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Topic: Lumpectomy for atypical cells

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: Apr 6, 2011 08:27AM

Lifeafter wrote:

I am 40 years old (3/26).  I have a family history of breast cancer on my mother's side (aunts). I had my first mammogram in August 2010.  I was called back a week later to have my right breast re-imaged.  They found a cluster of microcalcifications.  They said I needed to come back in 6 months.  I went back 3 weeks ago and the cluster multiplied.  I had a core needle biopsy done last week.  I was told they found atypical cells and that I would have a lumpectomy.  I told the women in my family and I'm getting the worst possible information.  I need to know facts and what I should be zeroing in on to ask my doctor.  I have an appointment scheduled with obgyn this coming Monday.  I am doing research on my own but there is to much out there and have no idea what I should be concerned with.  A couple of things I know I want to know is...what do the atypical cells mean in conjunction with my family history?  How much tissue do they have to take?  Are they going to be restesting the area they take?  What is my recovery time?  I'm going on vacation in a month.  Should this be scheduled before or after?  I'm reading stuff about different grades images were given.  Should I ask about that?  Does location matter? 

Can someone help guide me?  If I need to be on the freak out path, fine, I can deal with that.  But I don't want to deal with that if I don't have to.  I need a checklist to take with me to my appointment.  Anything that can be provided will be most welcome!

5/5/11 lumpectomy - 5/13/11 PMX - 6/20/11 BMX w/immediate recon 7/27/11 RT TE removed - 10/28/11 RT TE replaced - 2/3/12 oopherectomy/salpingectomy - 7/3/12 major revision, LFT implant - 9/7/12 RT Implant Dx 5/12/2011, DCIS, 3cm, Stage 0, Grade 3, 1/3 nodes, ER+/PR+
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Apr 6, 2011 08:48AM dlb823 wrote:

mrochon, at this point, you need the expertise of a breast surgeon, rather than an ob/gyn.  Atypical cells are pre-DCIS, and DCIS is pre-invasive breast cancer.  While a lumpectomy may be advisable, the need probably is not urgent.  From what you've told us, you certainly have time to gather more facts and make a more informed decision.

Here's a list of NCI-designated comprehensive cancer centers.  This is where you will find experts in breast health (breast surgeons). 

http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html

I would strongly suggest a second opinion app't. with a breast surgeon at whichever one is closest to you.  They will be able to give you a much better explanation of your situation, determine if your family history poses an additional risk, and guide you re. the scheduling a lumpectomy, if that's what's recommended.    

Good luck, and glad you've found BCO.   Deanna

Deanna "The soul would have no rainbow if the eyes had no tears" Native American proverb Dx 2/1/2008, 1cm, Stage IIA, Grade 3, 1/16 nodes, ER+/PR+, HER2- Dx 1/3/2014, Stage IV
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Apr 6, 2011 08:55AM Lifeafter wrote:

Thank you Deanna!

I have to meet with my obgyn because he needs to refer me to a surgeon.  I have other cancers that run on my mother's side of the family, my mom being one of them.  I really don't want to take any chances and would rather them just go in.  I've read about DCIS but didn't know if that had to do with me.  I will look that up some more.  Thank you for the link, I will check that out and go in with a list of surgeons when I see my doctor.

Michelle

5/5/11 lumpectomy - 5/13/11 PMX - 6/20/11 BMX w/immediate recon 7/27/11 RT TE removed - 10/28/11 RT TE replaced - 2/3/12 oopherectomy/salpingectomy - 7/3/12 major revision, LFT implant - 9/7/12 RT Implant Dx 5/12/2011, DCIS, 3cm, Stage 0, Grade 3, 1/3 nodes, ER+/PR+
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Apr 6, 2011 08:58AM Anne1962 wrote:

mrochon,

I had microcalcifications show up on my last mammogram. I had a stereotactic biopsy done and it showed  atypical lobular hyperplasia (ALH). I didn't have a lumpectomy or an excisional biopsy. In fact, my breast surgeon (BS) told me I could go back to regular screening. Others will be along soon to tell you of their experiences with atypical cells. Some do watchfull waiting, some do more testing, and some opt for a prophylactic mastectomy. A lot depends on how you feel and, of course, family history. 

Do you know if you have ALH or ADH?  Sometimes that makes a difference.

Good luck to you. 

Anne

Anne1962
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Apr 6, 2011 09:01AM Lifeafter wrote:

Hi Anne,

I didn't know atypical cells has classifications in themselves.  Good to know, I will be asking.  I'll be adding that to my research/question search.

Thank you!

Michelle

5/5/11 lumpectomy - 5/13/11 PMX - 6/20/11 BMX w/immediate recon 7/27/11 RT TE removed - 10/28/11 RT TE replaced - 2/3/12 oopherectomy/salpingectomy - 7/3/12 major revision, LFT implant - 9/7/12 RT Implant Dx 5/12/2011, DCIS, 3cm, Stage 0, Grade 3, 1/3 nodes, ER+/PR+
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Apr 7, 2011 02:17AM vmudrow wrote:

I too had microcalcificatiaons that started clustering after a couple of years.  Had excisional biopsy, they took a golf ball size piece of tissue.  Wasn't painful, took a few days to feel better.  It came back ALH, I was sent to oncologist who wanted me to start Tamoxifen.  I chose double MX because I didn't want the constant monitoring, biopsies, worry or Tamoxifen, also have strong family history - Huntsman Cancer center figured my risk was 40% of getting breast cancer at some point.  I have been very happy with the whole process and my decision.  Good luck to you!!  Keep us posted.

Hugs, Valerie

valerie, Diagnoised 1/24/2010 with atypical lobular hyperplasia, prophylactic NSM on 5/6/10, strong family history, 40% risk of breast cancer
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Sep 12, 2016 11:45AM loverofbooks wrote:

Bravo to you vmudrow! I was diagnosed with ADH after a suspicious cluster of calcifications and biopsy, and scheduled for lumpectomy on 9/20. Have to head out tomorrow pre op assessment. Surgeon told me he was taking golf ball size piece. I've heard the same thing from other women with ADH that they too had golf ball size pieces removed. Guess surgeons want to clear out the tissue bed and make sure nothing else is lurking around. But my surgeon also mentioned possible radiation and Tamoxifen for me afterwards and I freaked out--no wish to go through menopause all over plus the horrid side effects of those drugs and long-term treatments. Especially since I live out of state. I'm already on blood thinners so that complicates things even more. If my pathology comes back unpleasant news, I'm seriously thinking about mastectomy as well to clean up this mess for good since I'm at a high rate of getting breast cancer also..

Have any of you ladies had lumpectomy under light sedation with local? I'm fighting general anesthesia for several reasons: my age, it makes me violently nauseous, the risks, the lingering cognitive affects, and percentage of dementia it causes in people over 60. I'm going to ask for Valium over Versed since I don't like hypnotics--I want to know what's going on, even though the surgeon won't like that. I'd even watch if they let me. I know they'll give me Fentanyl to kill the pain, which is fine but no Propofol for me.

pleomorphic calcifications--ADH 8/8/16; complete hysterectomy 1980; lumpectomy 9/20/16 Dx Right
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Sep 13, 2016 02:21AM kwhit wrote:

Deanna, I had atypical cells (FEA) and was not told that it was pre DCIS or DCIS the only treatment I had was removal and have been told by a general surgeon, who is a breast cancer survivor and by a beast specialist that, that is all I need to do other than my yearly mammograms. That was in 2012 and I got a call back this year but it was a benign cyst in the same area......

I'm interested to know if anyone else has had anything similar happen....

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Sep 13, 2016 09:20AM leaf wrote:

I had conscious sedation for my lumpectomy is 2005, which took out about ?2 tablespoonfuls of tissue. (I have LCIS and ALH, and DH, but not ADH.) I didn't feel any pain, but any time I said 'Ahhh' (or anything) because I didn't know what was happening, they gave me another slug of propofol which put me out again. I had fentanyl, Versed, and propofol. It was perfectly fine.

For one colonoscopy, I think they didn't give any propofol, but just versed and fentanyl. I was awake the whole time, and when the procedure was done, I would have walked to the recovery area. (I may have needed a steadying hand.)

If it makes any difference, Valium is in the same medication family as Versed. We are all different, and different people have different reactions to different meds.

Classic LCIS.If knowledge can create problems, it is not through ignorance that we can solve them- Isaac Asimov Dx 12/8/2005, LCIS, ER+/PR- Surgery 1/24/2006 Lumpectomy: Left Hormonal Therapy 7/15/2006 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Sep 14, 2016 09:31AM dlb823 wrote:

kwhit, I'm far from an expert on atypical cells, but here are three articles that might be helpful to anyone dealing with this situation and concerned about their future risk.

https://www.drsusanloveresearch.org/atypical-hyper...

http://www.cityofhope.org/blog/breast-abnormalitie...

http://www.ascopost.com/issues/march-1-2012/atypic...

As always, so much depends on individual pathology, including the expertise of the pathologist.

Deanna

Deanna "The soul would have no rainbow if the eyes had no tears" Native American proverb Dx 2/1/2008, 1cm, Stage IIA, Grade 3, 1/16 nodes, ER+/PR+, HER2- Dx 1/3/2014, Stage IV
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Sep 15, 2016 03:55AM kwhit wrote:

Thank you, I will read this for sure!


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