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Feb 27, 2020 03:16PM
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)?
Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole