Atypical ductal hyperplasia

[pss60]

   I am 50 years old and have recently been diagnosed with ADT through a needle biopsy. I have three areas of concern in my right breast. They were only able to get samples from the largest site as my breast are very dense. After multiple tries the doctor said she's in to much pain and they are all probably due to the same thing.
   When seeing the surgeon she suggested removing the largest which is the one that was biopsied and doing mamograms every six months to keep an eye on the other two. The reason for this is that my breast are very small and removal of all three would be 5 centameters of tissue which would be my whole breast. So instead she is removing 3 centameters in the top center area. This in her words would leave me disfigured. When I asked about reconstructive surgery her answer was " yes you can have implants but not until you have one year of clean mammograms and I would still be disfigured but this would help to fill in". This is very disturbing as no one wants to be disfigured and I was not given much hope for reconstruction. The thought of leaving undiagnosed spots in is not good either. Then I start to wonder can all of these spots be put on watch if we're going to watch two of them. It is very hard to believe I may be disfigured and this is not even cancer yet and may never be. Please help shed some light on this for me. I have spent much time reading about my condition and about reconsturction, which from what I understand should be done as soon as your margins are clear not one year after clean mammograms. I have no immediate breast cancer releatives in my family. HELP!

[japdip]

You are correct .... everyone feels much the same way when faced with a possible diagnosis of cancer. There isn't the rush that is sometimes thought in these situations. It's better to get all your questions and concerns dealt with before you do anything than to jump ahead too fast and have regrets later. Take care now ... and keep in touch as you have more information and make your decisions. We are here to help in any way we can. You can always contact me by note or Private Message if you wish.    

[pss60]

Thank you for your concern. I pretty much felt the diagnosed area needed to come out. Your right about the other areas being sampled. I am looking for another surgeon as I am not at all pleased with someone who is willing to put me on watch with two undiagnosed areas. Likewise I am aware that if all were to removed  I might be able proceed with reconstructive surgery.
This is all very new to me and it is hard to wrap my mind around the whole thought of loosing my breast. I guess everyone feels this way.
I will take you advise and consult with a plastic surgeon before surgery. I would like to find a doctor who might steer me in a direction of someone they have worked with on others.
Again thank you for your input. My friends care but they haven't been through this so it is nice to be in a place where people understand!

[japdip]

It is standard procedure to remove completely, with clean margins, the area of ADH. Often there is additional treatment that is recommended following the surgery; Radiation & Hormone Therapy are quite common. ADH does increase your risk by a considerable percentage to develop breast cancer in the future. I would insist that the other areas in question be sampled, perhaps at the time of surgery just to be sure. It would NOT be good medical practice to leave a diagnosed area of ADH to just "watch". It would be much to risky if it were me. The one year wait for reconstruction may well be due to the fact of leaving the other areas "as is". If I were you I would consult a Plastic Surgeon for definite information regarding reconstruction before you decide which way to go with this. An Oncology Consult wouldn't be out of the question either in case there would be some additional treatment prescribed following surgery.    Regards .....