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DCIS Lumpectomy- Atypical Hyperplasia, Clear Margins. Suggestions?

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“However, anti-hormonal therapy (tamoxifen, anastrozole) in DCIS causes an increased morbidity without a reduced mortality”

Hi Cancer Coach- I was diagnosed by sterotactic biopsy with Ductal Carcinoma In-Situ (DCIS). A  lumpectomy was performed. The surgeon called regarding pathology report there was no more DCIS it had all. The DCIS
been removed previously with the biopsy, it did show some atypical hyperplasia.  Margins clear , so now what?

  • Radiologist wants to radiate-
  • Oncologist was me to take Tamoxifin  labs we 10 percent estrogen binding 90
    percent progesterone-
  • Surgeon suggest watchful waiting.

Any suggestions? Deborah

 

 


Recommended Reading:

Hi Deborah-
Thanks for contacting PBC. Excellent question. I will address your question now but please read the rest of my email below as the post covers several issues that you should consider going forward.
First, a few basics about a DCIS.
“Ductal carcinomas in situ (DCIS) represent one fifth of all detected breast cancers. The detection of DCIS can be regarded as collateral damage of breast cancer screening. The treatment of DCIS is based on surgery with or without radiotherapy. Women treated for DCIS have a 10 years survival of 98 %. Could there be a role for systemic therapy in case of a DCIS? Recent published studies suggest there is. However, anti-hormonal therapy (tamoxifen, anastrozole) in DCIS causes an increased morbidity without a reduced mortality. There is an urgent need for evidence-based guidelines in the management of DCIS in order to make appropriate shared decisions.
Second, a few basics about  “atypical hyperplasia”
Atypical ductal hyperplasia, abbreviated ADH, is the term used for a benign lesion of the breast that indicates an increased risk of breast cancer.[1]
The name of the entity is descriptive of the lesion; ADH is characterized by cellular proliferation (hyperplasia) within one or two breast ducts and (histomorphologic) architectural abnormalities, i.e. the cells are arranged in an abnormal or atypical way.
In the context of a core (needle) biopsy, ADH is considered an indication for a breast lumpectomy, also known as a surgical (excisional) biopsy, to exclude the presence of breast cancer.[2]
Treatment-
ADH, if found on a surgical (excisional) biopsy of a mammographic abnormality, does not require any further treatment, only mammographic follow-up.
If ADH is found on a core (needle) biopsy (a procedure which generally does not excise a suspicious mammographic abnormality), a surgical biopsy, i.e. a breast lumpectomy, to completely excise the abnormality and exclude breast cancer is the typical recommendation.
To answer your question “Any suggestions?” Frankly, each suggestion by your docs will have risks and benefits, pros and cons. If I understand your email below, you have 3 recommendations thus far to include:
  1. Your radiologist wants to radiate
  2. Your oncologist was you to take Tamoxifin
  3. Your surgeon suggest watchful waiting

Your pros/cons or risk/reward choices you face are:

My personal opinion as a long-term cancer survivor living with long-term and late stage side effects from my own conventional therapies is to watch and wait and lower your risk of BC with diet, moderate exercise and nutritional supplementation.

To learn more about DCIS and the evidence-based therapies that can help you prevent its spread into invasive breast cancer, please watch the video below:

To download the DCIS Guide, click here.

One of many examples of reducing your risk of breast cancer as well as a host of other chronic diseases is a nutritional supplement called curcumin. I have supplemented with curcumin for years and recommend it. Please scroll down the page to learn about the most bioavailable curcumin formulas.

David Emerson

  • Myeloma Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

The Most BioAvailable Curcumin Formulas

“Based on a review of these studies, it is evident that better bioavailability of formulated curcumin (CU) products is mostly attributed to improved solubility, stability, and possibly low first-pass metabolism”

A search of the Pubmed database for the word curcumin yields 601 studies spaning health topics from multiple myeloma and colorectal cancer, to chemotherapies that synergizes with CU, to Alzheimer’s Disease, arthritis and more. Based on years of reading studies and personal accounts, I think it is safe to say that CU supplementation is safe and relatively inexpensive.

I have read about myeloma patients taking daily doses of CU from 400 milligrams to 8 grams (1000 milligrams = 1 gram). By almost any measure, CU is a safe, inexpensive wonder drug.

The only challenge is that CU is famously difficult to absorb in the body. In other words, a person has to mix curcumin with some sort of fat (coconut oil, chocolate, etc.) or take a brand of curcumin capsule that is already formulated to be more “bioavailable” in order to derive the full benefit of CU.

The study linked and exerpted below reviews different formulations of CU. The study itself lists the three most bioavailable formulation/brand of CU and I’ve added an excerpt from a further review from Consumerlab.com that lists four additional bioavailable brands of CU.


Recommended Reading:


Curcumin

CU is a bright yellow chemical produced by some plants. It is the principal curcuminoid of turmeric (Curcuma longa), a member of the ginger family, Zingiberaceae. It is sold as an herbal supplement, cosmetics ingredient, food flavoring, and food coloring.[1]

Bioavailable curcumin formulations: A review of pharmacokinetic studies in healthy volunteers.

“Curcumin is a widely studied natural compound which has shown tremendous in vitro therapeutic potential. Despite that, the clinical efficacy of the native CU is weak due to its low bioavailability and high metabolism in the gastrointestinal tract. During the last decade, researchers have come up with different formulations with a focus on improving the bioavailability of curcumin. As a result, a significant number of bioavailable curcumin-based formulations were introduced with the varying range of enhanced bioavailability.

The purpose of this review is to collate the published clinical studies of CU products with improved bioavailability over conventional (unformulated) CU. Based on the literature search, 11 curcumin formulations with available human bioavailability and pharmacokinetics data were included in this review. Further, the data on clinical study design, analytical method, pharmacokinetic parameters and other relevant details of each formulation were extracted.

Based on a review of these studies, it is evident that better bioavailability of formulated curcumin products is mostly attributed to improved solubility, stability, and possibly low first-pass metabolism. The review hopes to provide a quick reference guide for anyone looking information on these bioavailable curcumin formulations.

Based on the published reports,

exhibited over 100-fold higher bioavailability relative to reference unformulated CU. Suggested mechanisms accounting for improved bioavailability of the formulations and details on the bioanalysis methods are also discussed.”

According to Consumerlab.com:

“Novasol has the highest bioavailability (185 x compared to unforumulated CU), followed by Curcuwin (136 x), Longvida (100 x), Meriva (48 x), BCM-95 (27 x), Curcumin C3 Complex + Bioperene (20 x), and then Theracumin (16 x).”

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Can Your Lumpectomy Spread Breast Cancer? - PeopleBeatingCancer says 3 years ago

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Low-dose Tamoxifen for DCIS-Less is More - PeopleBeatingCancer says 3 years ago

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