Do they always test excisional biopsy tissue?

BMrs · August 2017

Hi. I found a lump in my left breast. It came and went with my period for months, but decided to hang around one month, so I made the phone call.(I am only 35, so I waited longer than I probably should have.) Wouldn't you know, it went away the night before my appointment and has yet to make an appearance again. Anyway, the doctor said I have very dense breasts and sent me for an ultrasound and 3D Mammogram.

I went about a week later. They called me back to do the mammogram and three more times...for the right side. They then proceeded with an ultrasound and only focused on the right side. They then had another tech come in. I realized then they found something. I was told they wanted me back for a stereostatic biopsy. I went and waited for my results.
I still don't understand the results, but the main part was ductal atypia and intraductal microcalcifications.

I underwent an excisional biopsy last Friday. I didn't ask many questions. I just went with the flow.
I am scheduled for a follow up next week. Until then....the doctor mentioned nothing about getting the tissue tested. She just explained that they wanted to remove the precancerous tissue and the surrounding area.

Will they test the tissue further to make sure it's not cancer?

pingpong1953 · August 2017

As far as I know, they'll biopsy everything, including the surrounding area (margins) to make sure they leave only normal tissue behind.

MTwoman · August 2017

So the initial pathology report from your biopsy said " ductal atypia and intraductal microcalcifications". They will have sent the tissue from the excisional biopsy to pathology and you should get another report from that. Now, ductal atypia is not considered precancerous, but is considered a risk marker (meaning that it is a marker for an increased risk for developing bc in the future and may warrant increased monitoring).

Read more about that here: http://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/atypical_ductal_hyperplasia.html

BMrs · August 2017

I'm sorry. I was trying to make it brief. The doctor stated that it is precancer, but she couldn't say when it would ever become cancer.

The initial report said:

"-Ductal Atypia including:

*flat epithelial atypia

*atypical apocrine metaplasia

In addition there is a focal sclerotic portion of intraductal papilloma type changes (cannot exclude atypia) as well as dilated ducts/duct ectasia some with columnar cell changes and scattered chronic inflammation.

-Intraductal microcalcifications indentified"

Thanks for your response. I will be expecting more results next week then.

MTwoman · August 2017

BMrs,

So what I could find, is that of the specifics you listed (flat epithelial atypia, atypical apocrine metaplasia and intraductal papilloma type changes), the one that could qualify as "precancer" would be the flat epithelial atypia. From the Breast Cancer Resources Journal: "Observational studies have suggested that at least some of these lesions may represent either a precursor of ductal carcinoma in situ (DCIS) or the earliest morphological manifestation of DCIS."

There is actually a very nice journal article describing flat epithelial atypia and the research to date you may find informative. You can read that article here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314429/

read more about atypical apocrine metaplasia:

http://breast-cancer.ca/apo-meta/

and intraductal papilloma:

http://www.imaginis.com/breast-health-non-cancerous/benign-breast-conditions-1

Good luck and do let us know what you find out next week!

BMrs · August 2017

Thank you very much! I will look at all of the information now! I really appreciate it!

Do they always test excisional biopsy tissue?

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