Risk of dcis
Hi hope all is doing ok. Apologies if im posting to the incorrect thread. I didnt get responses from my other discussion. Moderators please feel free to move this to a more appropriate space. So a little history, im 41, no children, menstruation started at 10, never been pregnant , never breastfed. Family history with maternal grandmother and maternal aunty being diagnosed around age 50. two yrs ago i had a fibroadenoma surgically removed. About 2 months ago i had another lumpectomy for suspicious duct that was dilated, with also a bloody nipple discharge. See path report below. My question is, with having had three biopsies and 2 lumpectomies over a 2 yr period, what are my risks? over growth of cells but usual type (epithiliosis) was found, no atypia. Is it possible other ducts could be harbouring it? i have extensive duct ectasia too. Thanks in advance. Any and all advice is welcomed.
Path report
specimen 1 shows fribotic tissue with irregular proliferation of glandular structures. in parts having a fibroadenomatoid pattern. Apocrine blebbing is seen with focal cystic change whilst other areas show dilated ducts. Some of the dilated ducts contain macrophages and red blood cells and there is patchy chronic inflammation in the stroma. Minimal epitheliosis is seen but there is no cytological atypia. Immunohistochemistry using CD10, SMA, and P63 shows an intact basal layer.
Specimen 2 shows fibrofatty breast tissue with adenosis, ductal dilatation and focal apocrine change.
No obvious cytological atypia is seen. No evidence of malignancy is seen.
Whilst there is FOCAL EPITHELIOSIS, no evidence of cytological atypia, DCIS, or malignancy is noted.
Highlighed words were underlined by the specialist breast surgeon.
Comments
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Hi @mspaws , There is no way of predicting your personal risk but there are calculators that give the statistical risk of breast cancer in a large population. I had a very low risk (2.9%) on a more detailed calculator done by my PCP but ended out with bc. I have friends with multiple relatives who had bc but have not developed it at this point in their lives (early 70's.) This is a link from the National Cancer Institute.
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hi @maggie15 . thanks for your response. i will look into that. I was actually wondering if the Epitheliosis which is Usual Ductal Hyperplasia could turn into ADH? Or the fact that there is irregular proliferation be an indicator that things are heading in the wrong direction..
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Hi @mspaws ! I had genetic testing done once diagnosed with breast cancer. Thankfully it came back no genetic mutations that would explain my breast cancer. The Dr told me that most breast cancer diagnosis are actually not due to genetic mutations (like BRACA mutations). That most woman at some point in their lives were exposed to something that damaged the genes in their breast. Have you thought about having genetic testing done? I had no risk factors other than being a woman. I think all we can do is stay on top of our health and hopefully catch things early!
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thank u @flowergirl1975 . i have not considered gene testing yet. at this point i will stick to my yearly screenings. its just worrisome that each year something suspicious or concerning is seen. just afraid that the other shoe will drop at some point. but im thankful to be healthy now. i will stay on top of things too. did u have any symptoms with dcis? or did u have any benign conditions before dx?
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Hello @mspaws ! I did not have any symptoms of my BC. I have been going for diagnostic mammograms every 6 months for 5 years. It’s like once I hit 42 a normal mammogram was no longer in the cards for me. My DR said as we age our breast tissue changes, another joy of getting older I guess. In March I had a papillary lesion with internal blood flow so I needed a biopsy done. Biopsy came back atypical cells. First lumpectomy was done to get it out. Path results showed DCIS with microinvasion ( very small amount of invasive cancer starting). Back in I go for another lumpectomy, path results came back extensive DCIS with more microinvasions and a positive node :(. None of this showed up on my mammogram or the MRI that I had just had ( other than an enlarged lymph node which is why I had a SLNB done). It came to a surprise to both the surgeon and myself. On May 31st I had a double mastectomy and finally I got clear margins!!! Took removing my entire breast to do it, and the other one because I didn’t want to go through this again. I think part of the issue is that I have dense breasts so that may be why the extent of my BC was not seen. I think as long as you and your doctor are continuously monitoring your breasts, if anything other than benign changes pop up you will deal with it then. Don’t look for problems that aren’t there. If I did that I would have had BC 5 years ago. Trust in the doctors and the testing. Stay on top of your appointments, be proactive with your health. If something ever does pop up you will catch it early!
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