Jan 13, 2020 10:51PM Lea7777 wrote:
Hello RunningLibs and sorry you find yourself in this situation. I am in a similar situation but with more atypia than you and I was post menopause when the various abnormalities were found. Hopefully someone closer to your situation will respond.
First on the calculated risk. The Tryer Cuzick model, if that is what you used, WAY overestimates the risk per every "breast professional" I have dealt with, totaling about 10. But it is used because those high numbers help get you an MRI covered by insurance.
Unless your family history has close family members with breast cancer, a prophylactic double mastectomy would likely not be recommended. You can research this yourself to see that it is not the recommended course of action for ADH and ALH. Still, some people opt for it and are satisfied.
The most commonly recommended management plan by oncologists and medical professionals in breast clinics (again assuming no strong family history) would be Tamoxifen since you are pre-menopause. There is now a low dose option of 5 mg/day instead of 20 mg/day that you might want to discuss with your doctor. The most commonly followed management plan by women with atypia is surveillance only. Depending on the source, I've seen about 10% to 30% of women opt for the drugs. Most do not. I am taking a drug (one available only to post-menopausal patients).
My approach to the drug(s) was give it a try and see what happens. If it is awful, I'll quit. Some were awful and I stayed on them a couple of weeks or less. One of the drugs has been ok.
If you go the surveillance route, see if you can get an annual MRI in addition to the mammogram. A 3D Tomosynthisis would be a good choice. Maybe you already are getting this kind because of dense breasts.
Good luck to you.