Atypical Ductal Hyperplasia

Tonia,

This is not your husband or sister's decision. It it yours alone. You may want their input, just as your want the input of your doctors, but in the end it's up to you to decide what is best for you.

I'm assuming at this point you've only had the stereotactic biopsy? If so, proceeding now with an excisional biopsy is a very reasonable decision. An excisional biopsy is effectively the same as a lumpectomy but the purpose is to remove the concerning breast tissue, in your case the tissue with ADH, to see if anything else is lurking. Some doctors use the terms excisional biopsy and lumpectomy interchangeably but this is confusing since each term has an implied meaning, one being for diagnostic purposes and the other being for removal of cancer. If the surgery finds that there is a cancer present (about a 20% chance when someone is found to have ADH), then you can return for a lumpectomy or mastectomy, and if the cancer is invasive (vs. DCIS), then lymph nodes will be removed and checked during this second surgery. If there is no cancer found, then you can choose to do monitoring or you can choose to have a bilateral mastectomy to reduce risk. You may be more inclined to choose the second option if your genetic testing comes back positive.

Having the excisional biopsy/lumpectomy will provide you with more information, and it will give you time to get the genetic testing results and time to decide what's best for you to do, whereas having the MX now will shut the door to any other options.

Have your sisters or other family members had genetic testing? Usually it is preferred that someone in the family who has had cancer be tested first. If this individual tests positive, then they know what to look for in your testing, and if you don't have the same inherited mutation, then you will have a true negative result. However if you are tested and no one else has been, then testing negative will not provide the same level of certainty because you won't know if there may be a different mutation that is causing the cancer in the family. And did you have BRCA testing or a full breast cancer panel (20+ genes)?

it might not be a bad idea to get a second opinion if possible. Praying for wisdom and peace for you.

Hi Tonia, I know I'm late joining in. But thought I'd just add, I've been through that decision before and chose lumpectomy. Do you want to know why? Because I didn't have a lot of time, was new to the idea of all this stuff and knew that if I chose lumpectomy, I could change my mind later. But if I chose mastectomy, there was no going back. In the end, of course it's your choice. Just read back, hope your happy and recovered from that lumpectomy.

Cheers,

Laurie

Dear indahood

If it were me I would get a second opinion. You can get one just on the pathology if you want or a full second opinion from another surgeon and oncology team. Hope you get some good advice you feel confident in.

I recently had mx on right side for ILC. . Was supposed to have lumpectomy for ADH on left side, but when I went to imaging to have wire put in the doctor was unable to match wire with marker. Not a good experience. They couldn't do lumpectomy. I went into masectomy surgery confused and disappointed that I would not be done with surgeries.

I dont even know if this is a legit question, but has anyone taken a wait and watch mindset for ADH?

Thanks for reading my rambling.....