The next right thing Even though I am a guy I am humbly asking for directions...

[bestinfo]

Even though I am a guy I am humbly asking for directions...
and your help.  My friend has a coal burning computer that dies all the time so I am trying to help out and do the research and print it out for her.

What is the next right thing to do?


my dear sweet friend  was just diagonosed and had a needle biopsy and they found a .87mm tumor.  (see dx below) she is understandably upset and confiused by all this and I am trying to help in a balanced way by offering what support I can ... we are looking for the best information in the shortest amount of time, and trying to wade through all the info out there to only get the best that is applicable to her exact situation  The main questions are:

1) WHAT EXACTLY IT THIS?  WHAT ARE HER REAL OPTIONS? what is the exact next piece(s) of criteria we need to know about her condition to make the next decision?

so far all we know is tumor size (.87mm) and that it is atypical duct type epithelial hyperplasia.  What else EXACTLY do we need to know?


3) What is the difference between a breast pathologist and a regular one and is there even a Breast Pathologist available in Chicago for a second pathology opinion?


3) any other top ten questions you would suggest the newly diagnosed ask to get the very best treatment options?

Here is the only information we know so far if it helps.

dignosis:

Left breast, ultrasound guided needle core biopsy at 4 oclock  3 centimeters from nipple (4C) :  atypical intraductal papilloma with florid duct type epithelial hyperplasia and focal atypical duct type epithelial hyperplasia

[CCF-RN,MSN-rf]

Dear bestinfo:  Based on the information you have provided, your friend does not have cancer.  A papilloma is a benign tumor.  It can be removed with a simple outpatient procedure - just to be certain that it is only a papilloma.  The pathology of atypical hyperplasia may increase your friend's risk of developing cancer in the future.  Based on this information a good follow-up plan for monitoring will likely be recommended.

[bestinfo]

That is great news. Perhaps I misunderstood.  
thank you so much for your valuable time...

[bestinfo]

she is going into a Dr. Witt at Rush in Chicago to ask for a Second opinion on the pathology report and the DX.

What are the Exact questions she should ask the Dr. for the second opinion?

Thanks!

[bestinfo]

Then why did the Dr. say it was malignant?  and  What exactly is invloved in getting this removed?

Best info

[surgeon]

a papilloma is a common tumor in the breast; it is not cancer. The other terms describe what the cells look like, and are not rare in papillomata. It might or might not correlate with some increased risk of getting cancer in the future, but not enought to do anything about except maintain a regular program of surveillance (exams, mammograms). Most people would recommend complete removal of the papilloma, rather than just biopsy, in order to be sure there's nothing more there, and to prevent it from growing more.

[surgeon]

Sounds like there's some misunderstanding here: what you have quoted does not constitute malignancy. Where the misunderstanding lies, I can't say: either she misunderstood the doctor, you misunderstood her, or there's more in the report. Removing the tumor when it's not palpable requires an xray doctor placing a guidewire into the area -- a procedure usually simpler than the biopsy she already had -- following which she goes to surgery for removal, which the surgeon does by making an incision and following the wire to the area. Or, depending on circumstances, it might be done without the wire, if it's felt that the duct in which the papilloma lies can be found and removed directly.