I had my triple excisional biopsy Monday, and got the path report today. The surgeon's nurse called and told me there was no malignancy, but that the surgeon wanted to discuss the details of the report with me when I see him next Tuesday. From the wisdom of everyone here, I knew enough to ask that she fax me a copy of my path report, so I could read it and be prepared with any questions for next week.
Two of the areas biopsied were nice and boring, and included "patchy dense fibrosclerosis, cyst formations, apocrine metaplasia, small fibroadenoma, and fibroadenomatous change".
The other area wasn't quite as boring. The report on that piece of tissue (4.5 x 3.0 x 2.5 cm) included: atypical ductal hyperplasia present less than 1 mm from the margin; fibrosclerosis, apocrine metaplasia and adednosis; focally tubular. This tissue sample then said "See Comment". The comment for that tissue sample was, "An immunostain for cytokeratin 5/6 was performed on the ductal hyperplastic lesion and is mainly negative."
From my time reading these boards, I know that in a path report there are often more questions raised, even with benign results. While I am thrilled and grateful that I have no malignancy, I do have a couple of questions for the surgeon next week.
1) Do I need to be concerned that the ADH was found less than 1 mm from the margin?
2) Do I need to be concerned that the immunostain (which I believe is used to differentiate ADH from DCIS) was "mainly negative"? I'd feel better if I knew what percentage was negative and what percentage was positive.
3) I'm going to inquire as to whether or not I should pursue genetic testing. My maternal grandmother died of metastatic bc. My mother has a first cousin who dies of metastatic breast cancer (diagnosed in her early 30s): she had one type in one breast; 4 years later she was diagnosed with a different type in the other breast; she underwent genetic testing before she died of the disease - and was told that she did have the gene for bc. (That is all the family knows of her illness; they are amazingly uninformed considering she tested positive for the gene. They have, however, requested her medical records from where she was treated, and they will forward the records to me as soon as they get them.)
Any and all thoughts and suggestions on other questions for my surgeon will be greatly appreciated.
I want to thank you all for your kind thoughts and prayers. I appreciate all the wisdom and experience everyone so willingly shares here.
As I said earlier, I am thrilled that I have no malignancy. However, I don't know that I'll ever completely relax, especially given my family history. I plan to stay around on the boards, to continue to learn what I can about this horrible disease, and to support others who have abnormalities and have to undergo further testing.
Dukemom
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shabby6485 Joined: Apr 2008 Posts: 76 |
May 7, 2008 07:46 pm
shabby6485 wrote:
Hi Dukemom
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Sashie Joined: Mar 2008 Posts: 37 |
May 7, 2008 08:40 pm
Sashie wrote:
Hi Dukemom,
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Sashie Joined: Mar 2008 Posts: 37 |
May 7, 2008 08:42 pm
Sashie wrote:
Hi Shabby,
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shabby6485 Joined: Apr 2008 Posts: 76 |
May 7, 2008 09:37 pm
shabby6485 wrote:
Hi sashie, Yes, it states there is a microfocus of alh. I go for a mammo in six months. How about you? What's next? Hope you had a great vacation. Shabby |
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Sashie Joined: Mar 2008 Posts: 37 |
May 7, 2008 10:45 pm
Sashie wrote:
Hi Shabby,
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kathryni Joined: Apr 2008 Posts: 56 |
May 7, 2008 11:00 pm
kathryni wrote:
I can't help you at except to say that I might know how you're feeling. It's great to hear that you're free of malignancies, it's just sucky to have a caviot put on there. Like, hey you're fine, except, you know, now you have to worry about it some more. Or at least that's how it felt.
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Dukemom2 Joined: Mar 2008 Posts: 294 |
May 8, 2008 09:08 am
Dukemom2 wrote:
Kat, I'm sorry you have gotten a staph infection. I hope they caught it early, and that it gets resolved quickly. Do you have a fever? After 'sleeping on' the information in my path report, I'm going to ask my surgeon about sending my slides out for a second opinion. I had a problem with this particular lab after my hysterectomy two years ago. During the surgery, the doctor discovered a growth in my bladder. He removed it and sent if off to this same lab. When my internist read the pathology report, he sent me to a urologist. The urologist took one look at the path report and said I needed a second opinion on the slides. The lab had used two mutually exclusive terms to describe the growth. The urologist told me that if one of the terms was correct, the other was very wrong. He also said the protocol for follow-up care was different for the two terms. He sent my slides to Johns Hopkins, and the new report came back that it was something completely different. Thankfully, it was still a benign growth, and it required no special follow-up, but I found it very disturbing that the local lab had gotten it so wrong. It's great that they are keeping such a close eye on you, with 6 month checks on both breasts for life. I know you will go into each check up holding your breath, waiting to learn if they see anything suspicious. I don't know if we will ever lose that fear, but it's important to be monitored closely so that any abnormalities can be found early. Be sure to take it extra easy while your body does double duty: heal and fight the infection!! Please keep us posted. Dukemom "You have to accept whatever comes, and the only important thing is that you meet it with the best you have to give." ~ Eleanor Roosevelt
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leaf Joined: Dec 2005 Posts: 2295 |
May 8, 2008 01:59 pm
leaf wrote:
Sounds like it a real good idea to get your slides reread. Many people do recommend a 2nd opinion anyways (if its not already at a major institution) if a reading is ADH. That's because it can be hard to tell the difference between ADH and DCIS, and they are treated differently. If you're going through hell, keep going-Winston Churchill
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lvtwoqlt Joined: May 2007 Posts: 2267 |
May 8, 2008 02:33 pm
lvtwoqlt wrote:
Dukemom, Glad to hear that it was b9. I had 2 previous dx of ADH, once in each breast 18 months apart dx with the sterotactic biopsy prior to my DCIS dx April 07. I unfortunately did not get all the path reports from the first 2 dx or after the excisional surgeries that followed. I now know better and have all the path reports from last years dx. My surgeon did excisional surgeries after the stero to get the area of concern with the ADH. I was then put on a regiment of 6 month mammos. I also have a close history of bc/oc, my mom dx with bc in 2001 and her sister passed away with oc 1978. My mom did the genetic test and was negative. I know that I rambled but wanted you to know that others have been where you are and it is a personal decision what to do. Sheila Because of the history my surgeon suggested tamox after the first dx and I was reluctant to take it at age 44 for a b9 condition. He did more than suggest it after the 2nd dx of ADH 18 months later and I went on it for 6 months. We are like tea bags, we don't know how strong we are until we were thrown into hot water. Eleanore Roosevelt
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mtbmom Joined: Feb 2008 Posts: 111 |
May 10, 2008 07:52 pm
mtbmom wrote:
dukemom- don't these path reports just floor you?! My first report said ALH, then the excision found lcis. I am beginning to believe it's a trap shoot for finding the cells, and then the radiologist to find the results. I'm very happy for you that all seems b9- but, I want you to be diligent in pressing for your care. I'm in the process of waiting for the next biopsy, as well as changing oncologists. I'm amazed at how my radiologist gives me one impression, but the onc sees it totally differently ( does he see to much to look at the individual?). You are your own best advocate- push for the care you know you deserve, be it a second opinion on a biopsy, or for your follow up procedures. And honestly, I say this and I'm not an expert-I keep getting caught with two differing opinions, and struggle with how to progress. But I know internally I have to stop being shy about my health, and push, even if it means not so pleasant findings! My thoughts and prayers are with you- hugs-Denise When my time comes, help me leave behind some reasons to be missed- C.B.
Dx 2/18/2008, LCIS, 2cm, Stage 0, Grade 2, 0/0 nodes, ER+/PR+ |
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