Male with Atypical Ductal Hyperplasia

[Zapit]

I am a 62 year old male, in reasonable health. There is no family history of breast problems. About a month ago, I had a needle biopsy done on my right breast, as I had developed a lump there. There was an indication of Atypical Ductal Hyperplasia cells, and after discussion with my surgeon, we decided on a simple mastectomy. The surgeon told me he removed a piece of tissue about the size of a flattened baseball. Pathology reported 2 out of the 26 tissue slides tested returned positive for ADH. Since the surgery, I have developed a large hematoma in my right breast, to the point that it appears I have a substantial busom (at least on the right side). I am also experiencing intermitant sharp pains in this breast. My surgeon has told me there is little that can be done about the hematoma other than trying to asperate it with a needle (which he doesn't think would be very successful) or insert a drain (which, I believe, would expose me to the possibility of infection setting in).  I have no known problems with my liver, and my testicles are of normal size. In fact, I can think of no reason why I should have developed ADH. My personal Dr. is also clueless, as is my surgeon. Therefore, there is no further treatment scheduled. Should I be concerned about having had ADH? Is there something that can be done to prevent this from happening in my left breast? Do I need additional treatment? And finally, is there anything that can be done about the hematoma? Honestly, it is very hard to find any information about this condition in a male, and I am hoping you can shed some light.

[CCF-RN,MSN-JS]

Dear Zapit,  Atypical ductal hyperplasia (ADH) could be looked at as a risk factor for developing cancer.  We don't know if it means that atypical hyperplasia leads to cancer or that the conditions that allow atypical hyperplasia to be present also would let cancer be present.  This is an unusual diagnosis in men and the implications are uncertain. Close follow-up is the usual recommended course of action, this is in order to find an intraductal cancer or invasive cancer at an early stage, this includes physical examination by a doctor.  The value of screening mammograms in men is unproven, but you may want to discuss with your physician or with a surgeon specializing in breast cancer whether your personal risk of cancer in the other breast is high enough to recommend yearly mammograms.  



Regarding treatment of the hematoma (collection of blood resulting from a break in a blood vessel) this type of problem resolves with time. In the meantime, measures such as warm compresses, or pain medication (avoiding aspirin containing products) to help ease discomfort as this is healing.

[lizziecee]

So sorry to hear of your problems. I have had invasive ductal cancer and DCIS and have had wonderful support from a breast care site in the UK, which has a specific section for males diagnosed with breast cancer. You might like to post there to get some opinions from guys who have been where you are. The URL is: www.breastcancercare.co.uk.

Take care and good luck.

Liz.

[Zapit]

Thank you for your responses. I will be asking my Dr. about a possible consultation with a breast cancer specialist at my next appointment, which is next week. And I will be sure to insist on close follow up, regardless.



For the hematoma, I've taken to doing a cross-body wrap with an "ace" bandage to maintain some pressure on it, as this seems to relieve some of the pain. I am also taking a non-asprin analgesic. The combination of the two seem to be helpful.



Lizziecee, thanks for the link. I looked over the site, and it seems to have a lot of information, although living in the United States and thus not being part of the National Health appears to limit me in posting there.



Thanks again for the help

[lizziecee]

The Uk based breast cancer care charity is available to anyone worldwide. We have people posting from Australia, the US, France, Spain and India, among others. Wish I had found it when I was diagnosed and undergoing surgery, chemo and radiotherapy as it explains a lot of things doctors don't tell you. What I have learned is that breast cancer is not one disease, but can have many different manifestations. There aren't many men posting as the UK only has about 300 cases of bc in males each year, but the ones that do post are very knowledgeable and happy to impart their knowledge. Hope everything turns out to be benign for you.