followed. See what I knew.

 I'm sure you know that just having a condition that puts you at higher risk for bc is stressful.  

Its natural to want to be ready for whatever is ahead for us.  How else would we have found that its helpful to live in caves - as some protection against saber toothed tigers and mastadons?

Waiting is awful. I think its important to acknowledge what you are feeling, no matter what it is.  When you know what you are dealing with, you can make decisions about how to proceed.  Some women find distraction helps. Please know I am thinking of you.

lana... see if this helps you.  It's my own ordeal this year, just a couple of weeks ago:

http://community.breastcancer.org/forum/105/topic/755802?page=1#idx_14

The scar looks almost there (what a nice job he did)... my breast is still swollen but not a big deal; I did not take any pain meds, besides here and there over the counter Advil, Excedrin... and the brusing is looking might fine.

(((((((((((Hugs))))))))))))))

PS: it's under  « Forum: Not Diagnosed with a Recurrence or Metastases but Concerned: Meet others concerned about developing a recurrence or metastases.

Well, different studies differ.  But I haven't looked at the original papers, and your BS may know things about these studies and groups that  I don't know.

This study found radial scar had a 5-10% upgrade rate. http://www.ncbi.nlm.nih.gov/pubmed/20308524

This study put atypia in a higher risk group for upgrade than radial scar. http://www.ncbi.nlm.nih.gov/pubmed/19117040

In this study,it seems radial scar was associated with upgrade in 20%.http://www.ncbi.nlm.nih.gov/pubmed/16944680

Maybe your surgeon sees something in your left breast that he's not talking about, or maybe the ADH is a very small amount?  I'm just guessing.

According to this website, focal

1. limited to a small area or volume.

2. pertaining to or emanating from focus.http://medical-dictionary.thefreedictionary.com/focal+length

 I'm sure this is nerve-wracking for you. Please know we are thinking of you.

I'm so sorry this is happening. 

Maybe you can copy and paste the url?  (I have a Mac, so my computer may act differently than yours.)

What a neat strategy, NBN!  Thank you for sharing it.  I'm sure it will be VERY helpful to me!

No, it does not sound stupid at all because that's how I felt... as soon as the final surgery was done, even though the results could have gone either way, I felt soooooooo much better... just like you stated...a dangerous site was removed from my body and that right way that put me back to good spirits... and that is when the 2 plans come into action....

Glad to hear you are feeling better.  Keep smiling.

What great news!  What a relief for you!

Thanks for letting us know.  Unless you have a signficant family history of breast cancer, you are probably not considered to be at high risk.

Proliferative lesions without atypia: These conditions show excessive growth of cells in the ducts or lobules of the breast tissue. They seem to raise a woman's risk of breast cancer slightly (1½ to 2 times normal). They include:

• usual ductal hyperplasia (without atypia)
• complex fibroadenoma
• sclerosing adenosis
• several papillomas or papillomatosis
• radial scar

Proliferative lesions with atypia: In these conditions, there is excessive growth of cells in the ducts or lobules of the breast tissue, and the cells no longer appear normal. They have a stronger effect on breast cancer risk, raising it 4 to 5 times higher than normal. They include:

• atypical ductal hyperplasia (ADH)
• atypical lobular hyperplasia (ALH)

Women with a family history of breast cancer and either hyperplasia or atypical hyperplasia have an even higher risk of developing a breast cancer.

For more information on these conditions, see the separate American Cancer Society document, Non-cancerous Breast Conditions.

 http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-risk-factors

Women with some of the breast conditions listed above may be at increased risk for breast cancer. But it is important to keep in mind what this increase in risk really means.

For example, a recent study compared breast cancer risk between women with benign breast conditions and those without. The study found that about 5 of 100 women without any benign breast conditions developed breast cancer within the next 15 years. Among women with a benign condition that increases risk 1½ to 2 times, this would mean that about 7 to 10 out of 100 might be expected to develop breast cancer in the next 15 years. Among women with atypical hyperplasia (ductal or lobular), whose risk is 4 to 5 times normal, about 20 to 25 women out of 100 would be expected to develop breast cancer within 15 years. The risk for cancer then declines after 15 years. http://www.cancer.org/Healthy/FindCancerEarly/WomensHealth/Non-CancerousBreastConditions/non-cancerous-breast-conditions-women-at-inc-br-cancer-risk

Some of these numbers may be somewhat controversial. In contrast, women with a  deleterious BRCA mutation may have a 60-90% lifetime chance of getting breast cancer.   (I have classic LCIS, ALH, DH (not atypical), radial scar, with a weak family history.   Classic LCIS alone is widely thought to have about a 7-10 times normal risk, and I think the ACS doesn't consider me to be at high risk.  Risk factors are NOT necessarily additive - you may not have higher risk if you have 2 risk factors.  As far as I know, they haven't studied the long term risk of women who have a history of ADH with radial scar, so we probably won't know for some time.)

Best wishes to you!