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Posted by Sunnie on 8/18/2000 from 204.154.247.142:

In reply to: Medical Follow-up on Atypical Hyperplasia & Nipple Discharge posted by Betsy Mullen on 8/18/2000 from 152.163.204.24:

Betsy,

I am posting a followup to give the surgeon an opportunity to see what the history has been . At 43 I had a complete hysterectomy/ooph. Have been on premarin since then. At the same time, (1 month after hyst)I had a very large cyst on right breast. After ultrasound, they found 11 cysts in left breast, 4 in right including the large one that was visible without palpatation. The large one was apirated and was benign. Next year the other cysts were gone. The following is copied and pasted from my message of 8/1/2000.(Biopsies, Lumps and things that go Bump in the night)

This year I had a mammo in April. Called back for compression views. There were suspicious calcifications. Had a needle guided excisional biopsy. (FROM THE PATHOLOGY REPORT: Slides demonstrate severe fibrocystic disease with several foci of atypical hyperplasia and intraductal papillomas, acropine metaplasia, extensive sclerosing adenomas and ductal dialation and infiltration of chronic inflammatory cells with extensive metaplastic calcifications. Many of the ducts contained amorphous secretions.In the areas of atypical hyperplasia, the fenestations are irregular and slit-like and the lining cells show significant nuclear variation from cell to cell.) At first they told me it was DCIS, then changed it to atypical hyperplasia.

I live in a very small town in the California desert, so I asked to go to USC Breast Center to see Dr. Silverstien for a second opinion. At USC the diagnosis was also deemed it borderline, but he felt comfortable calling it atypical hyperplasia. Said to get a follow up mammo to make sure there was no more califications. So in June I had a new mammo just on the left. AGAIN I was called back. They now found two lumps (8mm and 5mm) side by side on my left breast (the excisional biopsy was done on the 7 oclock position on the left breast, the new lumps found in the 12 oclock position). These lumps didn't show up on any prior mammos. Sent for an ultrasound. Mamo report says suspicious. Ultrasound says NOT cystic (no fluid), says solid nodules, probably benign. My doctor was going out of town for 2 weeks, so he had the ultrasound reports sent to the surgeon who did the wire guided excisional biopsy in May (NOT a breast surgeon, he is a general surgeon). He was sort of undecided what to do. I am sure they don't have all the sophisticated equipment here to do stereotactic biopsies, or core biopsies.

He said he didn't want to do another biopsy because I just had one in May. He said he could NOT tell WHAT the new lumps were, but knew they were NOT cysts (thought maybe they were fibroadenomas). Then a week later, I noticed a discharge from left breast. It was blackish brown. My internist sent me back to the surgeon. He (internist) was concerned because of the unidentified new lumps and now this discharge. The surgeon took a sample and did a cystology. After 10 days I had to call him to find out results. He had told me that he would call me in 3 days - 5 at latest. He didn't speak to me, but told his nurse to tell me it was benign and to see him in 3 months. (OK.. finally caught up to date)
As far as a family history... My aunt on my mothers side had a mastectomy for BC and my grandmother had several biopsies (same as me) and my mother told me she thinks my grandmother had breast cancer right before she died of an unrelated throat cancer. My mother has not had breast problems. On my fathers side, his sister (my aunt) had a mastectomy. I have NO sisters (4 brothers), but my older brother died at 38 of cancer. All of my cousins are male also, so it's hard to tell if the history is really there.

Heart disease does run in my family (both sides.) I had a heart attack in January from coronary spasms (no cholesterol build-up/blockage in arteries), and that is why the doctors have kept me on premarin (in addition to the heart meds I take).

So back to my original question. I was told by many people that if you have atypical hyperplasia in one duct that it is very likely to be in others also. Is that true? I tend to believe it may be because my path said the atypical consisted of "several foci of atypical hyperplasia". IF it IS true, is it possible that because I had several foci in the areas that they DID remove, that it also could be in the other ducts too even tho they DON'T show calcifications?? Also is it true that these other benign conditions noted on the pathology, put me at greater risk of invasive breast cancer in the future? The reason I ask, is because the surgeon said the nipple discharge is probably from either ductal ecstasia of papillomas. These were also in the tissue that was excised. That tells me that I have some of the same "stuff" in OTHER ducts too! How would I know if I had atypical hyperplasia (or worse) in these other ducts too? Do they think it is NOT there because it hasn't calcified?

Also, it is my understanding that fibroadenomas generally were found in women from 20-35 or 40 and rarely in women over 40. So I am also concerned about the two new lumps in the upper part of the same breast, even tho the surgeon doesn't seem concerned.

Well, I hope I have given enough information now. Thanks so much for listening.

And for Renee: Thank you so much for the phone call the other day. I really appreciate it. Hope you are having a great day.

Sunnie

Follow Ups:

• Re: Medical Follow-up on Atypical Hyperplasia & Nipple Discharge - Betsy Mullen   8/21/2000 (1)
  • Thanks again - Sunnie   8/21/2000 (0)
• Re: Medical Follow-up on Atypical Hyperplasia & Nipple Discharge - Betsy Mullen   8/19/2000 (0)

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