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Category:

Breast Abnormalities and Other Symptoms

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Question:  #10171 02/16/2004		Q:	Hi I an 15 years old and have a lot of lumps on both of my breast's that have been there for three monthes. I wear a D cup bra. shuld I have a mammogram?
		A:	No mammogram yet, dear. You are experiencing hormonal changes in your breast, more than likely-- very normal.
Question:  #10172 02/16/2004		Q:	Sir; My sister has bleeding from the nipple. She is 48. Should she be concerned about cancer? Thank you.
		A:	Bloody nipple discharge is an abnormal symptoms and should be checked. It can be a symptom of breast cancer or other abnormality that may be benign but still warrants treatment. She needs a diagnostic mammogram.
Question:  #10173 02/16/2004		Q:	Hi. I am 32 years old, started menstruation at age 11 1/2, have had regular periods since that time, no pregnancies, have fibrocystic breast disease (which I know is common), have been told that the tissue in my breasts is dense. My mom was diagnosed with advanced breast cancer at age 53 (post-menopausal) and died at age 55. My great-grandmother was diagnosed with breast cancer at age 72. I have had mammograms at age 27, 28, and 31. I have had breast ultrasounds at age 27, 31, and 32. My most recent ultrasound states: Circumcised, oval, solid, hypoechoic mass, 1.3 X 2.6 X 1.2 cm in size, near the axillary tail region of the right breast, located at 10 o'clock, shows sonographic features favoring a benign fibroadenoma with strong posterior acoustic enhancement, lesion is far wider than tall and is surrounded by dense fibroglandular tissue, followup ultrasound within 6 months is recommended. I then saw a surgeon specializing in breast disease. She said that she thinks very strongly that this is a fibroadenoma. She said that I have 4 choices: 1.Followup with exam and ultrasound in 6 months. 2.Biopsy to remove some cells. 3.Mammotone to attempt to remove the tumor. (She said that due to the size of the tumor she may not be able to remove it all.) 4.Outpatient surgery to remove the tumor. I am not sure what to do. What would you recommend to me? I don't want to have surgery unnecessarily, but I also don't want to regret it if I don't have the surgery and find out later that this is not just a benign fibroadenoma. Also, what things can I do, at 32, to possibly lessen my chance of getting breast cancer? I am particularly worried about this, given my risk factors. Thanks in advance for your help.
		A:	We can't give you a recommendation without formally seeing you. But it is customary to remove fibroadenomas and given family history this would provide more peace of mind. Regarding what to do to reduce risk- avoid smoke, alcohol, do power walking 3 times a week for an hour, eat dark green veggies, and stay on top of research related to breast cancer. When you are older, going on tamoxifen might be an option.
Question:  #10174 02/16/2004		Q:	I recently had a core needle biopsy performed on my left breast. It turns out that the samples taken were benign. The nurse I talked to seemed to imply that the samples were benign but there is no way to know if the lump is totally benign. Is this true? So biopsy results are just based on the sample and they could have missed a section of the lump that could be cancerous? I'm a little confused. The doctor wants to remove the lump due to the size and other factors. Another question I have is, if a person has a cancerous lump, can a biopsy make it spread to other areas?
		A:	Biopsies can't make cancer spread. The radiologist would have taken images of the mass at time of biopsy to help ensure he/she was in the center of the mass. Core biopsies are usually good representation of the whole mass. Having it removed will provide you all the answers however.
Question:  #10175 02/16/2004		Q:	i have large aerolas and they make me very self concsious. i was wondering if there are any types of plastic surgery that i can have done just to decrease their size. But i don't want a breast lift or enhancement.
		A:	There are. So see a plastic surgeon who specializes in breast reconstruction.
Question:  #10176 02/16/2004		Q:	i am a thirty year old female and i know i am not pregnaunt have not had sex in over four months have not missed a period and i had my tubes tied in july of 1996 so my question is .........for about three weeks or more now i have had alot of soreness and unending drive me crazy itching on both breast what could this be i have used all sorts of creams (which i never do) and nothing seems to help they just get more intensly sore and itch more and more by the day? thank you
		A:	Could be a variety of things.. being bilateral makes it unlikely that it something serious like inflammatory breast cancer. Change soap in the washing machine can do it causing local dermatitis-- even changing the brand bra and finding in retrospect that you are allergic to the material may be the cause. so evaluate whether you have made any of these changes. if not, see a dermatologist.
Question:  #10177 02/09/2004		Q:	What are heterogenous calcifications? I have a large grouping of such, with some being suggestive of milk of calcium. Biopsy is this week. Mammogram was Birad 4. I am scared.
		A:	its a deion of the pattern of the calcifications--- if they look all the same or slightly different than one another. birad of 4 is the most significant comment to note. If they are cancer, they are probably very early stage. The value of mammography is finding cancer when it IS early. Remember though that calcifications can also be, and commonly are, calcium deposits that are benign. hang in there. either way you should do well.
Question:  #10178 02/09/2004		Q:	I have had my mammograms over the years religiously because my mother had breast cancer.I have also done self exams on my breast & never felt anything abnormal.However my last mammogram came back abnormal. I have been for a diganostic mammorgram & ultrasound. The findingd is that I have a "dilated duct" in the left brest.I am to see a surgon for a biopsy. My question is does a "dilated duct" always mean cancer & with it being so small that I couldn't even detect it,if it is cancer does the small size mean it's more curable?
		A:	dilated duct doesn't necessarily mean cancer. If cancer is found the smaller the better of course, but remember that today 85% of women factoring in all stages of disease are long term survivors.
Question:  #10179 02/06/2004		Q:	Can taking soy (instead of HRT) cause fibrocystic breasts?
		A:	there really isn't a known reason for fibrocystic disease. No studies to my knowledge have pointed toward soy related to it either.
Question:  #10180 02/06/2004		Q:	I have Lupus and a chronic breast abcess. This abscess has been going on since Nov. 2002. It seems to be antibiotic resistant. I really need help. Thankyou for any advice. Like what test I need to ask for to find out what is wrong. http://webpages.charter.net/mclon38/LupusLesionPhotos/Lupus%20Lesion%20Images.html
		A:	When a diagnosis is confirmed as an abscess and it is chronic over a long period of time and continues to occur, it is not uncommon to have surgical excision to remove the area so that it can finally at long last heal.
Question:  #10181 02/06/2004		Q:	I am a 47 year old female. During my annual mammogram there was concern. I had a second mammogram done a week later with an ultrasound, then a week later a core needle biopsy. The results were a large fibroademona deep in the breast.There was no pain or nipple discharge, and was not felt by myself or during my annual gyne exam. I was told to see a surgeon which I did. She wants to take surgically remove it plus surrounding healthy tissue. Is this the way to go? There is no breast cancer in my family.
		A:	A second opinion may be of benefit before going under the knife. It's been confirmed to be benign so a rationale for removing it since it appears small and without symptoms needs to be provided. pursue getting another opinion to ensure it really is necessary to remove it. what you have described (removal of the mass and tissue around it) is more in keeping with lumpectomy surgery for cancer.
Question:  #10182 02/02/2004		Q:	Hello, I was started on effexor about 2 months ago, and recently my dosage was increased about 3 weeks ago. I have now started to have some breast leakage which resembles breast milk (bilaterally). I stopped breastfeeding my daughter alittle over 3 months ago, and have not had this problem up until now with the increase in effexor. I had a mammogram and ultrasound this past November which was negative. Have you heard of any antidepressants causing breast leakage? Can women continue to leak breast milk well after discontinuing breastfeeding?
		A:	I've not heard of a connection between effexor and lactation, so see your ob/gyn doctor for evaluation and possible diagnostic evaluation in breast imaging. Yes, there are incidences when milk production resumes. sometimes it is endocrine related. see your doctor to discuss this and be tested for that. also avoid expressing the milk as supply and demand will happen-- the more you express the more milk you will produce.
Question:  #10183 01/29/2004		Q:	My wife is 38 with no predetermining factors for breast cancer. She had a pain under her arm and went to her GYN doctor. No abnormality was felt but a mammogram was ordered. When the mammo was done a lesion was seen and an ultrasound and a core biopsy was performed. The pathology was high-grade invasive ductal carcinoma with prominent chondromyxoid metaplasia. A lymph node was also biopsies and was positive. The lesion and the lymph node measured 2cm each. The SBR score was 8. The HER2/neu and the estrogen receptor results are not back. She is scheduled for the routine chemo regime prior to surgery. A lumpectomy will follow and radiation after surgery. The pathology is my concern. Is there any information on the chondromyxoid component. What is the treatment of choice with her age we want to be as aggressive as possible. Any information would be appreciated.
		A:	Check out www.breastcancer.org for more details regarding pathology. Critical factors though really are the information that isn't available yet--- ER/PR receptors and Her2neu (which is usually done as a FISH test for accuracy) to evaluate her prognostic factors. Being young and node positive triggers aggressive chemo. What drugs to specifically recommend though requires a formal consultation with medical oncology. Having her evaluated at a comprehensive NCI designated breast center is a good idea.
Question:  #10184 01/30/2004		Q:	I am a 34 yr old female, and I found a lump in my left breast in May,2003. I had an abnormal Mammogram and Ultrasound.The lump was somewhere between the 11-12o'clock position, I had post core biopsy x2 benign, and then I had a wire guided biopsy. In one of the Pathology Reports it says all of the cores show very dense fibrosis/sclerosis with scattered foci of chronic inflammation A single larger duct shows mild ductal hyperplasia without atypia this report was done on 06/20/2003, then on 09/08/2003 there was a aspiration of biopsy cavity done and the report says Atypical cell admixed with Leukocytes the thin prep shows a few large atypical cells. and on 09/30/2003, another aspiration was performed and the report of this states, There are atypical cells similar to those seen previously. Well now it is Jan. 2004, and I am going back to get another Mammogram done, because my MD has found a couple more lumps in my left breast. I have recently started having a throbbing pain in my arm pit, down my shoulder, and arm (left side). Could you please help me figure out what's going on if you could, I mean I feel that something is not right and this is my body I feel that I should know when something is wrong.
		A:	Anytime a biopsy is done, the nerves in the breast become awakened and are aware that someone has been there. it is not unusual to have aches and pains in the breast and axillae area following biopsy procedures and for that to last several weeks. When ADH is found on a core biopsy the standard of care is to perform an open excisional biopsy to removed more tissue surgically and determine if there is any evidence of DCIS-- the earliest stage of breast cancer-- in this area where the atypical cells were found. If this step hasn't happened, and it sounds like it may not have yet, talk with her doctor about it. It is usually done as a wire localization procedure. Evaluating these additional lumps is also important and requires a diagnostic evaluation which may include an ultrasound. so pursue it.
Question:  #10185 01/30/2004		Q:	How is it possible to tell by looking at lymph nodes that show up on mamogram that they are beign? Can you always feel lymph nodes in your armpit?
		A:	Usually you can't feel lymph nodes in your arm pit. Lymph nodes that appear on a mammogram that are part of the spence of the breast (tail of the breast/axillary area) can be enlarged for various reasons. Definitive verification is only possible by tissue sample but they have an appearance sometimes that looks different when cancer is involved. nodes can light up do to inflammation, infection, or cancer and sometimes for no reason at all.
Question:  #10186 01/30/2004		Q:	my boyfriend noticed a lump in his left breast about one year ago his physician noticed the lump about the size of a pea but stressed that breast cancer is so rare in men that he doesn't have to worry and suggested he wait until it gets bigger.Should he get a second opinion?Thanks for your help.
		A:	Since a year has passed it either got bigger or it didn't. If it did, he should see a breast specialist for evaluation and diagnostic evaluation. If it is unchanged, his family doctor can address this for him. 1% of individual diagnosed with breast cancer are men. Often times they have family history (ie, mother, sister, aunt) diagnosed in the past. Young men are the rarest to get breast cancer.
Question:  #10187 01/29/2004		Q:	I HAVE NOTICED A VERY SMALL HARD LUMP BURIED QUITE DEEP WITHIN THE SIDE OF MY LEFT BREAST DURING A SELF EXAM BUT MY BREASTS ARE GENERALLY QUITE LUMPY. I HAVE ALSO NOTICED SHARP PAIN FROM TIME TO TIME SHOOTING THROUGH THIS BREAST AND SOMETIMES A BURNING SENSATION, AND HAVE ALSO DEVELOPED SMALL RED PATCHES ON THE SKIN IN THE SAME SORT OF AREA AS THE PAIN. IS THIS SOMETHING TO BE CONCERNED ABOUT?
		A:	It's an abnormality so it warrants investigation further to determine what it is. so request a diagnostic evaluation by breast imaging center where you usually go for your mammograms and see your doctor for a clinical breast exam.
Question:  #10188 01/29/2004		Q:	I had a core biopsy last July using ultrasound on several lumps in my breasts (identified by palpation, mammogram and ultrasound). They were all identified as fibroadenomas, but one lump had grown as seen in a follow-up ultrasound in November. The surgeon advised removal and I am now having it removed this week (end Jan.). Should I insist on another unltrasound to see if there are any changes, given the time lapse, or is this done automatically? His office has advised it is done under a general, but is it possible under a local, which is my strong preference? Also, what about the other fibroadenomas. Should they also be removed, and if not, do I need to be monitored? Thanks for your help.
		A:	Usually additional films are not obtained right before surgery, but vry much is the surgeon's preference. The decision to remove is probably driven by the fact that it has changed/grown. ask your surgeon about the others that were previously identified. If unchanged, they may be fine as they are. If the surgeon or radiologist feels they are obstructing the view of seeing other breast tissue in the breast on mammography, then consideration is sometimes given to remving them. The good news is that they are benign based on the information you provided...
Question:  #10189 01/29/2004		Q:	I had a mammo that showed Fine Microcalcifications atleast 3cm from nipple shadow, Birad 4-5. The radiologist had no previous mammos to compare since it was quite sometime since I last had a mammo. Could he have put this Birad level due to non comparison?
		A:	Usually the scoring is based on several things-- are they new or not (no comparison films to tell); are they clustered close together; when magnified they may have irregular edging as well. These would flag the radiologist that they are highly suspicious.
Question:  #10190 01/28/2004		Q:	Last year, I thought that I had been bitten by a sprider on my left breast. I had an small but open oozing sore on my breast. The edges were black. It went away after about two weeks of using an antibiotic cream, but left a raised pink "scar". I thought that it was healed. Now it has returned in the same spot with two similar sores. My primary doctor thinks that I should have a mamamogram soon. Could this be a sign of cancer? P.S. When I was 15, I had a benign cyst removed from this same breast.
		A:	It's hard to say what it is but your doctor is directing you well. you need to have a diagnostic evaluation so go for a mammogram. they might also decide to do an ultrasound at the same time to help determine what this is. these aren't common deions of cancer, but it still needs investigation.
Question:  #10191 01/23/2004		Q:	What does "reactive changes" mean?
		A:	Any time a biopsy or surgical procedure is done to the body the tissue around it "reacts". Lymph nodes do this too as part of the healing process.
Question:  #10192 01/22/2004		Q:	my wife had a lumpecomty in august of 2002. stage 1, 1.5cm irregular in upper left breast. grade 3+. clear margins. 28 nodes were clear. followed by 4 chemo treatments and 30 radiiation treatmetns. Scans done show no other tumors. bloodwork is good except she is now on meds. for dead thyroid due to treatments. she has 1 more 4 month check up and if alll is good then it will be 2 6 month checks then every year. there is a lump by associated with her scar. Mammo and ultrasound were preformed. doctor/radiologist at mayo believe it is fatty tissue. they recommened self exam every 2 weeks and mammo at next check up. based on the above A. what to do B. what is her prognosis? she is 52 and overweight. It seem we have good news no nodes, clear margins, stage 1. but is it really?
		A:	Pts are always welcome to have another set of eyes look at breast imaging films to see if they concur or if they recommend biopsy or not or additional tests such as MRI. Stage 1 is good news. for women hormone receptor positive they usually prescribe hormonal therapy as well. her doctor needs to give her the scoop on her specific prognostic factors about long term prognosis but for node negative small tumors it usually is very good.
Question:  #10193 01/22/2004		Q:	I am a 42 year old female, mother of 2, and no family history of breast problems. 11 years ago I had 2 lumpectomies, left breast, but haven't had any problems since. I've been in great health, therefore I haven't seen a physician since my last child 12 years ago. All of the sudden (2 months time)I started noticing my pants,skirts didn't fit and I was losing weight 20+ lbs,(5'8,120lbs) have 2 nodes and 2 smaller nodes down my neck that are paltable.(hairline to shoulder) (I had two show up on my neck this summer(July) when I was working so hard on a mission trip, but they went away). They came back in Nov. so I called my kid's physican, got a round of antibiotics, which didn't change the nodes. Then due to the concern, and continued harrassement of my loving husband & friends, over the continued weight loss, I went to the same doctor (friend)last week who did blood tests, which came back normal, and he listened to my chest. He also said that I could probably feel the lymph nodes since I had lost so much weight but if I ever had a node on my collarbone show up to come see him, but he "wasn't concerned". He asked if I had seen a gyn, I told him 12 years ago, so I was given an appt. I didn't mention to him that I had a lump in my left breast( a little too personal). I later mentioned to a close friend that I had a lump,who got me in for a mammogram immediately, today. The lump is about the size of golf ball and sticks out a little to change the shape of my breast about the 10 to 11 o'clock position. They took multiple views, then would come back for more, then a few more. Then they did an ultrasound. Technology is amazing. (I mentioned to the sonogram technician that I had a bruise above the areola a month and a half earlier.) She relayed the comment.Yet I did not remember any trauma to that area. When she told the radiologist he didn't ask if I had the "titleist" (golf ball)when the bruise was present, which it wasn't. (I was extremely surprised when it showed up much later,after the bruise went away.) The radiologist came in and said it could be a hematoma or a cyst, "didn't think it was cancer". He asked if it was sore, which it hadn't been! but is now tender after all the mammogram views. I have also had what I call a "catch" when I breath sometimes in that same side, plus a small tender area in my back by my shoulder blade. I've figured since I have lost so much weight lately that it was a change in my muscle tissue, scar tissue, etc. The radiologist recommened to do a needle aspiration or a biopsy or watch it for 6 months. I chose to come back in 6 months. My questions are 1. What could cause this area to grow so quickly? 2.Why the lymph nodes? 3. Weight loss is probably due to the busy season. 4. I used to work out 2 times a week and run 3 times a week but haven't done so since Oct. because I've been busy and haven't felt like myself physically or mentally lately which I wouldn't admit to anybody. Is it because I am just getting old and out of shape? Or could playing supermom,wife and boss be catching up to me?? Is there a time I should be concerned, if so what should I be looking for?
		A:	Without a proper physical examination and personal review of your breast imaging studies it is impossible to say what is going on. you are always welcome to have a second opinion elsewhere and definitely should be getting physical exams including clinical breast exam and pap smear annually and mammogram annually. Cause of these things may be different reasons.... don't know without really properly evaluating you so consider a second opinion at another breast center near you.
Question:  #10194 01/22/2004		Q:	I am 34 yrs old and about 8 yrs ago i had a lg. lump in my left breast, it would form a blister like lump and blood and puss would come to the surfes and would finally pop and drain.I seen a specialist and she did a needle biopsy and then surgery. it took a long time to heal and then started again. I have tried alot of different dr.'s and they only want to watch it. Then this past december I found a dr. that took some action. He sent me to have surgery to remove the bad duct. He is calling it chronic reacurring mastitis. every thing i read on the net about mastitis is for women who either were pregnant or just had a baby. this does not pertain to me. do you agree this could be reacuring chronic mastitis or would there be another name for this. I had the sergery and it's still healing and I am not sure that the dr. got the duct or not. he did worn me it may take a couple sergery's to get the right one. any help would be greatly appreciated. thank you. tammy.
		A:	Without examining you and reviewing all your records and such it is impossible to make an opinion in email. the bottom line though is that it sounds like at long last the problem was solved.
Question:  #10195 01/22/2004		Q:	I am a 35 years old. In April 2002, I had three fibroadenomas removed from my left breast. They were very palpable and I discovered them myself. All went well except the excisional biopsy left me with a very thick keloid/scar which itches. The next year, I had a follow up mammo which revealed suspicious lesions in the right breast. After a 2nd mammo, more ultrasounds, and two opinions from breast surgeons, I had a core need biopsy done which revealed sclerosing adenomas, which she says some Doctors associate with increased risk of cancer. The "goods news" was that the lumps had been there the year before, but I was not told because the concern was about the left breast. In comparing the old films to the new, the lumps had not grown in that year. After the benign findings, the surgeon said to try vitamin E, possibly flax, and to stay regular with all BSE, mammograms, etc. Question: should I have the adenomas removed like I did on the other side? Also, I have moved and now I need to find a breast specialist in the Princeton, Hillsborough, New Brunswick, NJ area. Any suggestions/recommendations?
		A:	It is standard of care to removed fibroadenomas from the breast. I can't recommend someone in that area but if you call the local komen foundation they probably can.
Question:  #10196 01/20/2004		Q:	I'm 25 years old and went to the dr. yesterday for an annual exam. She found a rather large lump in my right breast between 3 and 6 o'clock near my nipple which was elongated to, what felt like to me, about an inch or maybe more long and about a 1/2 an inch wide. It was hard and felt like there were striations (sp?) down it. She also pointed out how it dropped off on both sides, as to say it wasn't flat but pronounced. About 3 1/2 years ago, at another annual exam, my dr. found the same breast to be leaking. Thyroid and pituitary gland testing was done but came out normal, however no lumps were found and no more testing was done. My dr. has now sent me directly to a surgeon for a biopsy. Is this strange? Why wouldn't she want me to get an ultrasound or mammogram first? Her attitude about the lump caused me to be very concerned because it seems that I should be getting more diagnostic testing before I go straight for a biopsy. And she was adamant that I be seen within the next two weeks, which I already made an appt for. Can you offer any feedback? Thank you
		A:	Diagnostic evaluation should be the next step-- see what it is by doing ultrasound and mammogram and a biopsy if warranted IN breast imaging. not a surgeon yet.
Question:  #10197 01/13/2004		Q:	I had found a small lump at 9 o'clock on the outside of my breast well two ultrasounds and a mammogram later showed it as complex cyst and i was sent for an aspiration/core byopsy the results came back benign and to be folowed up in three months for a baseline mamo, my primary was confused as to what i had done she said for if it where a cyst an aspiration would have made it go away. she mustn't have realized i had a core byopsy also during the procedure. So she sent me for another ultrasound which showed it again and she says its a nodule, I'm confused because the mamogram/breast center docs kept calling it a complex cyst. Is it called a nodule after the findings come back benign?
		A:	a cyst and a nodule are different.... and yes, if aspirated successfully and it was a cyst then ultrasound should show it to be gone now. Consider taking your mammography and ultrasound films to another breast imager for a second opinion and review as it sounds like there still is something there that warrants investigation.
Question:  #10198 12/22/2003		Q:	I have DCIS, comedo type with 4 mm of microinvasion. Pathology on the 2.5cm tissue in the lumpectomy showed no clear margins. Surgeon recommends a mastectomy with immediate reconstruction. SNB by tracer and dye was negative for the node taken. I have read many well known breast cancer books now and am puzzled by these statements: "DCIS is not invasive"(why do I have microinvasion?); "DCIS may not respond well to radiation because there is little oxygen in the ducts." (if true, why would radiation be recommended with the lumpectomy?)In addition, what is the possibility of getting this type of cancer in the other breast? Do pathologists normally do ER/PR/Her2Neu testing on DCIS? If you also do a prophylactic mastectomy, is tamoxifin a recommended follow up? DCIS seems to have many issues that are at times controversial. Your responses would be greatly appreciated.
		A:	In this case there is the presence of DCIS with a tiny foci of invasion-- so small that it is categorized as microinvasion.When DCIS progresses and figures out how to bore a whole through the duct into the fatty tissue of the breast it become invasive, which is the case for this situation-- but only a tiny tiny bit. Radiation is done when lumpectomy is performed and CLEAR margins are obtained-- no cancer-- invasive or otherwise, responds well to radiation therapy of the breast-- thus the need for clear margins. it is killed cancer cells routinely then we wouldn't even need to operate at all-- just radiate. radiation helps prevent recurrence however in the health tissue that remains. There is a 5-20% risk of getting breast cancer in the other breast-- any type of breast canceer. ER and PR is done on DCIS and if enough cells can be tested on the microinvasion then her2neu will also be done. When mastectomy is done unilaterally, it is not uncommon to recommend tamoxifen to protect the other remaining breast for women who are hormone receptor positive.
Question:  #10199 12/22/2003		Q:	I'm 44 years old, have 3 beautiful in vitro children , 28 years of various hormonal treatments. I was diagnosed with poly cystic ovarian symdrome at age 16. I'm gene negative, but had a maternal aunt die of breast cancer at age 46. Over the last few year's I've become extremely cystic that required several FNA's. The last one came back atypical lobular cells that required a biopsy which I had in July '03. The results were atypical ductal hyperplasia. Since then, due to HMO restictions I've seen several medical & breast oncologists. I am finally with a group at Hackensack Hospital in New Jersey where I feel comfortable. I've changed my insurance to go out of network to be able to see these specialisys. My problem is that because I'm in this "gray area" of little or no data(pre-menopausal) the opinions of each oncologist has been different. The surgeons recommend either a bilateral prophylatic mastectomy or tamoxofen, 1 oncologist recommened only tamoxofen followed up with a 2nd MRI in 6 months, another evista, another mastectomy and hysterectomy (I am obviously done having children, & just want to be around to enjoy them.) I would be slightly OK with the tamoxofen,(cetainly easier that radical surgery) but I feel that the vigilant surveilance that would be needed for my breasts wouldn't fully help with the atypia. MRI, mammography & ultrasound are wonderful tools, but don't show cells, so short of having monthly FNA's I wouldn't feel completely confident with this recommendation at this point. Plus I am at a higher risk for gynecological cancers because of my history, therefore would need surveillance in that area as well. I am aware there is a risk of uterine cancer from tamoxofen. I am so confused and exhuasted from the entire process. On one hand I feel blessed as if this was a 'red light' for my future; on the other hand, I fall into such a unknown catagory with these early detections that the recomendations are all so different and really just "opinions". There are times I just want to have both surgeries and just get on with my life. I'm aware that these prosedures aren't easy and the chances are still there for getting breast and or ovarian cancer, but the option of tamoxofen for 5 years, then what? I'll be 49 and still in the same preticament I'm in now. Medication that may or may not work, may give me other cancers...I'm just so unsure...I just wish someone would say, "do this & you'll be fine"! I guess what it comes down to is I'm not confident with either of my choices and really need to make a decision. I never had cancer anxiety before, but all of that has now changed in a huge way. Can you possibly email me personally? I'd really appreciate expert advice on this matter. Thank you so much.
		A:	When questions are posted on our board we can't see the emailer's email address to respond back privately. This is why the instructions say if you want to communicate one on one to send a private email to Lillie Shockney with her email address listed - shockli@jhmi.edu In any case, it is highly unusual for someone to recommend prophylactic mastectomy with these findings... hormonal therapy may be a consideration, but get yourself into the hands of a medical oncologist who specializes in breast and ovarian cancer and is a genetics expert for both--- we have one here. it is worth going out of your insurance plan to see someone like this who can better advise you. ADH is common.... take this a step at at time with a specialist who lives and breathes this stuff...
Question:  #10200 12/22/2003		Q:	LUMP IN ARMPIT: Hello I just emailed you with a request about illness prior to diagnosis. I have another question. My lumpectomy scar goes right up into my armpit - where 6 lymphnodes were removed - all clear. Over the last few days I've noticed a lump at the top of my scar. It's probably about 1.5cm and feels quite hard to touch. I have a lot of fatty tissue under my armpit - so I doubt it would be a lymph node - they'd be futher down deeper in the armpit itself - right? Or should I see my doctor? Thanks again.
		A:	Whenever a change like this is felt it is always smart to contact the doctor and see him for evaluation. could be just scar tissue or could be a node--- or could even be local infection. but worth having him evaluate you to determine this so call him.