Surgical excision biopsy
Comments
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What can I say, thank you. Thanks so much for your ideas, i'll let you know what NP has to offer.
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noticed tonight I have extreme tightness just below where excision was, it hurts when I raise my arm up above my head. Will mention it to doctor, anyone else have anything similar?
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momallthetime- of course! That's what we're here for. To help and support each other!
Bibi- I had that too. In fact, I was raising my arm today to close a window and can still feel the tightness. I think it's pretty normal, but definitely let your dr know
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Momallthetime - The 'Expand-A-Band Binder' was the brand that they had me in. I really can't recommend any place to purchase it since I didn't purchase it myself. I did find the manufacturer's website with sizing info https://www.eabmedical.com/wp-content/uploads/2016... . Good luck on your procedure.
Jamie
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Momallthetime....don't feel wimpy! I greatly underestimated this recovery. Somehow, I thought it would be a breeze! I was really surprised. I mean, it's tolerable,....we can get through anything! But take some time off, rest, make sure you get a prescription for pain meds, even if you don't need them.
I am back at work today. So I drove for the first time...forgot that the seat belt would literally cross my incision. Holy hell. But I made it! Probably good to get back to the routine and keep my mind off Thursday.
Even though I have my appt set, I'm still waiting for the other shoe to drop. My appt is with the PA...the BS had said, if the results aren't good, they'll switch the appt to meet with her, and then I should bring my husband....So of course I'm waiting for the phone to ring to tell me that. They couldn't be so cruel as to tell me that today, and then make me wait until Thursday...right?!?!?
Sigh. Waiting never ends.
Feel good ladies!
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mystic, yes my appt with surgeon is today..if I can find a ride! Car still un the shop and the person who hit me refusing to give her statement so her insurance hasn't claimed liability!
Hope your feeling better with your chrohns flare!
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Oh Mel! Can you take a cab or an uber? Don't miss that appointment! I'm sorry you're still dealing with all of that!
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mommakat, uber is 50 dollars one way. I'd be better off renting a car..but I did find a car to borrow. Going to call the insurance right now and what's going on.
Any of you ladies thought about using CBD oil as a preventive measure?
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yikes! that's steep. glad you found a car. I've never heard of using CBD oil. I just googled it. What would it be preventing?
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mommakat, some have used in in conjunction with chemo, others have used it as BC alternative treatment. I do know one person who has used it to stop the metastasis from breast cancer. I was thinking about it for the atypia..prevent those cells from turning cancerous. I'm a big believer in alternative medicine, but I do believe that western medicine is still necessary.
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mystic or any of the other ladies.. did they do biomarkers or immunohistochemistry on the biopsy. I was feeling ok with my decision to wait seeing that the results were mild ductal hyperplasia.. however, after reviewing it closely all my IHC were positive and tamoxifen is recommended I am kind if freaking out. It's not score in numbers or percentages which I've read just depends on the pathology. I'm pretty confused and he didnt really expmain the IHC part
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I got a phone message that my path results are benign. Hooray. My follow-up is next week, so I'll get path report then.
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Hi all! sorry for a late response. I was dealing with some family crazy times.
Jamie, that's great news! yay!
Mel, I can't use anything like CBD as we get dug tested periodically and any stupid thing can show up and then I'd get my licence pulled. Not worth it. In terms of IHC, I was not even offered it. My BS did not think it was necessary. I randomly got a call from the pathologist who read my biopsy to make sure I got my report. It freaked me out at first thinking that maybe he saw something he didn't see initially or something. But he did not think IHC was worth it either. Are you thinking about starting on tamox???
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Yes, mystic. The drug testing is a huge concern for me. I thought the the was completely removed but the smallest amt is 0.3% thc..
I am not considering tamoxifen. The side effects alone..smh.
Do you know what all this means?
SMMHC: positive in intact myoepithelial cells
P63: positive in intact myoepithelial cells
Calponin-1: positive in intact myoepithelial cells
Cytokeratin: positive in the lesion
Hope the craziness settles down mystic!
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Mel I don't understand, he gave you this info and that's it? I must tell you it does sound serious. How did they not explain to you? I think you'll have to do something...What did they tell you, what's the next step??
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Momakat could I ask you about the bra that you ordered, did it arrive. Thx for the heads up about taking time, it's good to know. No seat belt across breast! I feel quite a lot of pain in the side of my breast, I do have a simple cyst there, I asked if they would take it out, no they won't. It's really pain. Not all the time, but it's there. And I still feel stuff where the needle went in. Momakat yep they always let you wait. They should have told you either way you should bring your hubby, how silly if it's bad then we'll tell you to bring your hubby.
Mystic so sorry about the Crohn, stress for sure didn't help.
Bellapamthanks so much. I was asked when I went for the BS consultation if I will be willing to give it up to science as you put it so well, I said of course, I certainly don't wanna take it home. I am reading that Hibiclens skin cleanser is good to use.
Bibi this DD is being watched closely because of her sister's status, she's on Mamo/MRI for now. Last year she was going every 6 mos. Do you believe at first she had sclerosing adenosis only seen in an MRI, she was scheduled only for Mamo/US but RO said well she's young let her have an MRI. Then biopsy and that's what it showed. Then 2 yrs later the PASH. But they said yearly now.
CBD oil is a big plus in the mets thread. I go there because of my DD, they use it for many purposes, including help in sleeping. It has to be taken cautiously of course. And hope it's legal where you are.
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Mel, did they say something, is it beingn? What did they tell you?
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Mel, from what I know (limited human medicine knowledge to take with a grain of salt..)
SMMHC (smooth muscle myosin, heavy chain) is a stain that helps differentiate benign breast lesions and invasive carcinomas. It positive for benign lesions only, so this is good news.
P63 is involved in cell differentiation. The majority of invasive carcinomas is negative for this IHC, but metaplastic BC can be positive for it. Benign lesions are positive as well. The fact that only intact myoepithelial cells were positive for it reminds me of lesions we see in vet med that have a "ring effect" on the periphery of certain benign lesions. I would ask your dr more about this one though.
Calponin-1 is typically found in benign lesions (helps differentiate invasive tumors that mimic benign lesions)
In terms of cytokeratin, I can't offer much help. There are many types of cytokeratins, some are associated with the ability of cells to deal with stress, while others are associated with tumor progression. I would ask your doc about this too.
I think overall (if you were my four legged patient!) I would say it's good news. But I know there are many differences in vet med and human med. Are you able to call your dr tomorrow?
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momallthetime, lesion was benign, he wants to re-excise to remove the tissue with atypia. I dont want to. He recommended tamoxifen to cut down the chances.

The part that says small areas of ductal carcinoma in situ arising in atypical papiloma can not be comoletely excluded ..makes me nervous.
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Mel, that last statement is something pathologists have to say.. that's part of the reason why ADH should always be removed, so it does not progress into DCIS. Will you be able to call your dr tomorrow?
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I can, he briefly discussed the report, pushed re-excision and the tamoxifen. I asked for a copy of the report and before I left it was handed to me. He did suggest a second opinion as he wants me to feel comfortable in my decision. He felt a breast MRI w asnt necessary and I need to get another mammogram in 3 weeks.
I am a little confused on the significance of p63 , ssmhc etc.
This is why I wanted the report first so I could Google and then discuss. I hate that his office is almost an hour away.
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Listen Mel, first when will you see doc again? Also, you could take this at least to another opinion, see what they say...it does lean more to benign, when i did some reading now, i thought i understood their question is that this circle sometimes - sometimes is near a in situ situation.
First you are upset, in shock, or whatever, no one wants this nonsense, there is too much to do. BUT being on the mets thread is no picnic. PLEASE I AM BY NO MEANS telling you to run and get treatment, JUST be cautious, get ALLLLLLLLL your facts, opinions, what's the risk what's not, what's the wait situation, then you could make an educated decision. You are definitely right that Tamoxifen would change your life, if you get as far as an appointment with Oncologist they could do an Oncotype look into your level of risk etc...you need to get some rest, so much has been going on. But this atypical thingy and the other details have to be explained to you.
Please do not be upset with me. Go to at least 2 more docs IF YOU CAN, you need to be satisfied.
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momallthetime, oh no, not upset with you at all. I appreciate the input and opinion. He did suggest a second opinon so I would be comfortable in my decision. He was ok about waiting but he felt it should be removed.
Your totally right as I am not thinking clearly, a lot of things on my mind, esp. the financial aspect of this all. And I do need an explanation of the positive reading those things. I do see a hematologist/oncologist for another reason next month so I will bring the report to him. As far as the second opinion, I will call tomorrow my primary to put in the referral for a second opinion.
I am so thankful for you ladies!
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Sending big hugs Mel!!! Hope some of the above info helps a little. I'm sure your brain is doing backflips right now.
I think the good news is you don't need to make any immediate decisions. Make sure you are at peace and happy with whichever path you take. And know we are all here for you!
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thank you mystic, yes it does help! I was having trouble finding that information!
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No problem! Let us know what the drs say
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momallthetime, stupid bra doesn't come close to fitting!!!! I should have actually measured my body. I guessed. They have a size chart on the site. Dummy. They go be single number 1-5 or something. It's the enell sports bra on Amazon. Here are literllay 11 front hooks though. So I'm sure it would be nice and snug but that is a lot. If you can find one that zips maybe it would be easier? So frustrating!!!
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Mel,
I'm so sorry that you're getting such mixed results. I'm so surprised by this process (mine and yours, and so many others), that it isn't black and white! I really though way back when I had my core needle biopsy, I'd get results, yes or no and move on! I had no idea there was so much complexity in these results. This was my first mammo and boy, has it been a learning experience.
I hope you can speak with your dr or a 2nd opinion dr. It's so much to process.
Hang in there!
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I agree mommakat it's not as simple as I thought it would be. had my first mammo u/s last year and wound up needing surgery to remove all milk ducts. Follow up mammo and u/s in December, was recommended short term follow up. Mammo and u/s again in may (later than recommended) needed biopsy on the other breast. Going tomo to follow up with surgeon and go over results. I have very dense breasts with lots of benign things going on. I do not want to have continuous surgeries! Hoping all goes well tomo and I can take a break from thinking about this.
Mel, sorry you are going through this. I hope the second opinion gives you some more information and helps you make a decision as to your next step. Good luck.
I got a zip front but bra at Kohls that was great.
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Mel, I'm not seeing the part of the pathology or recommendations that are conflicting. The pathology revealed "a fragmented and incompletely excised papillary lesion". He is recommending that the rest of it be removed (re-excision is common when something hasn't been fully excised) due to the fact that "small areas of dcsi arising in atyical papilloma cannot be completely excluded". So he is recommending the re-excision based on a small risk, which seems to be a standard recommendation.
"There remains no clear, undisputed evidence that either hyperplasia without atypia and atypical ductal hyperplasia are precursors to either DCIS or invasive carcinoma" (read more about ADH and it's implications here: http://breast-cancer.ca/atyp-hyp/
I think a second isn't a bad idea, but I'm not seeing anything in your pathology report or in your doc's recommendation that are conflicting or confusing. Good luck!
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