Just want to say "Hey" everythingw! Good hearing from you! How are you feeling? You certainly have a lot you are dealing with and trying to sort through....

"I really do not know how significant LCIS is. My surgeon did not sound that alarming with ADH and LCIS. And lumpectomy removed them already and she said it is a very small area."

Several of us have provided a lot of information about LCIS in this thread and your original thread in the LCIS forum. With all the discussion, I think you may have missed the point that the removal of the LCIS doesn't reduce your risk because it's not necessarily the area of LCIS that develops into breast cancer but it's the fact that your breast developed LCIS that means that you are higher risk to develop breast cancer in the future, in either breast.

The following study isn't directly relevant to you because it looked at women with LCIS who did not also have either DCIS or invasive breast cancer, but it highlights the risk associated with a diagnosis of LCIS:

Lobular Carcinoma in Situ: A 29-Year Longitudinal Experience Evaluating Clinicopathologic Features and Breast Cancer Risk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC49346...

"For the entire surveillance population, the annual cancer development rate was 2% per year through the first 6 years after LCIS diagnosis with no evidence of a plateau out to 150 months of follow-up. Overall cumulative cancer incidence at 15 years was 26%....

One hundred seventy-three women took chemoprevention during surveillance without bilateral prophylactic mastectomy....The cumulative cancer rates for women who took chemoprevention compared with those who did not were 3% and 7% at 5 years and 12% and 21% at 10 years, respectively." Note that "surveillance population" refers to those with LCIS who did not have a BMX. "Chemoprevention" refers to Tamoxifen or an AI.
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"I do know that my breast is very dense and that is my concern"

everythingwillbefine, you are premenopausal. It is normal to have dense breasts if you are premenopausal. 75% of women in their 40s have dense breasts, either heterogeneously dense or extremely dense.

For women with dense breasts, a combination of mammogram screening plus ultrasound screening is usually recommended. Sometimes MRIs are done instead of ultrasounds but more often, MRIs are brought in at the diagnostic stage, if something appears unclear on the mammogram and ultrasound screenings.

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Just my perspective, but to me the most important question in your case is whether the risk from the LCIS is cumulative to your risk from the DCIS or not. As I see it, those are the two factors that present you with the greatest future risk.

I'm really sorry that you find the information to be depressing. It's not new information though - it's the same information that was discussed in this thread almost a month ago, and similar to the information that was provided to you initially by your surgeon (which, granted, is very different than what she told you this week). It's the same information that you had prior to making your surgery decision. You made your decision for a reason. Your pathology results were good. So has anything changed? LCIS is a significant high risk factor, but keep in mind that you really need the input of the MO to understand your risk level - as I said, I don't know how the LCIS plays into your future risk since you've already been diagnosed with DCIS.

Whatever decision you make, what does your family have to do with this? This is your risk, your body and your life.

Your husband's job is to support you in ensuring that you make the best decisions for your long-term health, whatever those decisions turn out to be.

Remember, this is about what is best for you. I'm not trying to scare you or depress you but want to ensure that you are armed with the right questions to ask the MO. Ask the questions, have a good discussion (and challenge the answers if they don't seem right - like your surgeon saying your risk is 2% over 10 years after telling your previously that it was 14%), and then decide if you are happy with your decision and want to stay down this path, or if you want to change direction.

No, it doesn't matter. And Tamoxifen should be prescribed by an MO not a surgeon, so waiting 3 weeks to talk to an MO is perfectly reasonable.

Keep in mind too that the Tamox is prescribed not to address your current diagnosis of DCIS - with the MX, no additional treatment would normally be recommended or required - but because you are high risk to develop a new primary in your contralateral breast. So it is addressing future risk. And while Tamox will significantly reduce your contralateral risk, taking it as a high risk preventative is entirely optional. You can start now or you can start in 6 months or in 6 years (6 years wouldn't be my recommendation given the LCIS and history of DCIS, however).

Glad you're following up with second opinions so you are comfortable with what you're doing....

Generally ovary removal is done to reduce estrogen and breast cancer recurrence risk, and/or so that the patient can take AIs instead of Tamoxifen (although I think ovarian suppression may be more common for this). Except for those with a genetic mutation that predisposes them to both breast caner and ovarian cancer, there is little to no increase in ovarian cancer risk after a breast cancer diagnosis.

Ovarian cancer risk after breast cancer https://www.facingourrisk.org/understanding-brca-a...

" Women with a family history of breast and ovarian cancer but no identified BRCA mutation have an elevated risk of ovarian cancer after breast cancer, but the exact risk is unknown. Research on ovarian cancer risk associated with mutations in BRIP1, RAD51c, RAD51d, and other genes found on many expanded panel tests remain an active area of research. Survivors with a family history of breast cancer only, (no ovarian cancer in the family) but no known mutation in the family, may not have an elevated ovarian cancer risk. A study on women from families with an extensive history of breast cancer but without a BRCA mutation found the risk for ovarian cancer was similar to women in the general population. "

Glad you are comfortable with the gyn and her recommendations. I agree we cannot ignore variants where there is more info. to be gathered yet. We do not know yet whether these add or detract from concerns. I was diagnosed with a variant as well - cannot remember the exact letters. Either way I looked it up and it said it can mean greater colon cancer risks while more info. needs to be gained about the variant. Interestingly there is a colon cancer history on my mother's side and I got a 5 year call back after my last colonoscopy. Just let's me know to be even more vigilant about these types of screenings. Sounds like you will be too. Interesting as well about your gyn's recommendation to get retested (genetics) every few years.... Hope you continue healing well from recent surgeries!