Confused About My Pathology Report
I had a stereotactic biopsy on 2/28/19 and was told I need to have a surgical biopsy because of ADH found in the tissue samples. Today I saw the surgeon to discuss the report and to have my breast checked due to excessive bruising. The report says: “multiple cores of breast tissue show columnar cell hyperpalsia with atypia (ADH). Foci of microcalcifications are associated with the ADH”.
Is this ADH or is it columnar cell hyperplasia? I was under the impression that CCH was a benign finding? I didn’t direct this question to the surgeon because she was explaining what ADH means and why we need to remove more tissue to be sure nothing else is lurking. I took my copy of the report and went home. I’m now reading it over and feeling confused. Has anyone else has this type of path report? And if so, did you have a surgical biopsy following the core biopsy because of it?
Thank you.
Comments
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Hopefully someone with a more similar situation to yours will weigh in, but here's my experience....
I had an MRI that showed enhancement of a duct, suggestive of ductal hyperplasia. They did a core biopsy, and found no unusual cell growth. Still, it was BI-RADS 4, so they went ahead and did an excisional biopsy to be sure they got it all and that there were no surprises. It came back as 'usual ductal hyperplasia' (which is benign). If there had been abnormal growth of cells, it would have been 'atypical ductal hyperplasia' which is a risk factor for developing cancer. I think what they are saying is your columnar cell hyperplasia might have something unusual going on (atypical) that could potentially be a risk factor for cancer, and they need to remove it 1) before it has an opportunity to turn into anything and 2) to make certain it's not anything significant. In my experience, when the doctor isn't clear with a diagnosis, it's often just because they aren't 100% sure yet. They have to get the pathologist to look at the cells to be sure.
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Thanks for your reply Alto! I was thinking that whatever it is it’s better to get it out if it has the surgeon concerned. I did message her via the patient portal so maybe she can clarify. I just want to understand what is going on so I can assess my risk factor. Each of my mom’s 3 sisters had BC and all of her 6 siblings died of some form of cancer, however my mom refuses to attend to breast or gyn health so I need to make sure I stay on top of my screenings and risk factors.
I noticed your diagnosis and surgeries are pretty recent, so I hope you’re doing OK. Looks like it was caught early so I hope you’re over the worst of it. Wishing you the best
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Thanks, yes I'm doing well. I had the excisional biopsy on the left breast and my tiny scar is nearly invisible now just a few months later and the little divot is gone. It's some comfort.
The doctors believe they caught the stuff in the right breast at the point it was turning invasive. Unfortunately it took years before I got a diagnosis with Paget's - everyone kept saying it was eczema. I did not know enough to ask for a biopsy, assuming the clear mammo and ultrasound were enough. Hopefully they got it all in time.
It is good to stay on top of things if you think there might be a problem.
There’s a lot they can do when they catch things early. I’m glad you are planning to have it removed - seems like the safest option
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