Please help me understand results from biopsy

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mom2six
mom2six Member Posts: 2
edited June 2014 in High Risk for Breast Cancer

Hi,

I went in for a second mammo because they found a single cluster microcalcifications in my left breast.  I was then referred for stereotactic biposy and today received the results and was told that I needed to contact a surgeon. 

Here is what they told me today: flat epithelial atypia in a background proliferative fibrocystic change with columner cell change and focal ductal hyperplasia.

I am being referred for surgery.  They say I am high risk for cancer.  My mother died of cancer.  They found a 4 inch tumor on her liver and the oncologist was certain that this was a secondary sight.  They probed her everywhere and never found the primary source.  But the doctors felt like the cancer came from her breast and died out there before cancer was discovered in her liver.  They found estrogen receptors on the cancer cells and that's why they believed it came from her breast.  My mother was diagnosed in Feb and died Nov of 1995.

I am scared because I took care of my mom and watch her fight for her life, suffer through chemo only to become sicker and then give up and die 9 months after dx.  I know what the horrors of cancer are, after watching my mom.

So who know's if I'm considered even a higher risk because of my mom?  I would love any insight to the results I just received if anyone understands...is ADH and focal ductal hyperplasia the same thing?  What about the other things it said? I just don't understand it all.

Best treatment at this time is surgery?  Then wait to hear further pathology reports? 

I don't want to suffer the same fait of my mother who died at 51.  I just turned 40 two days ago.  Please can someone help me understand my results and best course of action. 

Thanks Karen Mom2six




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  • Moderators
    Moderators Member Posts: 25,912
    edited March 2013

    Karen, we're so sorry you're having to deal with this worry.

    Other members will be along to post from their own experiences, but in the meantime you can read up on the meaning of every line of a typical pathology report in the Your Diagnosis section of the main Breastcancer.org site.

    Best wishes,

    • The Mods

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  • Beesie
    Beesie Member Posts: 12,240
    edited March 2013

    Karen, I'm so sorry about your mother.  But please don't start thinking that you will go through the same thing.

    Focal ductal hyperplasia is not the same as ADH.  Focal means that there are just small focuses of the hyperplasia and if it's not "atypical" then it either confers no increase in breast cancer risk or only a very small increase in risk.

    What's driving the concern in your case is the flat epithelial atypia - that is a condition with a risk profile that, at worst, is more similar to ADH.  Generally when ADH is found in a needle biopsy, about 20% of the subsequent excisional biopsies find cancer.  That's what happened in my case. With flat epithelial atypia, my understanding is that the rate of cancer diagnosis is a lower than that, more like 15% or less. And if cancer is found, it's usually DCIS, which is a pre-invasive cancer. So unless there is some other reason that your doctor is concerned, I wouldn't say that with a max. 15% chance of finding cancer in the excisional biospy, that you are high risk for cancer.

    Here are some write-ups about this condition:

    Breast-nonmalignant Atypical hyperplasia Flat epithelial atypia of breast

    Flat Epithelial Atypica: FEA "Columnar Cell hyperplasia"

    Good luck with the appointment with the surgeon.  Hopefully he or she will be able to ease your mind about your risk level.

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  • mom2six
    mom2six Member Posts: 2
    edited March 2013

    Hi Beesi,

    Thank you for pointing out to me the area of concern with the flat epithelial atypia and also helping me understand that focal ductal hyperplasia is not the same thing as ADH. I really appreciate your help!!

    I am scheduled to meet with a surgeon on March 18 for a consult for an excision and to schedule surgery. My stereotactic biopsy was not a good experience. The computer miss calculated (that's what they said) and the probe missed the cluster microcalcifications and pushed them aside the first time. After taking samples with no calcifications, they pulled out the probe and decided to try again and shot the probe in a different spot on my breast. My breast was not completely numb and I felt stings of pain, but they were successful in getting a sample of a calcification. I wish they would have hidden the two petri dishes of my breast tissue...this did not help me stay calm. I tried to be tough, but silently cried up on that table. I am grateful that we have the capablity to do these biopsies and act on their findings.  I know many lives have been saved.  It was just hard to go through.

    I hope the excision is a better experience and I pray they won't find anything new to worry about.

    Thanks again,

    Karen mom2six

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  • Irishwfl
    Irishwfl Member Posts: 22
    edited March 2013

    Hi Karen, I am in similar shoes, my excisional biopsy is tommorow but I have ADH and ALH.  Before this biopsy my risk wasn't that much higher than the average person even though my mother and grandmother had breast cancer.

    I should probably get off these boards for the night.  I am already stressed from worry and not sleeping.  The support here is great but  reading Beesies comment

    Generally when ADH is found in a needle biopsy, about 20% of the subsequent excisional biopsies find cancer.

    Isn't helping :)

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  • 1openheart
    1openheart Member Posts: 765
    edited March 2013

    Irishwfl...I know you are scared and worried about tomorrow.  But please try to appreciate what Bessie did not say....that 80% of the biopsies do not show cancer.  Try to get some sleep tonight if you can. 

    Sending hugs, positive energy and healthy thoughts your way.  Please let us know how it goes.

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