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atypical intraductal hyperplasia versus DCIS
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atypical intraductal hyperplasia versus DCIS

I'm 53 still have my periods and no history of any problems but have strong history of family breast cancer. I had a magnication mammo done which showed a cluster of microcalcifications on outer side of left breast. Was sent to a surgeon and he did a wire-localisation with surgical excision , it went ok. Got my results today and this is what the pathology report said.
Mucocele-like tumor with atypical intraductal hyperplasia versus DCIS grade 1. The size of this lesion as measured on the slide is 2.2mm. The lesion is at the superolateral margin of resection.
I don't know what the margin of resection means at all, I understand the DCIS a little and thats about it.What is atypical intraductal hyperplasia ? I was sure I would get an answer today but they sent out my specimen to a second pathology in Washington DC to Dr Tavassoli for consultation so that my doctor can determine my treatment. What could they tell him that he don't already know ?My doctor says the 2 condidtions are so much alike. Now I'm waiting again. What ever you could tell me on this would be deeply appreciated.
Thank You    GardenAngel
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Dear GardenAngel:  Atypical ductal hyperplasia (ADH) is a condition in which there is an overgrowth of cells within the duct and the pattern of their growth is atypical.  It is not cancer or precancer but its presence is considered to increase a person's risk for developing breast cancer in the future.  The area of ADH is usually removed as a part of a biopsy and close follow-up (with mammography and breast exam) is the extent of treatment.

DCIS is a condition in which there are abnormal cells within the duct that do not yet show signs of invasion.  DCIS is considered "precancerous" and is usually treated as a very early cancer.  The treatment is generally surgical resection (either a lumpectomy or in some cases mastectomy) followed in some cases with radiation therapy.  Hormone therapy may be recommended but chemotherapy is not necessary.

A margin refers to the edge of the specimen.  When tissue is removed, the edges are inked so that the pathologist can look at the cells on the edges.  If the abnormal cells are on or close to the edge, it is considered a close or positive margin.  In these cases, additional treatment may be recommended, depending on the final pathology.  Pathologists look at cells under a microscope to determine what they are.  In some cases, differentiating to very similar conditions can be very difficult.  In these cases, the slides may be sent to a second pathology department for another opinion (in some cases, these places may have expertise in certain conditions).
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