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Category:

Breast Abnormalities and Other Symptoms

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Question:  #571 8/9/2008		Q:	Thank you for answering my question regarding the fibroadenoma with adh and dcis. As for the mammogram prior to the biopsy, "there were no associated calcs within nodule but there is scattered benign appearing calcs in the vicinity which look stable. The rest of the breast shows no new masses or distortion or suspicious calcifications." Is this worrisome? If there was more dcis, wouldn''t the calcifications be clustered? Also, if there is no other dcis, what treatment would be suggested for the original fa with low grade dcis,adh? If there is dcis found, can I get another re excision? I''m scared they will tell me I need a mastectomy. Thank you so much for your help.
		A:	with luck, you will skate through with no additional findings. scattered calcs aren't concerning. possibly radiation and maybe hormonal therapy (like tamoxifen) is possible. requires a consultation to determine this of course.
Question:  #572 8/9/2008		Q:	I have a dilemma which is causing me much concern. I was diagnosed with breast cancer at the end of May. Initial pathology showed multifocal invasion (3 seperate tumours), the largest bieng 17 mm and grade III. Pathology report after mastectomy and sentinel node biopsy confirmed an invasive tumor with high grade morphology. Triple negative hormone receptor status with basal cell phenotype confirmed by immunohistochemistry. No evidence of metatastic disease in the 2 lymph glands removed.Nottingham prognostic index 4.34 Oncologist has recommended 6 cycles of Fec Due to the adverse effects of chemotherapy and the possible long term implications on my body I am very undecided about accepting treatment given that my lymph nodes were clear. I am aware of the prognosis for my particlar type of cancer. Would the benefits of chemotherapy outweigh the risks?
		A:	i don't think he would be recommending it if they weren't. ask him to use www.adjuvantonline.com to show you how things measure out for your specific situation.
Question:  #573 8/9/2008		Q:	I am a 33 year old female. A couple of years ago I was wearing an underwire bra that created what I thought was a friction burn on my areola. I was also breastfeeding and my doctor didn''t seem to think anything of it. To this day I have an area that is slightly darker in color and defined. Is it possible that it is a scar? It just looks a bit distorted. No lumps,oozing, bleeding, etc. I am still concerned because I have not been able to find anything about scars on the areola from friction burns. I have only found information on IBC and Paget''s.
		A:	if its been there for several years and unchanged then this would reduce the likelihood that it is cancer related. it still warrants evaluation though. so go to a breast center and get it checked out. if you want to come to us call 443-287-2778.
Question:  #574 8/9/2008		Q:	hi, i am 32, with a a family history a breast cancer on both sides especially on my moms side.her mother,brother and cousin.well anyways when i was 19 i had a large lump removed on my left breast that was benign. i discovered another lump on 6/22/08 which was measured to be 2 cm on the same breast.i had a mammo on 6 aug and ultrasound and they seem to think it is a cyst and they will aspirate it next wed.well they found another pea size solid mass on my right breast close to my breast wall i guess it would be on the outer side of my breast from where they were looking.i didn''t feel comfortable with the radiologist but he said it is probably a fibroadenoma which i know most of them are benign lumps.i don''t want to take any chances i want to have it removed especially with my family history on both sides.my husbands aunt was told the same thing and it ended up being cancer.i am waiting for my surgeon to get the results so i can talk to him.i am just totally scared.the radiologist just wants me to play the waiting game and come back in 6 months no way no how.what do i do?? oh just before i got the lump i had some horrible itching on both nipples that nothing seemed to help it kinda went away,they still itch a little but not like they did.i mean i even had problems getting to sleep.does that have any correlation? thanks
		A:	both nipples itching usually implies hormonal changes happening. we worry more when a new finding is only on one side. when we see breast cancer in a family and one of the family members having it was a man, it sends up a red flag that there may be a genetic cause. meet with your surgeon and discuss this with him and your desire for a pathology diagnosis of the lump. fibroadenomas are benign. they can't turn into cancer. there can however be abnormal cells near, around them. explore it further. LS
Question:  #575 8/9/2008		Q:	After Halo pap with Atypical Ductal Hyperplasia found in both breasts, I had ductal excision and I don''t understand the results:interstitial fibrosis, cyst formation, apocrine metaplasia and focal adenosis, no lesions. My surgeon recommends no follow up other than another MRI in 4 mos. Should I get a second opinion?
		A:	yes, second opinion would be helpful given the original finding of atypical cells which increases your risk of breast cancer in the future. LS
Question:  #576 8/9/2008		Q:	I had a lump removed which has been dx as a fibroadenoma with adh and dcis. I know this is very rare that dcis, which is low grade, is found in a FA. I had a re excision for clear margins since only the FA was taken in the first surgery since surgeon was convinced this was a simple FA. I had a negative mammo, u/s and MRI. What are the chances of finding more dcis or worse in the adjacent tissue? Since the FA was not attached to the adjacent tissue, are the chances less that it will not be the same? Also, if this low grade DCIS is confined to the FA what is the recommended treatment? Thanks for your help.
		A:	to answer this would require examining your mammograms and other breast imaging studies and examining you as well as reviewing these pathology slides. that can be done though at hopkins for you. if you'd like to come call 443-287-2778. if there were say microcalcifications near the fibroadenoma then anticipate more dcis being possible found for example. LS
Question:  #577 8/9/2008		Q:	I''ve had an inverted nopple for about 2 months now {new finding} and MRI report states that it could be atypical fibroidadenoma or small invasive carcinoma. I have a core biopsy scheduled in 2 weeks. I am having pain in my breast and underarm and have lost 25 lbs , fatigued {to name a few} and have some swollen lymph nodes. My question is , what do you think my odds are of it being benign? I am afraid that it is not going to be. I already had one bone tumor , it WAS benign but I had to have an above the knee amputation anyway due to the destruction of bone. So I hate to be pessimistic but......
		A:	i personally haven't seen a benign mass cause an inverted nipple so this sounds concerning. then add weight loss and fatigue and i get more concerned. are you able to come to us? 443-287-2778. 2 weeks sounds far away to get this answered.
Question:  #578 8/9/2008		Q:	I am deciding whether to do full breast radiation or partial breast radiation. Can you please tell me if it''s okay to do a partial breast radiation on a stage 1 grade 2 no lymph node involvement and 1 centimeter of clear margins. Size of tumor 1.2 centimeters in greatest dimensions. Moderately differentiated infiltrating ductal carcinoma. Bloom Richardson score 5/9. What type of partial radiation would you recommend? John Hopkins site has been very helpful to me. Thank you very much for your good work.
		A:	you would probably be a candidate to participate in a clinical trial for partial breast radiation based on the size of the tumor and degree of margins obtained. we prefer external beam to the mammosite method. it should be done as a clinical trial though as partial breast radiation is not yet standard of care at this time. LS
Question:  #579 8/9/2008		Q:	For about 2 months now my left nipple has a horrible itch on the nipple and aerola. It cracks and peels also. I have a greenish discharge also. I have been treated with creams but nothing works. Both my grandmothers had breat cancer, could this be a early sign?
		A:	nipple changes are not to be ignored. time to see a breast specialist. consider coming to us if you can. 443-287-2778.
Question:  #580 8/9/2008		Q:	I am a 42 year old woman that recently received two biopsy, the first a core needle and the second an open surgical with wire localization. The second biopsy results were scelerosing adenosis marked with associated focal usual ductal hyperplasia, perilobular fibrosis, negative for atypical ductal hyperplasia and maligancy, a 2.6 cm lesion is made up of sclerosing adenosis. What does all this mean?
		A:	it means you got lucky. normal benign findings. no atypical cells that imply increased risk. celebrate this good news. LS
Question:  #581 8/9/2008		Q:	Dear Lilie, Two years ago I had a mammotome biopy on both breast, the right breast lumps shows portions of fibroadenoma, the rest of breast tissue shows cystic change, apocrine metaplasia and mild epithelial hyperplasia, no malignacy. one year later when I went to the breast surgeon to have regular check upd, it was found another lump in the right breast in the position of 12 o clock, the surgeon adived me to remove it, so the biopsy was done, the result is they show focal areas of fibrosis, adenosis, fibroadenomatoid hyperplasia ,cyst formationof ducts and focal epitheliosis, there is no evidence of malignancy, the features are those of hyperplastic cystic disease of the breast. 6 months later I had regular check up with radiologist, they said the right breast still have lumps in the same position, 12 o''clodk, I was so stressfull to hear that, and I did another ultrasound with other radiologist, it also said the lump was still there, and I went to see oncologist, she asked me to do ultrasound with vasculality, the result is good, it is only fibroadnoma,no suspicious, and no need to remove the lump, she said since in the last biopsy, I had mild hyperlasia, so it is alittle high risk, so I need to have follow up, and had adiet and exercise to reduce the risk, so Lilie , Am I higher risk to get cancer because of having mild hyperlasia ? How many percent ? I have no family history of breast cancer and my mammogram every yaear is good. Is it right the the ultrasound with vasculality can dertemine that the lump is cancer or not ? Should I need to see oncologis for the next follow up ? Iam looking forward to your reply. Thanks alot for your willingness to help.
		A:	increased risk is associated with "atypical" hyperplasia. that isn't what you had...
Question:  #582 8/9/2008		Q:	I am 33 with hetergenously dense breast and I have had problems with one breast for quite sometime(very painful and reoccurring breast infections). Being labeled with this density should I have MRI''s done or mammos? I have a family history of breast cancer as well.
		A:	depends on just how dense as well as what your family history entails. first degree relatives diagnosed premenopsaually is more concerning than say a second degree relative diagnosed after age 55. you are still young to begin mammograms. an MRI is never to serve as a substitute for a mammogram either. it is to be done in additional to, for women that a radiologist deems needs additional screening.
Question:  #583 8/9/2008		Q:	What is PASH? Is it cancerous and is it bad if it happens twice, once in each breast?
		A:	please use the search feature provided with this section of the website as this question has been answered several times before.
Question:  #584 8/9/2008		Q:	In 2006 I had Stage 1 IDC, had a nodule on the surgery side, mri and u/s showed nothing, mri showed multiple areas of enhancement on the contralateral breast, only 2-3 mm in size. Had a repeat MRI this week, showed no change in the multiple enhancements, but it did show a bright enhancement of a nodule in the axillary region (contralateral), considered to be a intramammary gland, on t-2 image. THe radiologist states it does not show suspicious morphology. The sternum also showed enhancement at the manubriosternal area. Radiologist said likely more arthritic than a neoplasm. I just turned 50 and had a bone scan at the end of 2006 after lumpectomy surgery. THe sterum did not show any arthritis at that time. I am stressed by the possibility of this being a mets. Originally, all my mammo''s were abnormal and then after add''l views they would say - no cancer. I have lost faith in these reports after the cancer diagnosis, as I wonder if the next year, one of the scans will say - oop''s it is met''s. Radiologist said could follow up with another bone scan, breast surgeon says no way. This scan is unchanged - minimal likelyhood of cancer returning. Oncotype Dx score was intermediate risk, ER+, PR-, Her2-. SHould I be concerned?
		A:	first, focus on them anticipating you are okay. second, your cancer was stage 1 with excellent prognostic factors. that's good. having another radiologist look at the images and see if he concurs might help you to know if this is or isn't something to worry about. doing another scan to verify that it hasn't changed may help you too.
Question:  #585 8/9/2008		Q:	I was just dx. with invasive ductal ca with well defined margins, stage 2. I am concerned about radiation as I have a pacemaker. I ALSO HAVE ATRIAL FIB. What are the rec. tx. options for me? Thanks for you time and consideration in this matter.
		A:	depends on which breast this cancer is in. left breast will give your heart and probably pacemaker exposure to radiation and in such cases it is not unusual to consider mastectomy as a way to reduce the need for radiation. if you want to come to us for a second opinion just call 443-287-2778.
Question:  #586 8/8/2008		Q:	Sir/Ma''am, I have done a search on Carsinosarcoma, and the only question found was from 2002. My wife was recently diagnosed with a 2.2cm carsinosarcoma cancer in her breast. We have not had any procedures/treatment done yet. As this is of course a rare cancer, we are looking for advice/avenues from experts.
		A:	consider coming to us then. we are experienced with seeing and treating rare breast cancers as well as the more common types. depending on the size and some other prognostic factors we can get her surgery determined and underway. call 443-287-2778. you want someone who has dealt with unusual cancers.... we are it.
Question:  #587 8/8/2008		Q:	Thank you so much for your time - In ''06 I was DX with ILC (L breast UOQ) Stage 1 - 1 CM no nodes. Lumpectomy and 33 rads, tried Tamoxfen several times- unable to deal with the side effects, I have also had 6 other biopsies in R breast, papaloma and B9 cysts. In Feb of 08 routine tests Mamo, Ultra Sound and MRI all came back unchanged (yes my left breast has multi foci ILCS, ALH, and my path report after Lumpectomy said one focus of ALH is seen within 2mm of one inked margin) I have VERY dense and cystic beasts as I am told. I was 46 at time of BC DX. Well now 7 months after an unchaged MRI, I have noticed a small BB sized single lump in UOQ of left breast - above lumpectomy scar by several inches, this is not the cystic type lump I am used to feeling, as I feel it is exactly the same texture as original DX, it it single and unmoving. I have also been experiencing much discomfort in the same shoulder and radiates down my arm, I do not believe I have any swollen nodes, however the "fatty area" of my arm pit feels and appears to look heavy??? Also I had very little "denting" from the lumpectomy, and to me my breast now appears to be "sagging" and almost appears to be dividing in two. I started noticing the changes about 4-6 weeks ago. I visited my surgeon, and to be as brief as I can be - he just basically dismissed me -with out hearing a word I said, he said he did not feel "MUCH'' of a change, what he felt was too small to worry about right now - it would not change any outcome if we knew something now or later - and because my tests 7 months ago were unchanged didn''t think anything now had changed, he said cancer is slow growing and if I only noticed this lump 4 or so weeks ago none of my other symptoms are relevant - and then said woman who have had BC -tend to have a "PHOBIA" about it coming back - DARN TOOTIN I DO!!!! I am very concerned right now, this is not a bumpy oatmeal, golf ball feeling lump - It is single and seperate, I feel it my husband feels it. Is it possible even with clean tests something can change in 7 months? He has agreeded to an Ultra Sound but not until 9/2/08 - that is a long time I think. Any help suggestions I would appreciate.
		A:	glad you are getting an ultrasound. that will help in determining that this is. the symptoms related to your armpit area may not even be related.... let's focus on the more concerning thing at the moment-- the new mass you feel. don't know where you live but if you want to come to us for evaluation of this just call sheila at 443-287-2778. we can see you certainly sooner than the time frame you were given.
Question:  #588 8/8/2008		Q:	I had a mammogram done week before last. The nurse called me to say I needed a biopsy. When I asked why she didn''t have much of an answer except that is what the radiolist wants done. I asked her if it was something that was there last year and had grown or showed up in the last year. She told me that they didnt compare to last year that wasnt important. Now Im not that stupid that is the whole reason to have them yearly so they can compare when there is an abnormality. Anyway this is what my report says 2 views of each breast showed tissues that are average to above average in density. Faint region of increase density in upper outter left breast and contains some ill defined microcalcifications. Elswhere I see no mass, skin thickening, or destoration of breast arcitecture. There is upper outer postierer right breast lymph node that appears stable. Ok I have a couple of questions. If they didn''t compare from last year how do they know the right breast is stable. What does ill defined mean? I have done some research on calcifications and micro being the worst of both. What are the chances of noncancerous and cancerous on the micro? I am really worried and concerned please help. Thank you
		A:	you are correct to question this. before making a determination about microcalcs these new images ARE to be compared to last years to see if these microcalcs were there before, are there more now, etc. Time for a second opinion before embarking on anything. if you want to come to us you are welcome to do so. just call 443-287-2778. bring ALL your imaging studies with you.
Question:  #589 8/8/2008		Q:	I''m 25 coming on 26 years old and I have a question that i''m too embarrassed to go and see my doctor about. My left breast is significantly smaller than my right and i get stabbing pains shooting through it almost everyday. The pains can be very painful at times. When this happens, my nipple sometimes turns purple and I seems to have small bumps on the tip of my left nipple. When i lightly push on the side of my left breast it feels tender like when you have a bruise.My breasts look so different from eachother. I''ve tried doing a breast exam myself but I don''t really know what lumps and bumps are meant to be there and what are not. Could you please let me know if you consider this serious enough to go to my G.P as i''m incredibly shy about getting a breast exam. Thankyou for your time.
		A:	you truly need a clinical breast exam to determine what this is about. maybe an ultrasound to help answer the question of what is causing the pain. it is not unusual to have one breast smaller than the other. you'd be surprised the number of women that have this. they simply don't talk about it and wear shoulder pads in their bra. pain most often is due to cysts or hormonal changes. bite the bullet and see your gyn. if shy about it, get a female gyn.
Question:  #590 8/4/2008		Q:	Tomorrow I am having a follow-up mamagram and altra sound for small size of asymetrical breast tissue. What does this mean? last year I was called back for over lapping tissue in the oppisite breast and it turned out to be a mistake in the mamagram but I am really scared. I would appreciate some feed back. thank you so much.
		A:	An ultrasound is a second means of looking at the breast to help understand what the mammogram is seeing. 80 per cent of abnormal findings are benign. Hopefully this will be like last year. ds
Question:  #591 8/3/2008		Q:	Lilly ,I had surgery for an 8cm metaplastic tumor 3 mons. ago i am currently on chemo.That was on the right side.Now I have sorness below my scar below my ribs.Do you think this could be more tumors or do you have sore musles etc this long after surgery? Thanks
		A:	usually sore muscles from side effects are not limited to a local area of the body as you are describing so this is an important new symptom to bring to the attention of your oncologist. we will hope it is nothing of concern. LS
Question:  #592 8/3/2008		Q:	I recently had a mammogram that indicated extremely dense breast tissue with extensive fibrocystic change in both breasts, scattered microcalcifications. Had a breast surgical biopsy January 2007 for an abnormal mammographic finding (diagnosed as benign - sclerosing adenosis). How does this lastest report affect my risk for breast cancer? I''m 45 years old. Thank-You
		A:	findings just learned don't increase your risk. you woudl however benefit from getting digital mammograms going forward. very helpful for evaluating dense breast tissue. LS
Question:  #593 8/3/2008		Q:	Sorry if this seems like a repeat. Here is my screening mammogram: The breast paranchyma remains heterogeneously dense bilaterally. On the left there is a very small, irregular nodular density with apparent architectural distortion involving the mid-central, slightly outer upper region. Both breast otherwise remarkable and unchanged. Impression: irregular nodular density, left breast. Recommendation: specialized radiographs and possibley US. BIRADS-0. What does all this mean?
		A:	they were't able to assign a bi-rad score due to needing more imaging studies to look at this irregular area more closely. too soon to tell what the findings may be. get the addtional imaging done this week. LS
Question:  #594 8/3/2008		Q:	Had my first mammogram. What do these results mean? "Scattered fibroglandular densities are noted. I see no suspicious cluster of calcification. There is a 7.0mm nodular density seen anteriorly behind the nipple on the right MLO projection, possibly lateral to the nipple on the CC view where it is not as well delineated. Cone-compression views in CC, MLO and ML projection advised as well as ultrasound for further evaluation. Benign calcium present bilaterally. A right axillary lymph note is present. Help!! I am really upset. Is this normal or not?
		A:	the majority are normal findings. they want to look closer at the "nodular density" are that is very tiny. 7mm. I would not be sweating over this finding. LS
Question:  #595 8/3/2008		Q:	Would it be possible to have an MRI guided surgical biopsy at JHU''s breast cancer within a weeks time? Who would I call? I have atypical hyperplasia, 7mm nodule with slightly irregular margins, have had 5 previous biopsies for calcifications and one mass all benign. I am 45 my sister had breast cancer at 40. This week would be the best timing for the MRI cycle wise. I have been waiting since 7/19 and the soonest I can get in Boston is 8/20 not a good time for the mri 24days after period.The nodule has been there for at least one year.
		A:	Before an MRI biopsy is scheduled we try to do several things-- review your films to confirm you need a biopsy and see if the biopsy can be done stereotactically. call sharon bean at 410-955-7288 to assist you with this.
Question:  #596 8/3/2008		Q:	My mother died from bc last year. She was HR positive. My sister was diagnosed 8 weeks later, she is triple negative. I went for my first mammo immediately (age 43). Recalled for diagostic in left (microcalcifications) and ulrasounds in both breasts. Later had FNA biopsies on 5 areas, (one "mass, possibly FC or FA", several complicated cysts, several simple cysts) all came back fibrocystic changes. One supraarolear mass says on "Gross Deion" bloody fluid in alcohol for 2 smears. Others say rare benign ductal cells and rare macrophages, fluid was clear on those. I was asked to return in 6 months for another diagnostic and more ultrasounds. Scheduled to go in 2 weeks. Before the FNA, I was experiencing sharp pains in my right breast. The pains went away after the FNA. A few months later, they were back. I''m assuming the cysts are back. What can be done if these cysts keep refilling?
		A:	yes, cysts can refill and they can cause breast pain. your family history is no doubt worrying you. consider having your sister and you go together to meet with a genetics counselor about it.
Question:  #597 8/3/2008		Q:	This is in response to my question asking about a small, irregular breast nodule with architectural distortion. I have been called back for u/s and diagnostic and am concerned. You asked what the birad is. It is 0 right now. What are the chances of it being benign or cancer?
		A:	no way to guess yet.
Question:  #598 8/3/2008		Q:	What is the likelihood that a dimple in the breast is benign? Can it be something that you are born with? The reason I ask is that I have a long standing dimple in my right breast - I had a couple thorough workups on it in comprhensive centers but they always come up with nothing. The area is very soft with no lump underneath. I had a baby a year ago and have extra weight so it seems deeper now. I just had another mammo and ultrasound which showed no mass, the breast did contain benign looking microcalcs-would an MRI be a good idea for me?I am 37 and recently (2 weeks ago), weaned my son. Thanks for the help.
		A:	dimpling that has existed for years, since youth, is part of your breast structure for some reason that we may not understand. if it has changed though, even due to weight changes, it warrants a second look. MRI may be quite helpful. LS
Question:  #599 8/3/2008		Q:	Is it the standard of care with a BIRAD 3 rating of microcalcs to redo the mammo in 6 months? Should I accept that?
		A:	yes, that is the standard. you can always get a second opinion reading of the mammogram to ensure that another breast imaging radiologist agrees.
Question:  #600 8/2/2008		Q:	I am 45 years old with no family history of bc. I have had all normal mammogram until this one. It came back showing very small irregular breast nodule with architectural distortion. I am now going back for diagnostic and ultrasound. I realize there is a supicion of cancer. My question is can an irregular nodule appear normal on a diagnostic or u/s? Also, can the distortion be something else besides cancer?
		A:	they are taking these additional images because they aren't sure. too soon to assume anything. wait for the additional imaging to show what this is and how worrisome it may be.