Trying to Understand Atypical & DCIS

[twinz529]

Hi,Just Curious.I am having a hookwire biopsy done.I'm trying to understand why.I talked to my surgeon . So please tell me if I'm getting this Correct.I had 2 areas of microcalcifications which after the stereotactic biopsy results came back benign.But in 8 other samples I showed Atypical Micropapillary Duct Hyperplasia.From what I read this is just a risk factor for possible ductal carcinoma in the future.So since my mom had bc ,combined w/ these findings & fibrocystic breast I could possibly have or will have Ductal carcinoma in situ in the future????Does the amount of Atypical cells determine the risk?? I don't have a tumor so does the amount of tissue that have these cells make a difference?? I do talk to the doc but get caught up on her words & forget to ask my next question.Please help where you can..I can't stop thinking..Thanks in Advance....

[twinz529]

Hi, Thanks & you know what your soooo right ...I went thru hell for this last biopsy & I didn't even need it..I didn't tell you all of it but they basically cut almost all of my nipple off & put it back on just to say we could'nt find anything....They gave me codine when I told they I couldn't take it & I threw up  all day the day after surgery..I was sooo dehydrated I wound up in the hospital w/ chest pain...You know for what we go thru we should all go to heaven...Take care of yourself & good luck..I'm sending you a hug....

[andreak]

YAHOO!  You absolutely should go out and celebrate!  That is excellent news and I'm sure it is a load off your mind.

Got a letter in the mail from the breast center - that said this last mammogram was abnormal.

Called for radiologist results and they said there are a few remaining microcalifications.  HELP!

Recommend excisional biopsy to be sure.

Nope......I'm waiting the 6 months.  And then another 6 months.  This really sucks.....I think it is CYA all the way.

I'm sure they got the right spot on you  - or else they'd be hounding you to come back!

Enjoy your new found peace of mind.  You deserve it.

Take care.....

[twinz529]

Hi, I went to my surgeon today to get my stitches out...It looks pretty good...It is still really raw & the skin is gonna take time to heal she said up to 2 monhs...Now I am really excited because she told me I was all clear..She said they probably got all the Atypia cells during the stereotactic..She said that microcalcifications are almost always associated w/ the Atypia & my micros were very small...I want to go out & celebrate..I see her in 3 months...I know it's terrible but in the back of my mind I can't help but wonder if she biopsied the correct spot...I know I have to stop & say your ok stop & enjoy the next 3 months.....Anyway thanks for being there & I think you are doing the right thing..This excisional biopsy was rough almost my whole nipple was cut open just to get to the site....Take care....

[andreak]

Hope you're feeling better today.  That was some procedure.  I understand the need to have the patients ready for the Dr.'s - but surely they could humanize it a little.....

Mammo showed that all calicifictions were removed by the stereotactic biopsy.  As I discussed with my surgeon - There are several studies that show when all calicifications are removed using a mammotone and the diagnosis is benign (but with atypia) - there is (in the studies at least) no incidence of cancer to follow.

So at this time I have elected to NOT undergo any further biopsies.  I will follow up in 6 months, and then again every 6 months for a few years - when I hope to finally be off this awful ride.

Please let me know the results - I'm sure you'll have them this week.  I know exactly how you feel - LEAVE ME ALONE!

Thinking of you.....

[twinz529]

hi, I had my hookwire excisional biopsy yesterday.....It was a long day to say the least...A lot of people involved..1st thing that scared me to death, all the paperwork was written out for the right breast so I told them "I can't sign that" So they said'Well than you can't do the procedure" I said well thats fine because it's my left breast that needs the biopsy...Than they said sorry a millon times & got me all new paperwork...But I was like great could you image waking up w/ the wrong breast done....Anyway putting in the wires was pretty rough..I got nausea from the pain & just looking at it..I had 2 needles w/ the wire hanging out the end..I felt like a dart board,where someone left in the darts..I had to walk to the mammo room holding my breast straight out from my body so the needles wouldn't fall out,Then theytook mammos w/ them in me to see if the placement was right...Then they thru a sheet over me because I couldn't wear anything from the waist up & put me in a wheelchair & brought me upstairs to a waiting room next to the or...Then I sat there for 1/2 hour w/ my breast in my hands trying not to move the needles..Once in the OR they knocked me out & I was in recovery for 1hr. I was sore all day yesterday but today I am feeling much better..I have to see the doc on tues & get my stitches out...Hopefully she will have the path reports & all will be clear..I WANT TO BE LEFT ALONE for a while.I'm sure you know what I mean...Of course I will be anxious until tues...Hope your mammo went well..Let me know I will be thinking of you...

[twinz529]

Thanks.....Good luck w/ the mammo on thurs..I will let you know how it goes ...Hoping for my luck to change...Talk to you soon.....

[andreak]

Best of luck to you on Thursday.  Please let me know how you make out.

I have another mammo scheduled for Thursday too.

I understand the security in KNOWING that it is nothing...or something.  That's why I'm doing this too.

And of course your right - I'm sure if they could do a scan of my entire body - somethings are bound to show up abnormal.  I guess we just do the best we can.

Try not to worry about the results - I'm sure you won't have them until next week.

Keep me posted.....I'll be thinking of you.

[twinz529]

Hi, I'm so glad you love your new doc..It is very important to feel comfortable w/ your doc..I love my doc too..She does everyhing from mammo,to stereo to reconstruction.I had researched her and chose her because I wanted to have the same doc from start to finish...She gives me all the scenerios so that I can choose appropriately...It seems like there is a certain protocol for these microcalcifications...1stmammo,then 2nd mammo,then stereo,then excisional,then lumpectomy & so on depending what they find...My microcalcifications came back bengin so then it would be a wait & see but in my case & I think in yours these atypical cells showed up...So now there is a different path...In my case 8 samples showed atypical cells,my mom had bc, & I have fibrocystic breast...So I am going for the excisional biopsy this thurs at 8am..My doc has told me from day one that she is aggressive when it comes to breast cancer...My only concern since I have been reading these posts,talking to people & looking on the internet is are we putting ourselves through a bunch of unescessary procedures because of something that could possibly be cancer one day..I mean any part of our bodies could develop cancer...I will go ahead w/ this procedure & I will see what they find...I'm hoping to have good results of course not only because I just want the security that I'm healthy but also because I just want to go on w/ my life..I have 3 little girls & I feel like all I do during playdates & life's tasks is think about my next appointment...I appreciate your response..Let me know how the mammo goes...I had a mammo 1 1/2 wks ago there were no micros the stereo got them,so i'm having the hook wire procedure to target the area of atypical cells....I'll let you know how this procedure goes..Sorry for the long response...Nan in Westchester,N.Y.

[andreak]

Saw the second opinion surgeon today.  I loved her.  I'm sorry I didn't go to her first.

She spent over 45 minutes with me answering every question and discussing every option.

She is a breast surgeon AND she does sterotactic core biopsy!  She told me the best results were all in the targeting.  (I had 2 mishaps witht he targeting!)

She also agreed that they cast a wide net - resulting in hundreds of benign biopsies to catch a few breast cancers.  But she also told me it was worth it - that catching it so early lead to a close to 100% recovery rate.

I agreed to have another mammogram to see how much microcalcification (if any) was left and where the clip was.

If there was microcalcifications left - I agree to have the lumpectomy.  She indicated that even if there was no change in 6 months on a mammo - it wouldn't mean anything - I still had a biopsy with atypical cells.

If no microcalicifications were left - the chances of any cancer were very slim - and it would be my choice to go with the biopsy or not.

She also agreed with me that I needed to be my own advocate - and make medicine and this process personal for me.

Wow - what a difference in surgeons.  I'm sorry I didn't hold out to find the surgeon that also did stereotactical biopsy as well - that is what I initially wanted.

So my advice to anyone starting out in this process (abnormal mammo with microcalcifications - biopsy warrented) is to take a few days to find the surgeon that best fits what YOU are looking for.  I knew enough to get a second opinion - but I should have kept seeking until I found the right confidence level.

Keep me posted about you.  I'm not sure where you are - but I can give you a second opinion surgeon if you're in NY (Long Island)

[twinz529]

Hi, I'm glad your going Monday...Ask alot of questions...Ask what are the risk involved in  waiting?? I mean w/ atypical cells could it take 3months or 3 years to turn if at all..I read about all these women who have mammo,steretactic,excisional,then lumpectomy all for possible cancer...Are we going thru too much too fast because of what could happen?? Anyway Good Luck & keep me posted...

[andreak]

HI:

Still trying to decide myself what to do.  I meet with a second opinion surgeon on Monday (the 28th).

I appreciate Dr. Roque's information - as that is just what I thought- increased risk.

They took 21 core samples from me.  Almost all samples contained microcalcifications - yet just one sample showed atypical hyperplasia.

As of today - my mind says wait and see.  I'll keep you posted after Monday.

let me know what you decide to do.

[twinz529]

Hi,thank you for your response.I guess I will find out how much area is affected w/ the atypical cells and decide what to do from there.I have never smoked a day in my life but I am 37 & have endured enough 2nd hand smoke for a lifetime.I know I have an increased risk because of my mom & having fibrocystic breast but I am trying to understand all these terms & procedures.I have never been in a hospital except to have my kids.I have never really been sick.These tests,docs,procedures,big words, are a whole new world & I want to educate myself ..So Again Thanks ..

[Fernando Roque, MD]

Hi.   The "Atypical Micropapillary Duct Hyperplasia" may lead to the development of breast cancer in the future, but this is not a sure thing.  It only means that you have an increased risk of developing breast cancer.  The amount of atypical cells and the extent (if atypical cells are found in lots of areas) do determine the risk.  There are certain things that you can do to decrease the risk. Aside from stopping smoking (if you are), and living a healthy lifestyle, you may benefit from a course of tamoxifen or raloxifene.  Discuss this with your doctor to see if this kind of treatment is appropriate for you.