focal sclerosing adenosis & mild ductal epithelia hyperplasia

[djcdms]

Hi I am deciding if I should have the BRAC test to see if I carry the gene for breast cancer.  My mom had ovarian cancer and breast cancer of which she passed away.  My grandmother also had cancer both at around the age of 49.  I had a biopsy which came back with the diagnosis of focal sclerosing adenosis and mild ductal epithelia hyperplasia.  Does that put me in a higher risk for breast cancer?

[bluebutterfly2222]

Some women with with a hx of early BC and/or ovarian cancer in first-degree relatives decide to have the BRCA  (BR for breast, CA for cancer) genetic testing  because, if found to be positive, besides increasing  surveillance,  they would consider having prophylactic mastectomy and oophorectomy.

This is an aggressive approach, but on the other hand, the BRCA gene vastly increases a woman's cancer risk. Women with the BRCA1 or BRCA2 gene have a 56% to 84% lifetime risk of breast cancer. Lifetime risk of ovarian cancer increases by 36% to 63% for women with BRCA1 and by 10% to 27% for those with BRCA2.

A study of BRCA-postive women showed that such prophylactic measures can reduce their cancer risk. Only 10% of the BRCA-positive women in the study underwent preventive breast removal. Over three years of follow-up, none of them got breast cancer. Over the same period, 7% of BRCA-positive women who kept their breasts got breast cancer.

Only 38% of the BRCA-positive women in the study chose to have their ovaries and fallopian tubes removed. These women had a significantly lower risk of both breast and ovarian cancer than women who did not have the surgery.

They also reduced their risk of death. Among women who underwent the procedure, known as risk-reducing salpingo-oophorectomy or RRSO:

3% died from any cause, vs. 10% of those who did not have the surgery.
2% died of breast cancer, vs. 6% of those who did not have the surgery.
0.4% died of ovarian cancer, vs. 3% of those who did not have the surgery.

"You can prevent a death from ovarian cancer by appropriate use of genetic testing and preventive surgery. That is a message that some women should get to save their lives."


You may decide not to have genetic testing, or if you do and find out that your are positive, you may decide not to take these steps, but I thought you should at least have this information available as you consider your options.

Best wishes...

[djcdms]

Thank you for the information.  I am not being tested as of yet I went to see a Dr. that deals with genetic testing.  But he seemed to be very relaxed about the family history.  That is why I am asking for an opinion .  I thought for sure with my medical history of family breast cancer they would want to do the test.

Thank you
Djcms

[ncmichigan]

I had a biopsy in '04 that found moderate ductal hyperplasia, screosisn adenosis, adenosis, calicifications and stromal fibrosis. The pathologist indicate an associated slightly increased risk of 5% at 10 years for developing invasive BC on my report. Since yours was mild ductal hyperplasia, I would think your risk was even lower, but I would talk to my doctor about what exactly this means. I also have a family history of BC with my sister and maternal grandmother and a biopsy in '09 found LCIS, which increases my risk even more. Basically, all this means is more vigilant screening, which I'm more than happy to do. My sister's BC was found very late and she passed away before her 51st birthday, so if I do happen to get it, it will be found early and highly treatable. If you're tested and found positive, I'm sure all the screening needed and any other options will be outlined for you by your doctor.
I sincerely wish you all the best.
nc

[japdip]

I see no mention of "atypia" so I doubt that your risk would be increased by much other than your family history. I can't speak to whether it's wise to have the BRAC ... it depends on whether you want to know any more than you do now, referring to your family history. Obviiously you are being tested and I'm not sure what else you would do if you were proven to be positive for the BC gene.   Regards ....