Flat epithial atypia

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lamb
lamb Member Posts: 90

I have had my slides examined by two pathologists. The first dx adh. The second - who specialize in breast pathology dx flat epithial atypia. I spoke with the breast pathologist and he feels no further treatment is needed as the area was

Foci and it was excisesd My breast surgeon is referring me to an oncologist. I'm very confused. Any advise you girls

Can give me would

Help.

Comments

  • BLinthedesert
    BLinthedesert Member Posts: 678
    edited September 2012

    Flat epithelial atypia is a type of benign cells that are not malignant, but some physicians characterize them as potential pre-cursors of cancer that might put you at risk for future problems (much like ADH - but with lower risk than ADH for future problems).  As you have seen, there is often a fine line between FEA and ADH ... though pure diagnosis of ADH is likely more serious ... the standard-of-care is close monitoring and follow-up.  Your doctor is likely being cautious and sending you to an oncologist for their recommendation of whether or not you would benefit from hormone therapy (tamoxifen) - which is being used by some, not all, oncologists for patients with ADH/FEA as a chemoprevention (cancer prevention).

    Good luck. I am sorry you have had to go through such waiting and confusion, it sounds like you will be getting more frequent mammograms and closer follow-ups ...  

  • lamb
    lamb Member Posts: 90
    edited September 2012

    Thank you for posting .My appointment is in the 24 for the MO. I am very nervouse that he is going to say I should take tomoxifin. I have read the side effects it can cause. I am finally feeling better from my lumpectomies. I don't know I'd I am ready to deal with it. I know I should be great full it was nothing worse buy I can't helP feeling down. Do you know if you tomoxifin puts you in menopause.

  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2012

    While tamoxifen can cause some SEs that are similar to menopause (like hot flashes), it does not "put you into menopause". Many continue to have regular periods while on tamox (while most have irregular periods and some stop altogether.) I took it for 5 years and tolerated it well; I would just recommend a yearly transvaginal US to monitor both the uterine lining and the ovaries.

    anne 

  • MoodyMoo
    MoodyMoo Member Posts: 30
    edited September 2012

    I was diagnosed with FEA and LCIS on a core biopsy, ALH on the MRI, and when they did the excisional biopsy they found two areas of ADH.  A lot going on in only one general biopsy site! 

     In speaking with my BS just this past week, she indicated that FEA in and of itself would not be of utmost concern, and as mentioned above, would be addressed by monitoring and follow up, especially since I have no family history of breast cancer.  However, because of the 4 different findings, and the fact that I'm not comfortable with a "wait and see" approach, I have a referral to a MO early in October to discuss treatment options, specifically the use of tamoxifen as a prevention alternative.  At 44, and premenopausal, my BS doesn't think it's indicated, however she supported my desire for a second opinion. 

  • BLinthedesert
    BLinthedesert Member Posts: 678
    edited September 2012

    Lamb, If your BS goes with the FEA diagnosis, or assumes the diagnosis is very low risk ADH (since it is so similar to FEA) I don't think that tamoxifen will be prescribed - not all physicians are prescribing tamoxifen in cases of ADH/ALH. 

    I hope you continue to heal from the biopsies, and try to stay calm, hugs to you. 

  • lamb
    lamb Member Posts: 90
    edited September 2012

    This might sound silly but I am going to ask anyway. Last year I has one ovary and a Fallopian tube removed to ti ovarian torsion. Can this cause the other ovary to



    over compensate and create too

    Much estrogen which cn cause cell changes in the breast??



    Thank you awb... So you can basically get menopausal symptoms but you are not actually in menopause. And all women can react different with it. Are there any other estrogen blockers that r given instead of tamoxifen ?

  • lamb
    lamb Member Posts: 90
    edited September 2012

    Thank u Blinthedesert., I am

    Trying to stay calm. I do most of time. I have been referred to

    An oncologist for

    Risk assessment That's on the 24. Time goes slow when u r

    Waiting. I will post when I know more.

  • lamb
    lamb Member Posts: 90
    edited September 2012

    Moody Moo- How do u feel about taking tamoxfan ??? Im not sure I will be asked to take it -Mabe just close monitoring. Not even sure which way I would rather go. Please let me know wht they reccommend for u? When wAs your excisional??? Are u feeling better now?

  • Anonymous
    Anonymous Member Posts: 1,376
    edited September 2012

    Lamb----coincidentally, I had ovarian torsion and ended up with a TAH/BSO (they suspected ovarian cancer, but fortunately the ruptured ovarian cysts were all found to be benign). As far as I know after speaking with my doctors and researching, your overall estrogen would be lower with the one ovary. (there is estrogen produced in the adrenal glands, as well as skin and fat). I had everything removed, so I went into immediate surgical menopause.

    Evista is another preventative (I took tamox for 5 years and have been on evista for over 3), but it is only for post menopausal use.

    anne 

  • MoodyMoo
    MoodyMoo Member Posts: 30
    edited September 2012

    Lamb...I'm not so sure.  Another reason why I'm very interested in the consult with the oncologist.  I'll be sure to come back here and post after my appointment.

    My excisional was May 31st, and I tolerated the surgery quite well, and had a very speedy recovery.  I'm just a control freak by nature, and the idea of continual monitoring, possibly waiting for another shoe to drop, just isn't my thing.

  • lamb
    lamb Member Posts: 90
    edited September 2012

    Awb. The torsion was painful wasn't it? Morphine didn't even help me As I waited in the er. I didn't know estrogen was produced in other areas as well. Do you know if there is a test to find out your levels Well Monday is approaching nd I must say just the thought of SAying I am going to an Mo scares me I am also very curious to c what he will advise

  • lamb
    lamb Member Posts: 90
    edited October 2012

    Hi ladies. I have been reading posts everyday to see how everyone is but I haven't posted. So here is an update on what's going on: I met with my MO and he wasn't happy with the two different dx. So off my slides go to a third pathologist Due to backup somewhere- seems everyone is blaming the next guy- three and a half weeks later my slides arrive at yet another NYC breast pathologist lab. He looks at them within an hour Of receiving them and dx= focal ductal hyplasia. No adh seen. So first = adh. Second. FEA. Third focal ductl hyplasia. No atypia. Have to

    Make a appt with MO to discuss. Any input. ????? I'm

    Thinking the FEA is basically similar to the ductal hyplasia. So ????

  • BLinthedesert
    BLinthedesert Member Posts: 678
    edited October 2012

    I think that you should feel very confident that you have no malignancy.  You are likely going to be followed somewhat closely (maybe diagnostic mammos rather than screening) -- maybe every 6 months, maybe yearly -- but if I were you, I would NOT lose any sleep over it.  

    Also, it is likely you will not be prescribed tamoxifen (which is a very good thing).

    Congratulations, this should make you feel relieved.

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