Diagnosed LCIS SECOND OPINION PATH FINDS ADH
Had a Radial Scar found on mammo then stereo biopsy in to center of radial scar was benign . Radiologist suggested excisional biopsy to remove Radial Scar. Came back with LCIS and surgeon immediately suggested prophylactic mastectomy. My gyn said that was too extreme. My radiologist ( who I work with) said just do the mastectomy so it doesn’t become a problem. A hematologist I went to see said to monitor and take Tamoxifen. I had my pathology slides sent to MSK for second opinion , they concurred with the LCIS and also found ADH. Now surgeon is saying more of a reason to do mastectomy.
I am so stressed out. Part of me worries that if I don’t do MX I will get invasive cancer and the other part of me wonders if the excisional biopsy took it all out and I can just monitor.
I don’t know what to do ☹️
Comments
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Hi @zuzubanks, I'm sorry that you have to make this difficult decision. Radial scars are problematic in that they are benign but grow in a tissue environment favorable for cancer. They can mask both precancerous and cancerous cells so that they are not seen on imaging.
The doctors you have consulted are evenly split on the best course of action. Either one is fine depending on your preferences. Some people feel that a prophylactic mastectomy would relieve them of their constant worry and scanxiety for every mammogram. Others feel that the surgery is too extreme and monitoring would catch anything early. Also, taking tamoxifen is systemic and would help protect your other breast, too.
I ended up with invasive cancer and had a lumpectomy. The pathology found numerous radial scars in the tumor margins so I know there are radial scars left in my tissue which could be hiding things. A clear mammogram does not give me any reassurance given my history but I have learned to live with the uncertainty. While things would be better if this had never happened stage 2 bc is not the end of the world.
I am in the monitoring camp but those who would prefer prophylactic surgery have just as valid a point. Base your decision on which course of action you would have the fewest regrets about no matter what might happen in the future. All the best!
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Hi @zuzubanks and welcome to Breastcancer.org. We're so sorry for the worries that bring you here, but we're really glad you've found us. As you can already see, our Community is full of amazing members always willing to offer advice, information, encouragement, and support — we're all here for you!
In addition to the helpful post from Maggie, you may find the information here helpful:
We hope this helps. Please let us know how you make your decision and how we can help!
—The Mods
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For certain things like ADH even if they took it all out, that does not decrease your risk of cancer. The issue is as maggie said, if your breasts can grow ADH, LCIS, etc., they can grow cancer. I also have ADH and am getting a mastectomy. The choice is yours, and hopefully your surgeon went over the statistics with you (35% chance of cancer at 30 years). This can potentially be even higher with other risk factors, but that is for the average person. I don't want to think about this every scan, biopsy, etc. but I know others feel differently and it is all valid.
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