Second Biopsy Scheduled After Core Needle Biopsy for Atypical Lobular Hyperplasia

I have been diagnosed with Atypical Lobular Hyperplasia as the result of an ultrasound guided needle biopsy where they took 7 tissue samples.  Now, it has been advised that I proceed to a surgical biopsy at the end of this month.  I'm a nervous wreck as my mom and her cousin have both had breast cancer (at the ages of 67 & 69).    I've been told that 25% of these cases are positive for breast cancer which means that 75% are not and I am trying to focus on that number primarily. I'm perplexed as to how the biopsy will change with the two different types of biopsies.  The wait is just awful!   Furthermore, I've been advised that I'll probably be a candidate for Evista or Tamoxifan (tamoxifen) post biopsy, pending the results.  I had previously been taken off of birth control pills (several years ago) due to leg pain and see that these drugs can create the same concerns.  

Any advice to settle my nerves for the next 3 weeks? Any other questions that I should be asking of my doctor?  I love her (she was my mom's surgeon as well) and greatly trust her.   I've got 4 kids, and my first to enter college in 2 weeks and I'm trying to stay positive.

[PaulMD]

Hi there.

Needle biopsies only sample a portion of a lump or nodule, and the findings of atypical hyperplasia should warrant further investigation to rule out foci of DCIS or invasive cancer in the other parts of the lump.  The surgical excision biopsy would do just this.

I believe the figures quoted to you are quite accurate in that 1/4 of ADH biopsies may harbor DCIS or invasive cancers in some parts of the lump or nodule.  I know that this is primarily the cause for your anxiety, but then again, the odds are still in your favor.  

If there is indeed DCIS then I agree that hormonal treatment after the excision may be needed to lower the risk of developing invasive cancers.

Regards and God bless.

[Melis49]

Thank you SO MUCH for your response!  It was especially helpful to learn what we are trying to 'rule out.'  I pray I am part of the odds that are in my favor and still pray for those whose odds fall in the lesser percentage.  That word "invasive" is very scary for me but I appreciate the physicians who are forthcoming with the information.

What does "foci of..." mean?  

God bless YOU!
Melissa