ADH

[lynnie2945]

I had a screening mammogram done 3 weeks ago that revealed an abnormality (microcalcifications of the right breast) and upon further evaluation it was recommended that I have a stereotactic biopsy. I had the biopsy this week which revealed atypical ductal hyperplasia. I have no family history of breast cancer and am in the process of obtaining an opinion from a specialist regarding an excisional biopsy. The path report showed foci of cribiform glands associated with the microcalcifications where the pattern was collapsed. There were a few nuclei that are streaming in addition to trabecular bars. No invasive tumor was seen. Is this finding typical of ADH?
I have been researching so I can go see the specialist as an informed patient and to help me in making a decision in how to proceed. My gynecologist recommends the excisional biopsy with follow up treatment with tamoxifen ( I am pre-menopausal). Is this standard of care for treatment of ADH?
Needless to say this has thrown me for a loop but I want to make the right decisions.
Thanks.

[lynnie2945]

The BIRADS score was a IV. I have an appointment with a specialist on 9/14 and am trying to gather as much information as possible so I can ask the appropriate questions. The opinions from the pathologist, gynecologist,and physician who performed the stereotactic biopsy are all in agreement that an excisional biopsy should be performed. My understanding of this procedure is that the microcalcifications will all be excised as well as margins around this to check for any invasive tumor. Do they typically do receptor site testing as well? Another question I had is do they do a frozen section of the biopsied area to check for malignancy?

Thanks

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
What was you mammogram BIRADS score?
It may be advisable to get an excisional biopsy of the breast area which showed the microcalcifications. Stereotactic biopsy may sometimes sample only a small part of the lesion and may not always reveal the invasive component.
You need closer surveillence as there may be some risk of developing cancer in the future.
All the best, and God Bless!

More info here: http://surgpathcriteria.stanford.edu/breast/adh/clinical.html