Atypical Intraductal Hyperplasia of Apocrine type

Hi,

I've had three lumps removed in 14 months, all with needle biopsis show atypia.  The last Excisional Biospy involved two lumps.  One was diagnosed by the AFIP as Atypical Intraductal Hyperplasia of Apocrine type show aspects of DCIS but not quite architecturally formed all of the way.  They put the specimen in between their category 1b - 1c (where 1c required further surgery, and 1-b did not if margines were clear.

This all comes on the heels of 3 years of Acute Bi-Lateral Refractory Optic Neuritis of unknown origin.  My right eye which was 20/15 is now 20/400.  My left eye was hit first and has blind spots and color desaturation, but visual acuity varies between 20/30 20/40 (used to b 20/20.  All attacks have been non-responsive to steroidal treatment.  And vision never improved.

Since I am in such a severe state on the verge of blindness I have two questions:

1.  Do you know of any research that shows that the MS immune-modulators (beta interferon 1b &1a and glatimer acetate) has negative effects to those at high risk of breast cancer (which my surgeon & oncologist agree upon)?  I ask because it has been suggested as a last resort to try one of these drugs, however if they suppress the immune system, I don't know how that will affect my risk of developing a full-blown breast cancer.  Luckily we have caught the tumors in pre-cancer state.

2.  Do you know of any research (or can you direct me) where people who HAVE developed a breast cancer (not "pre") and who have an MS-like illness which responds negatively to physical and mental stress... research that talks about the effects of radiation therapy and/or chemo on the other illness??

My concern is going blind if I develop a full blown cancer.  On the other hand, I am very concerned that the MS drugs may facilitate the development of cancer as I am high risk.

My preference is to keep my left eye and lose the breasts if it has to come down to that.

Any direction or answers will be MUCH appreciated.  Thanks in Advance,

Christine

[CCF-RN,MSN-JS]

Dear Christine,
Your situation has many complexities that the answer to your particular question would not be found directly in the literature.  The question does interferon increase a persons risk of breast cancer?   I do not know of any correlation between these and did not find any in a Medline search.  Having a diagnosis of atypical hyperplasia puts a person at a moderately higher risk for breast cancer.  

In regards to your second question, treatments of breast cancer vary widely.  There are local treatments; surgery and radiation, as well as systemic treatments; hormonal therapy or various chemotherapies.  It is very difficult to say if, in general, treatment for breast cancer would have a direct effect on optic neuritis, although a specific treatment may.  

Decisions regarding treatment for any condition need to take into account all information that pertains to your individual situation.  These decisions are best made through a dialogue between yourself and your physician.  If this discussion is not satisfactory you could always seek a second opinion.