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Question:
#10501
12/30/2002
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Q: |
COULD YOU PLEASE SEND ME SOME INFORMATION ON INFLAMMATORY BREAST DISEASE? I AM HAVING DIFFICULTY FINDING INFO. |
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A: |
Inflammatory is the rarest form of breast cancer and occurs 1% of the time among women diagnosed with breast cancer. It starts in the skin of the breast and grows inward. It is known for being aggressive and is oftentimes misdiagnosed as mastitis initially. Chemotherapy is usually the first treatment given with mastectomy being done once the disease is in control locally in the breast. |
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Question:
#10502
12/27/2002
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Q: |
64 year old female just had a 3.2cm.tumor,invasive,removed along with lymph nodes 6 positive out of 15. I am in good health otherwise. If i have the new dose dense regimen,could I miss out on a better chemo. since the drugs I will be given are almost determined by a flip of the coin and,could the rapid white blood cell replacement cause a break down of something else in my body? Thank you |
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A: |
The desne dose method is part of a clinical trial which is good. Participation in clinical trials helps ensure that you are getting treatment that we know is effective as well as being offered the possibility of additional treatment that may be even better than what we currently have to offer. So rest easy. Celebrate the completion of each treatment as it brings you closer to completion and to becoming a long term breast cancer survivor. |
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Question:
#10503
12/27/2002
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My sister was diagnosed with DCIS and had a mastectomy while seven months pregnant in summer of 2002. There is no other known history of breast cancer in our family.
During an ultrasound, three lumps were identified in my breasts. Two in the right and one in the left. The two in the left were removed via lumpectomy. AFIP Pathology reports state that I have ALH and ADH. What should I do? Who should I see at BOSS? Since they are not really cancer cells, should I just forget it?
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A: |
you would benefit with being evaluated to determine if there are some steps that can be proactively taken to help reduce your risk. Start with Jennifer Bucholtz, one of our nurse practitioners, by calling her and telling her your sister's history and your medical history. she will help you take it from there. 410-614-STAR. |
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Question:
#10504
12/27/2002
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i am a 33 year old woman. i have had to have a mammogram last year and this year. i do have fibercystic disease. on my last two, my lymph nodes under my right arm are swollen up. it has been since last year. my gyn. has got me on an antibiotic for 7 days for it to go down. if it has not, he is talking biopsy. i have also found new lumps he knows about. my question is, could it be cancer since it has not gone down in a year?
thanks,"poobear" |
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A: |
Dear Poobear,
Yes, it is possible that it might be cancer but it also could be an infection or inflammation of the nodes caused by something else-- thus the trial of antibiotics. No doubt these are scary times for you... I understand as I've had breast cancer twice myself. Take things one step at a time though... first finish the antibiotics and be reassessed. Try to avoid touching and rubbing your armpit area (to see for yourself that the nodes are smaller) as frankly this can aggravate them if they are in fact infected. Feel free to email again once you know the results. take care. |
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Question:
#10505
12/26/2002
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Q: |
what is the more sure sign of the differential diagnosis between adenosis and carcinoma in the frozen section? |
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A: |
well, frankly, it is not considered advisable to do frozen sections on breast tissue due to a 25 % error rate. Most institutions stopped doing frozen sections more than 2 decades ago due to this problem. breast tissue is most made up of fat and fat freezes poorly, thus the problem with accuracy.so don't hang your hat on frozen section results on breast tissue. wait for final pathology and if there is still a doubt, get it read at another institution where there are pathologists who specialize in breast cancer. |
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Question:
#10506
12/27/2002
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Q: |
what is the more sure histological sign of lobular carcinoma in situ in the adenosis? |
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A: |
Lobular carcinoma in situ is characterized by small, dyscohesive cells that have uniform round nuclei and often show intracytoplasmic vacuoles. The cells of LCIS are confined within the duct and lobular epithelium so that they are separated from the surrounding breast stroma (connective tissue) by myoepithelial cells and basement membrane. LCIS is not invasive cancer (it does not invade the stroma), so it cannot metastasize. However, LCIS is a risk factor (approximately 10 fold) for invasive breast cancer developing in either breast.
LCIS may involve preexisting benign proliferations of the breast, like sclerosing adenosis, and then be difficult to distinguish from invasive carcinoma under the microscope. Occasionally, a pathologist will need to use immunohistochemical stains that prove that myoepithelial cells are still present (like actin, calponin, smooth muscle myosin heavy chain) and therefore prove that the lesion is still carcinoma in situ and not invasive.
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Question:
#10507
12/27/2002
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are there myoepithelial cells present in the lobular carcinoma in situ? |
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A: |
Myoepithelial cells are retained around the cells of lobular carcinoma in situ (LCIS).
Lobular carcinoma in situ is characterized by small, dyscohesive cells that have uniform round nuclei and often show intracytoplasmic vacuoles. The cells of LCIS are confined within the duct and lobular epithelium so that they are separated from the surrounding breast stroma (connective tissue) by myoepithelial cells and basement membrane. LCIS is not invasive cancer (it does not invade the stroma), so it cannot metastasize. However, LCIS is a risk factor (approximately 10 fold) for invasive breast cancer developing in either breast.
LCIS may involve preexisting benign proliferations of the breast, like sclerosing adenosis, and then be difficult to distinguish from invasive carcinoma under the microscope. Occasionally, a pathologist will need to use immunohistochemical stains that prove that myoepithelial cells are still present (like actin, calponin, smooth muscle myosin heavy chain) and therefore prove that the lesion is still carcinoma in situ and not invasive.
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Question:
#10508
12/23/2002
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Q: |
Approx. 6 months ago after a routine mammogram (I am 43) I received a letter stating I needed further evaluation in the left breast. I went in about a week later for the diagnostic mammogram and after close to about 8 different pictures they gave a form that said "most likely benign, follow-up in 6 months". I realize now I should have asked more questions, but I didn't. I am now scheduled for the 6-month follow-up and am scared to death. How concerned should I be? |
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not too concerned. More and more mammography identifies abnormalities that warrant a second look and are then most of the time found to be okay. so go in with a positive attitude that you wil get a good report. |
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Question:
#10509
12/23/2002
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my friend had a mammogram, and is told she has rather loose cluster of pleomorphic microcalcifations in the upper outer quadrant,suspicious for malignant microcalcifications.there is a second faint cluster of more tightly packed microcalcifications in the retroareolar region.biopsy is recommended. Is there a concern of cancer?? |
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yes there is. she needs a stereotactic biopsy of both clusters. This is the true value of mammography-- catching cancer at its very earliest stage even before a lump forms. so encourage her to follow up on this. |
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Question:
#10510
12/18/2002
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I had a lumpectomy in 8/00 no arm lymph nodes taken dx dcis, 6 weeks radiation, now I have been told I have breast lymphedema, what can you tell me, what precautions should I take, most places talk about arm lymphedema, I have pain and swelling in my l breast, some times when I am at work and it is sore I will put hot packs on it, is that ok? thanks |
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A: |
this is fairly rare but can happen and obviously has happened to you... it means that the lymph nodes that are inside of your breast became irritated by the radiation and now have triggere the development of lymphedema, causing the breast to swell. see a rehab medicine therapist who specializes in lymphdema for direction how to minimize this problem. |
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Question:
#10511
12/18/2002
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I am 27 yrs old. I have had a lump in each breast from the age of 22. Ultrasound, mammogram & FNA for the past 5 years confirms fibroadenoma. During my latest examination the ultrasound showed that the lump in the left breast has grown by 4mm and the one in the right by 2mm. Why is that? The doc. has advised a FNA.I am really worried as to why this is happening and if this is normal. Please advise. |
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the risk os very low that this is something serious. as your own body changes shape over time, due to age, hormonal changes, and such, so can benign masses like fibroadenomas. it is smart to get a biopsy though to have peace of mind once again. |
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Question:
#10512
12/18/2002
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What is invasive lobular cancer? |
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A: |
cancer that has infiltrated the lobules of the breast. It occurs about 12% of the time among all the types of cancers that can happen in the breast. It is usually less, but not always, less aggressive than ductal invasive, which also happens to be the most common |
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Question:
#10513
12/04/2002
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Q: |
I have been followed for bilateral galactorrhea-slightly high prolactin and negative MRI. Usually my breast discharge is clear or creamy but last month it was bright orange on both sides. Do you know what this means?
Thank you! |
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A: |
note sure-- you need a clinical breast examination and probably diagnostic mammogram to decipher it. so go ahead and give your doctor a call. it could be cystic fluid or could be something else-- impossible to say without proper hands on evaluation. |
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Question:
#10514
12/04/2002
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WoW how laog does it take to get an Appt to go to one of our Doctor's. I havebeen calling for a week and cant get anyone to call me back. I talked to one Lady who transferd me to another lady and she took a message and I have not heard anything yet.I would Like to get all my slides sent to you for a second Op. Then if I need to be re-seen I would like to make an Appt. |
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I'm not sure who you spoke with or what nubmers you called so I'm a bit handicapped in investigating the problem. I recommend calling 410-955-8964 ext 4071 and speaking with Judy Pitt who will assist you in getting an appointment and your slides reviewed. |
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Question:
#10515
12/03/2002
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Q: |
my mom has bloody or black discharge from her breast. she has 2 yrs seeing doctors and no one seems to know what is goimg on. is this breast cancer? |
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it may or may not be. she should have a diagnostic evaluation in a breast imaging center that includes a mammogram and ultrasound and probably a ductogram if needed to determine the cause of the bleeding. 2 years is a long time to go undiagnosed. There are benign reasons as well as cancer causes for this symptom so don't panic, but do get her properly evaluated at a comprehensive breast center |
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Question:
#10516
12/01/2002
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Q: |
I live in a small town and fear that my breast problem may be inflammatory breast cancer. However, I don't feel the doctors here are very familiar with disease and the wait time for procedures is driving me crazy. Would a visit to MD Anderson be reasonable? |
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A: |
If you have a rash on your breast, nipple looks scaley or redness of the breast that goes unexplained and despite a week long course of antibiotics doesn't clear up then yes, a visit to a large cancer center would be in order. It is common for small rural areas to be unfamiliar with inflammatory breast cancer as it is rare. But is it deadly and can't wait for someone to eventually figure it out. so check it out. Hopefully you will be diagnosed with some form of dermatitis but if not, treatment asap is needed. |
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Question:
#10517
12/01/2002
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Q: |
I have had a mammogram and a diagnostic mammogram. The radiologist feels that the microcalcifications have multiplied more than they should have in the last 4 months and has recommended a biopsy; although he feels that there is probably nothing wrong. The surgeon and I have scheduled the biopsy, and he too feels that there is probably nothing wrong. What are the chances that this could actually be breast cancer? |
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it directly depends on what the calcification look like on magnification and how clustered they are. Ones that are truly spherical are usually just calcium; those with an irregular shape are often times an early stage of breast cancer called DCIS. It is smart to have them biopsied. Usually they are able to biopsy them without a surgeon though-- doing it stereotactically by a radiologist using MIBB or mammotome device so ask about this before undergoing an open surgical excision. |
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Question:
#10518
11/30/2002
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I just got the results from my annual mammogram. It reads that the breasts are symmetrical wihtout skin thickening or nipple retraction. No parenchymal distortion or microcalcific clusters. On the CC view of the left breast medially, there is a well-defined small nodule and compression view is recommended. The radiologist's assessment was a Category 0 with additional radiological evaluation. What does this mean? I am so scared and unable to reach my OB/GYN. My mammogram was done about a week before my period. Could this be a reason for the finding? I also recently underwent a diagnostic mammogram and ultrasound on the right breast due to breast pain. I was told that I had fibrocystic breast tissue but no further work was recommended. Could this nodule found in the left breast also be fibrocystic breast tissue? Please answer as soon as possible. Thank you so much. |
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A: |
Dear Scared, relax. you are fine... category 0 is good news-- this means that the radiologist thinks there is a very very low probability that this nodule is cancer or even precancer. Yes, it could be related to when you were in your cycle. Yes, it could be fibrocystic tissue. Many women are called back today for spot films to simply ensure that all is well... rest easy and enjoy the holiday. You have gotten good news so far and probably will with the final report too. |
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Question:
#10519
11/30/2002
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is is true that microinvasion is often seen with dcis and if so that many pathologists do not list microinvasion in their reports and also that her2 + is common with dcis. how could this be if dcis is good prognosis and her2 is not? |
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no and no. microinvasion is rare withDCIs unless there is the presence o extensive DCIS occupying a large space in the breast. No her2neu actually isn't even a test done on DCIS because this is a test reserved for invasive disease. |
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Question:
#10520
11/30/2002
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if you were diagnosed with dcis high grade and opted for mastectomy instead of lumpectomy, would the surgeon give you simple or mrm? |
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total simple mastectomy would be the standard of care for DCIS. If there were the presence of extensive DCIS making the patient uneligible for lumpectomy, a sentinel node biopsy may be done just in case there is a tiny bit of invasive disease lingering somewhere in the DCIS. Axillary node disection should not be done for DCIS. It's illogical since DCIS can't go to the lymphs since it is noninvasive to begin with. |
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Question:
#10521
11/29/2002
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for the last 14 months i have had a green coloured fluid leaking from my right breast. It seems to occur more when i am due my period!. is this why i went to see my doctor about this but she really did not have a clue as to why this could be happening. i am 31. i would be so grateful for a reply just so that i can put my mind at rest. |
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greenish fluid is often times from a cyst and as your breast changes with influence from hormones during your cycle, cysts can change in size. It is not uncommon to have cysts that drain to the nipple. Have an ultrasound done to visualize for cysts, if one is present, and have it aspirated to relieve this problem hopefully. worth trying... |
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Question:
#10522
11/28/2002
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Lately, I been noticing that my left breast is twice as large as my right. It feels more tender and sore. It's unusual because I'm only 17. Please help me find the answer. |
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you are a young woman still going through many hormonal changes as your body develops. It is not unusual for breasts to be different sizes at your age and for one to feel more tender than the other. If you haven't begun seeing a gynecologist yet this may be a good time to initiate that annual physical. This would ensure you are getting a clinical breast examination annually too. Try not to worry... you are a young lady developing into womanhood. |
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Question:
#10523
11/28/2002
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I'm 56 years old, and have gone through menopause. This week, I've been having hot flashes and tenderness in the breast that was similar to when I used to get my period. When I took a shower, I noticed a red lump on the lower part of the right breast. It looks and feels very much like a third nipple. It is tender as my breasts are right now. What's going on? |
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hhhhmm. not sure without a clinical breast examination. Keep in mind though that your breasts and the rest of your body will go through many changes as you are weaning off of hormones that you body got accustomed to taking. You may want to follow up with your gynecologist for a clinical breast exam to see what this new oddity is though, just to feel sure nothing is seriously wrong. |
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Question:
#10524
11/24/2002
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Found a lump on my left breast. Located inner quadrant on chest wall. Lump does not move, does not hurt unless pushed. But, when pushed my left armpit will ache. Should I have this looked at? |
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definitely. Give you doctor a call today and get scheduled for a clinical breast examination and a diagnostic mammogram. Better safe than sorry. |
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Question:
#10525
11/24/2002
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I just found a lump in my right breast towards the armpit side. It is not IN my armpit and it is not painful really. I had a fibrocystic lump removed in my right breast years ago. I am scheduled for a diagnostic mammogram next week. If this is fibrocystic breast disease..will it affect a breast augmentation surgery? |
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Many women have augmentation done who have fibrocystic disease. Talk with your radiologist when you see him next week about augmentation and what methods can he use in doing future mammograms and diagnostic evaluations of your breasts going forward though |
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Question:
#10526
11/24/2002
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I am 29 yrs old, no family history of breast cancer. Went into my docs office because I had a lump that was in the same place for 2 years. Well Dr. found a lump in the other breast. I went in for a bilateral Mammogram, and then Ultrasound. They found a lump but wasn't the one that me or my Dr. found. Went in for a Biopsy guided Ultrasound. The Dr. who performed it said he thinks it is a Subcutaneous cyst. If it is a Subq Cyst shouldn't fluid have come up when he put the needle in? He ended up just taking tissue from the cyst. Or when he was probing the cyst wouldn't it have started to leak fluid. It did not do either. Also, can a subq cyst become cancerous? I had Grave's Disease but my Thyroid is almost back to normal now. I had the Radioactive Iodine treatment to cure it. Are my chances any higher of getting breast cancer because of this Thyroid problem? |
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A: |
Risk of breast cancer goes up for women who have had radiation treatments for thyroid or adnoids in the past, or treatment for hodgkins disease as a young person. Yes, cysts are filled with fluid so ask the doctor where this fluid is now? You might want to pursue a second opinion with a radiologist who specializes in breast imaging too and have your films all re-read. |
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Question:
#10527
11/24/2002
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Can LCIS ever become DCIS. Do you have any statistics on this. Thanks |
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no it cannot. it actually occupies different structures of the breast too. DCIS is noninvasive breast cancer inside the ducts. LCIS is a marker for risk for developing breast cancer and is located in the lobules. |
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Question:
#10528
11/20/2002
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Do we have any information about patients who ADH and LCIS together that are followed in the Breast Clinic who despite the best efforts are diagonsed with Breast Cancer, any Statistics about what stage they are diagnosed with? |
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Usually women who are high risk and are followed by a comprehensive breast clinic program for high risk women are diagnosed, if they develop breast cancer, at an early stage-- 0,1 or 2 and do quite well. |
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Question:
#10529
11/20/2002
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i found a strange shaped nodule in deep of my upper left breast. it.s not hard
or soft it's in betweem both.firm to the touch. i had my gyn appt. she wanted to get a second opinion from a breast surgeon, i will be taking my annual mammogram in two days. the surgeon ask me to bring my films with me to my appt, on monday, my question is, my mammo is just reg screening,is that the right screening ?i'm nervous but i don't want to sound paranoid. |
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You need a diagnostic mammogram done so ask your gyn to call and order the mammogram to be done as a diagnostic evaluation-- not just a screening mammogram. this will include spot films of the area you feel as well as probably an ultrasound. Remember too that most of the time what is found is not something serious so don't fret yet... glad you are following through on being evaluated though. More women should take the lead from you and do the same when they feel a breast abnormality themselves. |
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Question:
#10530
11/18/2002
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I just received the results of my 11/7/02 mamogram. The results are a new small 5.0 millimeter nodular lesion in the lateral aspect of the mid left breast. What does this mean?
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It sounds like a biopsy may be recommended. an ultrasound might be done to visualize the mass in a different way as well as some additional spot films to enlarge this area and evaluate it better. Don't assume cancer right away-- but you need a definitive answer as to what this nodule is. |
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