atypical ductal hyperplasia

I had a stereotactic biopsy and it was determined by pathology that I have atypical ductal hyperplasia.  The dr. has recommended another type of biopsy to remove more tissue for analysis.  What information can you give me regarding this next procedure and information regarding ADH?  Although the dr. stated this is benign, my risk is approximate 50% greater that the ADH can develop into a malignant breast cancer.  Can anyone give me their recommendation on this?

[shabby6485]

I am in the same boat.  Had stereo. and showed atypical lobular hyperplasia.  Was told it was benign but must have a needle loc. biopsy in one week.  The needle loc. is surgery under local anest. and iv sedation.  I am more nervous about the results than the procedure.  Did your dr. say that they need more tissue to rule out cancer?  That was my understanding.   Do you have any info on that or chances that the stereo. bio did not adequately diagnose cancer? confused

[BhumikaMD]

Hi,

Atypical ductal hyperplasia is not cancer nor is it a pre-cancerous lesion. But it does mean that the individual is predisposed to increased risk of cancer.

For you to understand it - this means that there is an area (focal) from the duct of the breast (ductal) of an increased number of cells than usual (hyperplasia) that look different than normal breast tissue (atypical).

You should follow up with your doctor about the further management plan in your case.

Let us know if you have any other doubts and post us about how you are doing.

Regards.

[shabby6485]

Thanks for your reply.  If this is "benign", why the need for excisional biopsy?  Is there a chance that there will be cancer found on this biopsy? If so, how likely would that be with atypical lobular dysplasia? I go next week and I am scared.

[PaulMD]

Hi there!  In stereotactic biopsy, only a small portion of the lump is sampled and sometimes, the rest of the unsampled lump can harbor a precancerous or a cancerous area.   Do you have a palpable lump or mass?  Or is this biopsy done based on a mammogram finding?  The risk of harboring cancer also depends on the characteristic of the lump/mass or certain mammogram findings.

[shabby6485]

Thanks. I had a stereo. bio after they found microcalcifications on a screening mammo.  I was told the biopsy was benign but said the next step is surgical biopsy.  So, no palable lump or mass.  She said there was a very small area of lobular dysplasia.

[sarasam]

I am in the same situation.  Although the stereotactic biopsy results for microcalcifications came back benign, they found the presense of a radial scar in the tissue and want me to have a surgical biopsy.  I am leaning toward not having the additional biopsy and waiting six months for the follow-up mammogram.  I have dense breast tissue and have dealt with fibrocystic breasts for over twenty years, so there always seems to be something abnormal on my mammograms.  Scar tissue from multiple biopsies leads to more abnormal mammograms, which lead to additional biopsies.  Vicious cycle that creates havoc with your emotions.

I discussed this with my primary care doctor, who is also a breast cancer survivor, and I still don't feel my test results warrant an additional biopsy.  I know I am at a greater risk for developing breast cancer, but I think overdiagnosis and fear of malpractice lead to a lot of unnecessary procedures.  I am going to meet with the surgeon in a couple of weeks, but unless I get different answers to my questions than I have so far, I will probably not have the surgical biopsy done at this time.

[BhumikaMD]

Hi,

Atypical ductal hyperplasia is not cancer nor is it a pre-cancerous lesion. But it does mean that the individual is predisposed to increased risk of cancer.

This is the reason why an excisional biopsy is done.

What doubt do you have about atypical lobular hyperplasia? Could you post it to us again?

Let us know if you have any other doubts and post us about how you are doing.

Regards.

[Fubba123]

In August I had an abnormal mammogram which led to magnifications of the breast in question results were many microcalcifications.  A biopsy confirmed that which led to the removal of the breast where most of them were located.  Results from that showed atypical ductal hyperplasia. Because I needed time at this point to digest it all my appt. with an oncologist to discuss options is in the future.  History of  breast cancer in my family (mother passed away at 58).  Honestly, at this point I think I would rather just have my breast removed then to have to do this every year! I just spent two months going from appt. to results, to appt. to results.  I just can't see myself possibly doing this every six months.

[madgeOwens]

My pathology was also Atypical Ductal Hyperplasia, and they removed it with Lumpectomy and after said I may want to see an Oncologist because my risk of breast cancer has now doubled.  I am in process of that now.  The way I understand it is that ADH is one stage from DCIS (which is still considered pre cancer) and two stages or steps from Cancer. It gets quite confusing but I am hanging in there and hope you will keep looking for your answers also.

[Kathy1124]

My situation was the same as yours.   I decided to go for the excisional biopsy.  At my surgical consult my surgeon decided to have me do an MRI before surgery.   The MRI detected cancer that the mammogram AND ultrasound did not pick up.  The mammogram and ultrasound only picked up the microcalcifications.  The microcalcifications were at 3:30 on my left breast and the cancer was at 2:00.  I am so grateful for my surgeon's gut instinct, as there was no palpable mass or lump.  I originally went in for a lump on my right side.  The cancer is on the left.   Should you consider surgery I have one major piece of advice.  I had to have two loc wires placed and mine was a little complicated.  I found the whole morning to be quite traumatic and the procedure miserable.  I would suggest taking a family member who is authorized to sign all authorizations for you, which would allow you to take some calming medication.  I have written letters to my doctors and the hospital.  It is a fairly standard procedure to NOT give anything prior to the different pre-op stations.  I'm a tough gal...and it got to me... get DRUGS.  The mental anguish and physical is too much sometimes..... best of luck!!!