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Post Message ] [ Message Board ] [ Search ] [ FAQ ]Posted by Betsy Mullen on 8/18/2000 from 152.163.204.24:In reply to: Thank you all so much!! posted by Sunnie on 8/17/2000 from 206.37.206.68:
Dear Sunnie:
We ran your current message and questions by one of our medical experts, a surgeon with great expertise in breast health, breast cancer and women’s health in general. Please let us know if you need additional information in answer to your questions and concerns. Please take care, be well and keep us "posted" on how you are doing.
Best regards,
Betsy
Betsy Mullen
President/CEO
WIN Against Breast Cancer
www.winabc.org
(626) 332-2255
The following is her feedback:
I need a little more information on this patient to comment. It sounds like she is 47years old, no family history of breast cancer, on estrogens, with a history of breast cysts. She had a stereotactic biopsy which showed atypical hyperplasia, but did she have an excisional biopsy after that? I couldn't be sure from her message. If not, then she should, because in the radiology literature, a significant number of patients who have atypical hyperplasia on stereotactic biopsy are actually found to have DCIS or more on excisional biopsy, up to 50%.
In terms of the discharge, it would be helpful to know if it is bloody. Sometimes you cannot tell just by the appearance of the discharge, but a simple test (guiaic) can be used in the office to detect blood (the same test is used to detect blood in the stool). If blood is present, it could be
related to recent surgery (if she had an excisional biopsy). If she did not have an excisional biopsy; bloody nipple discharge should be pursued with an excisional biopsy.
Cytology (smear) of the discharge is generally not thought to be that reliable of a test, as there are numerous "false negatives" (i.e., there is a cancer present, but the cytology is negative).
Atypical hyperplasia found on excisional biopsy is a risk factor for breast cancer, and can be multifocal (i.e., in more than one area of the breast), but I generally consider it to be grounds for close follow-up (just like LCIS or a family history of breast cancer). By this I mean annual mammograms, self-exam each month, exams by an experienced healthcare provider once or twice a year. Consideration should be given to coming off of the estrogen, although this is debatable, especially in someone with heart disease.
I hope this is helpful. Let me know if I can be of further assistance.
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