What to do?

My_Body_Has_Lost_Its_Mind · December 2010

Surgical Pathology Report

A: Breast, left duct excision:

- Duct Dilation

- Fibrocystic changes with associated microcalcifications

- Sclerosing adenosis with associated microcalcifications

- Pseudoangiomatous stromal hyperplasia (PASH)

- No in situ or invasive carcinoma identified

B:

- Microscopic intraductal papilloma with focal atypical ductal hyperplasia

- Fibrocystic changes with ductal epithelial hyperplasia

- Columnar cell change

- No in situ or invasive carcinoma identified

Size of specimen: 2.5cm med. to lat., 2.4cm ant. to post., 2.7cm sup. to inf.

Fragment of dense fibrofatty tissue with fibrous:adipose tissue ratio of 90:10%

Left breast discharge tested + again and ductal dilation showing raised on skin at 1 wk postop

Breast, right major duct excision:

-Atypical ductal hyperplasia

-Sclerosing adenosis

- Fibrocystic changes

- (PASH)

-Luminal red blood cells present in some larger ducts

- No intraductal papillomas identified

- No in situ or invasive carcinoma identified

Size of specimen: 3.4cm sup.to inf., 2.9cm med.to lat, 1.8cm ant.to post.

Right breast discharge tested + again and ductal dilation showing raised on skin at 1 wk postop

38 years old, Family History: grandmother double masectomy (deceased from cancer) and aunt masectomy when they around my age. 18 yrs of smoking, first abnormal mammo at age 35 ½ (slightly enlarged lymphnode right upper breast axillary area) no biopsy just watched it, also had bilateral discharge, at that time I was also diagnosed with mild cervical dysplasia (once again no treatment was done), and thyroid disease with thyroid nodule. All I know is that my body has lost its mind! I hope you can just give me your thoughts on all this. I am suppose to have scheduled an appt for total duct removal in both breast for Jan. And to do Tamoxifin for 5 yrs & I have put it off until I could research and think more on all this. I am worried that they won't do enough. My husband will deploy soon and I would like to be at my best when I am taking care of our 2 young daughters. Both surgeries they have had to take more than what they thought. I know my body and I really believe that this goes way beyond some precancerous cells. Maybe all the black discharge from both my breast running down the plastic piece when they did my mammo kind of freaked me but, at this point with this crazy body right now I just and waiting to find out what else is wrong. I have very low protein level right now so I have low immune system. I have 2 bacterial infections (bladder and cervix) Yes, a mess! My cat, ultrasound, mammo, all came out normal before any breast duct removals. My breast are so fibrocystic I don't know how they would tell anyway. All I feel is lump after lump and that is pretty much what it looks like on the mammo film I have seen. Do you think asking to get a double masectomy or discussing it with the dr. is ridiculous? I have a very tender spot in the left side of my left breast. I've heard surgery can make it worse and spread more?

Beesie · December 2010

You have ADH, which is a high risk condition. There are a number of discussion threads about to do after a diagnosis of ADH in the High Risk forum. You might want to read those or post your question there.

Anonymous · December 2010

The great news in your pathology report is that "no in-situ or invasive bc was identified". Most of the other conditions in the report raise your risk only slightly; the ADH carries a risk of about 20 to 25%. Generally, the recommendation for ADH is just yearly mammos and breast exams every 6 months, with the addition of tamoxifen IF there are other significant risk factors such as family history. (usually meaning in a primary relative--mother, sister or daughter--your grandmother and aunt are considered secondary relatives). Considering bilat masts is certainly not ridiculous, but it may be a bit extreme for ADH. Even with LCIS (a step further along the bc spectrum with double the risk of ADH) and family history of bc (mom had ILC), all my doctors felt BPMs too extreme for my situation. I do high risk surviellance and preventative meds and am doing well after over 7 years. Not a choice for everyone, but works for me.

Anne

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