ductal hyperplasia, stromal fibrosis, microcalcifications

[knany]

I have had 4 breast biopsies (all open) for lumps/masses in my life (age 51). The last 2 were 2 wks ago and showed the conditions in the title plus blue cysts. My breast tissue is very dense and is hard to the touch. I have had mammograms at 6 month intervals with occ sonograms to distinguish shadows vs mass vs cystic mass. No breast cancer history personally or in family, but there is history of colon cancer and melanoma in the family. I have had 2 melanomas removed, one from my mid-chest. Drs are considering estrogen blockers and increasing Vit D levels (from a study that shows women with Vitamin D levels of 75 have not developed breast cancer).  What are your recommendations for consideration with this scenario? Increased risk for breast CA? Elective surgery? Other diagnostic tests? I have been under close observation but to what avail? Mammograms nor sonograms are noted for great accuracy with very dense breast tissue. Any suggestions would be appreciated.

[knany]

Thank you for all the information. The report recommended another mammogram in 6 months (which will be my fourth time having a mammogram in 6 month intervals). My dr visit yesterday---wants me to have breast exams every 6 months along with mammograms and possible ultrasounds. Wants me to stop my estrogen (I have been taking it for 20 years since my hysterectomy and ovary removal {both}) I am 51 years old. I would like to have a molecular breast image but I don't know where the closest one to southwest GA is---I will try to find this out) He also recommended taking Vitamin E daily (400-1000 IU) along with Vitamin D. The Dr said the ductal hyperplasia was the biggest concern for him because just because this area did not show atypical hyperplasia, that did not mean that the other side of the breast or even 2 inches away from the biopsy would not be atypical.
Has anyone had a molecular breast image. He also told me I could consider bilateral mastectomies and to talk to a surgeon about it.  I'm not ready for that.
Thanks for your support and help.

[bluebutterfly2222]

Microcalcifications are frequently found in breast tissue. In most cases they are a benign finding, but certain sizes, shapes, or patterns of them may raise a suspicion that they could be signaling  some abnormality, in which case a biopsy may be recommended.

Stromal fibrosis is a pathological term used to describe a usually benign change in the breast tissue. But a confirmed diagnosis is required before ruling out malignancy.

Hyperplasia is an overgrowth of cells, but again not too much of a concern unless it is classified as atypical ductal hyperplasia, in which cases removal of the ADH by lumpectomy, and sometimes follow-up with radiation  and possibly hormone therapy may be recommended.

Usually the pathology reports from  biopsies will result in recommendations regarding what follow-up treatment is needed. What have you been told?

Regards,
bb


p.s. Going back to your original question, maintaining a good Vit D level is important in prevention of a number of medical conditions, as well as being associated with a lower risk for BC and a lower risk for recurrence in those who have had BC, so I'd definitely support that recommendation.

[knany]

Thank you for explaining this to me. Has anyone else had these same findings before?

[bluebutterfly2222]

Hi and welcome to our community,

Questions in this forum are answered by survivors and other volunteers generally not identified as medical professionals. We are unable, therefore, to provide a specific treatment recommendations  as you requested.
  
It would be best for you to discuss these questions with your doctor(s), who would have the necessary medical expertise,  as well as having available all of the details of your  medical history and test results, to recommend the best tx plan for your specific case.

MRIs are superior to mammograms in their ability to "see" through dense breast tissue, although they are so sensitive that they may result in false positives.  If you and your doctor(s) are left with uncertainty after standard imaging, follow-up with an MRI for clarification might be a consideration.

Best wishes,
bluebutterfly