ADH

[richrona]

I had a stereotactic and a needle localization excision biopsy done in the past two months.  The first round of path reports indicated I had borderline low grade DCIS which necessitated the next biopsy.  The surgical biopsy path report says the tissue, the target area and the margin around it, is all ADH.  I was referred to an oncologist for further discussion re: tamoxifen.  I am deathly afraid of the side effects as I am 44 years old and premenopausal and do not want to trade one disease for another.  I am also concerned about the difference in diagnoses. I'd appreciate any input regarding how to manage this situation.  I have an appointment with an oncologist as per my surgeon's suggestion for July 13.  What should I be asking?

[japdip]

Usually the area of ADH is completely removed surgically and then often some treatment following surgery; radiation and/or Tamoxifen. It is true that Tamoxifen does have side effects just as all drugs but not everyone will experience these. I'm not sure what you should be asking the Oncologist .... any question or concern you have regarding the treatment that is being recommended would be a place to start. Some women choose not to take Tamoxifen but it has been proven very valuable in such cases. You would never know what, if any, side effects you would experience unless you tried the therapy and you could always stop it if the side effects were severe.   Regards .....

[richrona]

Thank you for your response.  After all that I have read, I didn't think Tamoxifen was prescribed in the ordinary course and was wondering why the surgeon felt I ought to take it.  I am concerned that not all the ADH has been removed since the margin around the clip came back as ADH as well as at the location of the clip. I have a tremendous amount of calcification in the breast and am worried that ADH is lurking about in other areas.  Is removal of all the calcifications routinely done in cases like mine? I appreciate your input.  Thank you.

[japdip]

Only areas of clustered calcifications are cause for concern ... scattered calcifications are normally present in the breast tissue. The main objective with surgery is "clean" margins and often this takes more than one excision. Tamoxifen is pretty much the norm for these cases.     Regards .....

[richrona]

Thank you so much for your response.  I hope another excision won't be necessary, but at least now I know what to expect.  This forum is amazing.  I feel fortunate to have found all of you and your insight and guidance during such a difficult time.  Thank you.