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[…] DCIS, lumpectomy, atypical hyperplasia. Margins clear, so now what? […]
Reply[…] DCIS, lumpectomy, atypical hyperplasia. Margins clear, so now what? […]
ReplyHi Diane-
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 need to understand going forward. To answer your question "Any suggestions?" frankly, each suggestion by your docs will have risks- ADH increases your future risk of BC, radiation increases your risk of cancer and has side effects, tamoxifin increases risks and has side effects. My personal opinion as a long term cancer survivor living with several side effects is to watch and wait and lower your risk of BC with diet, moderate exercise and nutritional supplementation.
If you are interested in specific examples of what these are- diet, supplements- let me know and I will be happy to make suggestions. I don't want to get off the topic here.
If I understand correctly, your current situation is:
1) there was no more DCIS it had all-been removed previously with the biopsy, lumpectomy performed
2) it did show some atypical hyperplasia
3) Margins clear
If I understand your email below, you have 3 recommendations thus far to include:
1) Radiologist wants to radiate
2) Oncologist was me to take Tamoxifin
3) Surgeon suggest watchful waiting
First, let me address "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.
http://en.wikipedia.org/wiki/Atypical_ductal_hyperplasia
Diane- this exchange on Breastcancer.org addresses your questions- please read-
http://community.breastcancer.org/forum/5/topic/724532
First Name: Diane
Last Name:
Email:
Comment: Diagnosed by sterotactic biopsy with DCIS lumpectomy performed. the
surgeon called regarding pathology report there was no more DCIS it had all
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?
—
David Emerson
Multiple Myeloma survivor
Founding Director, Galen Foundation
David.PeopleBeatingCancer@gmail.com
David, I have been reading the suggested sites. I have been to two radiologist and two oncologist, neither has suggested I have futhur pathology evaluation. I am stage 0 grade 2 with necrosis. Also I am a registered nurse who would have asked for this other testing if i had known The Oncotype Dx helps make an informed incision about radiation&the Mammostrat would also be helpful. I thougt I was going to top docs, could you please give me some rec's in the New Jersey, New York City area. I was thinking of going to a Doctor Dupre in Penn. for a consult she is a surgeon & a relative went to her. Not sure if is the same one that was mentioned in one of the articles I just read. Maybe you can not give just one name but several would be helpful. It seems I have to tell the doctors what they should be doing. Yes I am also interested in the best herbs, vitamins, food ect. Hope to hear from you soon. My followup surgical doc is the 9th, by then I need to make a decision- thanks
ReplyHi Diane-
I'm not quite sure what you need. Are you asking for doctor recommendations in general or breast surgeons, radiation oncs or something other than these? If you are thinking of a breast surgeon, Dr. Dupree sounds wonderful. She would be able to talk to you about watchful waiting (after a lumpectomy) or local radiation or tamoxifan.
Dr. Dupree sounds like a great doc- http://www.breastcancer.org/about_us/pab/beth_baughman_dupree
To read more about Dr. Dupree- https://www.google.com/search?q=Doctor+Dupre+in+Penn&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a
For anti breast cancer supplementation I would normally recommend fish oil- I happened to come across the article linked below which is also about breast cancer prevention.
1) Vitamin D30
http://peoplebeatingcancer.org/article/vitamin-d-level-47-ngml-associated-50-lower-risk-breast-cancer
http://peoplebeatingcancer.org/article/supplemental-vitamin-d-may-help-reduce-breast-cancer-risk
2) curcumin and various aspects of breast cancer-
http://peoplebeatingcancer.org/search/node/breast%20cancer%2C%20curcumin
3) green tea-
http://peoplebeatingcancer.org/blog/green-tea-extract-inhibits-breast-cancer-relapse
4) moderate regular exercise-
http://peoplebeatingcancer.org/article/exercise-produces-hormone-changes-may-cut-breast-cancer-risk
http://peoplebeatingcancer.org/article/impact-mixed-strength-and-endurance-exercise-intervention-insulin-levels-breast-cancer
http://peoplebeatingcancer.org/article/exercise-may-put-breast-cancer-run
Diane- the point in all the above info is that once you have a lumpectomy, anti BC nutrition, regular moderate exercise and nutritional supplementation greatly lower future BC risks.
Let me know if you have any other questions-
David Emerson
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