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Question:
#10531
11/18/2002
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Q: |
If a stereotactic biopsy shows ductal hyperplasia with atypical cells and a follow excisional biopsy does not mention this but states LCIS, would the ductal hyperplasia with atypical cells sway one toward Prophlactic mastectomy? |
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A: |
No, not usually. Patients with a diagnosis of ADH or of LCIS are usually followed annually with mammography and do just fine. Prophylactic mastectomy is more commonly done when there is extensive and significant family history of breast cancer and there are abnormal findings on biopsy as well as possible difficult to read mammograms due to density of breast tissue. But just LCIS alone or ADH alone would be unusual for persuing prophlactic mastectomies. |
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Question:
#10532
11/18/2002
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I am 42 with a strong family history of cancer (my 2 sisters both had a mastectomy)I started having blood coming from one of my breasts. After many mammograms, slide smears, a cyst aspiration and a ductogram all turned out negative. The surgeon said to come back in one year with updated mammograms. I didn't feel comfortable with this because of family history and with never finding out why or what was causing the problem. The surgeon was a little short with me saying that there is nothing more to do unless to have a portion of breast removed and biopsy, that it's nothing more that fibrocystic breast change. Well I started to having a discharge (grayish) in color from another duct in the same breast this has me a little worried. Is it normal to have discharge from 2 ducts in one breast, and what else can I expect from fibrocystic changes? |
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A: |
You can have discharge from more than one duct of the breast. fibrocystic changes are usually commented on in a mammogram but that doesn't mean that your breasts are going to do anything unusual. With your family history you may want to enroll in a program for high risk women to see what steps can be taken to help reduce your risk as well as possibly consider genetic testing. Additionally you may want to have another radiologist who specializes in breast imaging to review the films including your ductogram to give you more peace of mind. |
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Question:
#10533
11/17/2002
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Q: |
I have discovered a thick, scaly, dry patch of skin about an inch away from my nipple. I have been having some strange 'drawing' pains in my breast, particularly around or in the nipple. Should I be concerned? |
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yes, see your doctor soon. it may be nothing than dermatitis or it could be pagets disease of the nipple or even inflammatory breast cancer. we will hope for a benign diagnosis like dermatitis but better safe than sorry. |
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Question:
#10534
11/17/2002
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I'm 34 y.o. w/ 2 kids. Recently my husband noticed small amt. of bloody discharge from my left nipple during intercourse. The day after, it did bleed again w/ manual pressure to the nipple. No blood noted in bra. Please advise. |
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A: |
time for a mammogram and ultrasound and possibly a ductogram to see what is going on in there. Call your doctor and request a breast imaging diagnostic evaluation and kiss your husband and thank him for his close observation. |
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Question:
#10535
11/17/2002
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Q: |
I had DCIS L breast in 8/01,lumpectomy done with 6 weeks radiation, mastitis/cellulitis L breast 3/02, L arm gets tired and I have L breast pain, was told I had a seroma........got told I could have it for a long time, what can you tell me ? This month it feels better than it has in a long time. |
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A: |
hhmm. seromas are not to last for years though. get another opinion from another breast surgeon as well as radiation oncologist to decipher what this is... might be lymphedema too or other abnormality. |
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Question:
#10536
11/17/2002
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Q: |
I am a 33 year old mother of a 2 year old. I never got milk after pregnancy.
two weeks ago in conjunction with a very bad cold I began having localized soreness in my right breast. Somtimes the breast would feel heavy or hot or the pain would radiate slightly. I went to the ER because I was out of town. The doctor said I had mastitis and put me on antibiotics. After 4 days there was little change so I went to my obgyn who could not find any thing abnormal. She sent me for a mammogram which was fine
But it still hurts,I am due for my period any time and have had premenstrual
soreness in the past but always in both breasts. What now ? |
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A: |
hhmm. you weren't on antibiotics very long-- 4 days. usually the coarse of treatment would be 7 or even 10 days. See a breast specialist in your area to confirm mastitis and get the proper treatment for it. if these symptoms persist then a punch skin biopsy might need to be the next step to ensure you don't have something more serious. |
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Question:
#10537
11/17/2002
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Q: |
CAN YOU GIVE ME ANY INFORMATION REGARDING TREATMENT OF FIBROADENOMAS WITH CRYOABLATION? |
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A: |
We are not doing this at Hopkins at this time. Our method for now remains open surgical excision. So check with other breast centers for their experience with this. sorry |
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Question:
#10538
11/12/2002
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Q: |
when you have dcis but have comedo cells do you usually end up getting invasive cancer if you had a mastectomy? |
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A: |
Removal of the entire breast, mastectomy, reduces the risk of breast cancer returning locally to that breast tissue that remains by greater than 99%. Some doctors even use the word "cured" when talking about DCIS and mastectomy as treatment. As long as clear margins were obtained, and with mastectomy this is virtually a sure thing, and only DCIS was found (including comedo type), the risk of developing invasive disease from it has been removed... |
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Question:
#10539
11/12/2002
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Q: |
received diagnosis of dilated milk duct. for one year have leaked fluid. no children. never breast fed. doctor recommended duct be removed. any info? what are my options? my diet? any info? |
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always beneficial in getting another opinion before going under the knife. A radiologist who specializes in breast imaging might recommend a ductogram to determine the cause of the fluid and see if there are the presence of papillomas (benign) in the duct. diet usually doesn't contribute to fluid leakage from the breast. |
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Question:
#10540
11/12/2002
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Q: |
received diagnosis of dilated milk duct. for one year have leaked fluid. no children. never breast fed. doctor recommended duct be removed. any info? what are my options? my diet? any info? |
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A: |
you may want to consider a diagnostic evaluation at the breast imaging center where they might consider doing a ductogram to see the cause of the leakage. Diet is usually not a contributing factor to these symptoms |
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Question:
#10541
11/12/2002
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Q: |
My wife had a crecent shaped line just appear out of no where on her left breast. It looks as if it runs right along her inframamarry ridge it has been there for a week now. Should this concern her or me? My wife is 34 years of age and no family history of breast cancer or any other symptoms. |
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A: |
any breast abnormality that doesn't spontaneously go away about 10 days warrants investigation. Have her see her gyn doctor for a clinical breast exam and probable mammogram to see what is going on. Try not to worry-- remember that most breast abnormalities are benign, but we still need to do the due diligence to figure that out |
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Question:
#10542
11/11/2002
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I am 35 years old and Have had 3 children. I have had 2 lumps removed in the right breast both were B-9. I have found a new lump in the left breast Dr said it was at 7oclock. I also have a small hard pea like lump in the right breast again. and a green discharge from one duct and a clear discharge form another duct both on the right side. I do have an Aunt that had cancer, we lost her a year ago it spread to other places in her body. My Surgeon is a general surgeon and he did 2 slides of the discharge, and I took them over to the Lab at the hospital. I do want to add that i had a HYSTERECTOMY
5 years ago and have been on a HRT since then. I also have a swelling under my arm pit on the right side. What do you think this sounds like, and do you think I should go see someone else, Should they have sent all my tests off some where to have them tested
they did them right in the hospital. At Jefferson Memorial In Charles Town WV. I am getting really concerned about this now..... |
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you have a lot going on in your breasts that warrants diagnostic evaluation in a breast imaging setting where a large volume of diagnostic mammograms and biopsies are performed. It is unclear presently what all of these abnormalities mean. Having a lump in your armpit area may be the most concerning of them all however, so consider going to a facility where a diagnostic evaluation can be done which will include a mammogram, spot films of the abnormal areas, an ultrasound and probably biopsy (ies) of what is found. If surgery is needed, consider a surgical oncologist who specializes in breast. |
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Question:
#10543
11/10/2002
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Q: |
Do microcalcifications sometimes resolve and go away? Can they show up on one mammogram, then on a recheck six months later, be gone?
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A: |
they usually don't "go away" but can hide in the fatty and fibrous tissue of the breast. what the doctor is looking for is an increase in their number and clustering behavior. |
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Question:
#10544
11/10/2002
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Q: |
Can shaving the hairs around the nipple be dangerous? |
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A: |
only if you aren't really really careful and nick the skin resulting in the possibility of infection, not to mention pain.-- ouch! some women instead pluck the hairs which can hurt a bit more but has to be done less frequently than shaving usually does. something to consider. |
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Question:
#10545
11/07/2002
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Q: |
I would like more information on ductal lavage. I heard Dr. Love speak about this on television. Thank you.
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A: |
ductal lavage is strictly a research study. We have no clue of the sensitivity or specificity of the results. A catheter is inserted in through the papilla of the nipple and sterile saline is flushed (lavaged) into the ducts of the breast then milked out. the objective is to see if there is a way to detect early stages of breast cell changes that would be precancerous by flushing out the cells that slough off and line the inside ducts of the breast. Some early stage breast cancers have been found but there are also women who have had this procedure done and had perfectly normal findings only to then learn a few months later that they did in fact have cancer inside the duct that produced the fluid. This is why much more research is needed to determine its value and potential benefit. Though exciting research, insurance companies are not impressed. it costs more than $1000 per procedure. and it is not pain free-- two reasons why even if the test results can be deciphered better, it won't ever replace mammography. |
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Question:
#10546
11/07/2002
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Q: |
I am a 27 year old mother of one. About 5 years ago, I had a mammogram, and no cancer tissue was found. I have fibrocystic tissues is my breast. I have a mole on my left breast, and was seen by a doctor who says its an aerola cyst. Once removed, do I have to worry that another will reappear? |
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A: |
probably not. Glad that it is something benign too. take care and glad to hear you are being watchful and maintaining good breast health. |
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Question:
#10547
11/07/2002
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Q: |
Please give me information on angioscarcoma of the breast |
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These are connective tissue tumors that commence in the breast itself. It can be a sporadic event or related to prior therapy.
Primary breast angiosarcomas are exceedingly rare. There are about 220 cases in the literature and occur mainly in women aged 20-40 years.
Secondary angiosarcomas, that is similar tumors occurring after breast treatment, have as well been reported. They occur after radical mastectomy (removal of the breast) or lumpectomy (removal of the cancer alone) and radiation.
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Question:
#10548
11/06/2002
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Q: |
My 72 year old Mother recently observed a wart like growth on the tip of her nipple. She denies any past nipple discharge. Can a papilloma actually grow out of the nipple? Is this a sign of breast cancer? |
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frankly, it could actually BE a wart. have her see her doctor who will probably do a punch biopsy of it to determine its etiology. |
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Question:
#10549
11/06/2002
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Q: |
I recently had a double core biopsy. One lump was diagnosed as atypical ductal hyperplasia. I have been told that i need to have it surgically removed, along with a needle localization to test the surrounding tissue. Should I get a second opinion -- from both another breast specialist and/or pathologist? I have read that tamoxifen is sometimes recommended in such cases as well. My mother has not had cancer, but my father has prostate cancer, my maternal aunt had a double mastectomy for br. cancer, my paternal aunt died at 49 of colon cancer, another paternal aunt has had skin cancer, and two of my grandparents also died of cancer (stomach and lung). I'm in my early 40's. |
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A: |
the standard of care is to do a needle localization biopsy and determine if there is anything else other than ADH present in that area. you have family history of breast cancer too which increases your risk. Have the procedure done by a breast cancer surgeon and you are always welcome to have your pathology slides re-reviewed at a facility like ours that has pathologists who specialize also in breast cancer and breast disease. |
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Question:
#10550
11/06/2002
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Q: |
My breast surgeon wants to do an excisional surgical biopsy on a lump/thickening in my breast that seems to be growing. We have already done FNA's and a core biopsy on the area previously as well as mammograms, sonograms and an MRI all of which showed nothing but fibroid tissue. A few years ago, I was diagnosed with LCIS, ADH as well as other numerous fibrocystic changes after bilateral excisional biopsies involving other lumps and calcifications and this is one reason my surgeon wants to investigate further. I am wondering if this really needs to be done again in light of the fact that all the testing we've done on this lump so far showed no cancer. I would like to avoid having surgery again but am a bit nervous not to go along with it because of my high risk status. I am concerned that this might be overkill and unnecessary. |
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let's face it-- if it comes back benign you will think it overkill; if it comes back as cancer you will be thankful for his thoroughness... until it is definitively evaluated with biopsy, you really won't know what this unknown thing is. |
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Question:
#10551
11/06/2002
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Q: |
I am 18 years old and my right breast has always been larger than my left. A couple of years ago I noticed a pimple on the side of my right breast. It kind of dried out but it never went away. Should I be worried? |
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sounds pretty normal, as breast findings go dear. and it is not unusual for one breast to be larger than the other. sleep easier and don't worry |
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Question:
#10552
11/05/2002
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Q: |
when you have dcis with "foci of microinvasion" do you still get the same prognosis as just dcis. 98 % cured with a mastectomy? |
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A: |
it depends on what your read... some schools of thought discount microinvasion and don't "count it"; others do count it and change the staging from a stage 0 to a stage 1. |
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Question:
#10553
11/05/2002
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Q: |
breast cancer in young women 32 in lymph node there is no evedens in the brests after MRI. YES OR NO MASTECTOMY after chemotherapy |
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A: |
Other breast imaging methods may be considered to help determine exactly where the primary tumor is inside the breast. mammogram, ultrasound, pet scans, even having another radiologist who specializes in breast imaging review the films would be useful to do. More evaluation and a second opinion needs to be formally obtained before such a decision could be rendered so consider seeking a second opinion about it. |
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Question:
#10554
10/29/2002
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Q: |
I have a pain, a bit like muscle stretching/tearing, in my right side/my right breast - I only really feel it when I stretch my arm and slightly when I wear a bra. I don't seem to have a lump, but is sensitive to the touch (when I can directly locate it) and no pain when I breath in. Its almost as if its my rib cage, near by right breast. Can you advise me of what it might be? |
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you need a clinical breast examination to figure it out. It might be nothing more than a pulled muscle or bursitis in your shoulder, or it could be something more worrisome. so follow up with your doctor soon for peace of mind and resolution so you can feel better, physically and emotionally |
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Question:
#10555
10/27/2002
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Q: |
Ten months ago a needle core biopsy on my left breast revealed "fibrocystic change with extensive fibrosis and mild ductal hyperplasia without atypia" (dignosis.) Five months ago a follow-up mammogram showed no change, however for the past 6 weeks I have had a pinching or poking sensation within the area of the mass and it appears to be getting larger. The doctor explained that a "marker" was left in the breast for future identification purposes. Could this be the source of the pain? Should I try to schedule yet another mammogram, or learn to live with this uncomfortable sensation? |
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The clip left behind probably isn't the cause of this pain so consider getting re-evaluated if you are finding an increase/change in symptoms. |
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Question:
#10556
10/26/2002
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Q: |
I had my regular mommography in 1999 at that time they told me they found calcifications. Since that time, I have had regular 6-month mammograms. My last mammogram was done in Sept. '02, and the radiologist that read the mammogram at JHH said no need to come back until my yearly mammogram. When the report was sent to my doctor's office, she called me and recommended a second opinion by a surgeon because her report indicated worsening calcifications but they said they were benign. Do you think I should get a second opinion. I would like to follow the recommendation of the radiologist and not put myself through unecessary steps if they are not necessary. |
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I'd recommend calling Breast Imaging and speaking with Dr. Khouri regarding the above. He is director of Breast Imaging at Hopkins and can re-review your mammograms and advise what is best to do at this point. you need a resolution. sorry you are getting mixed messages from doctors. that is frustrating to say the least. Call 410-955-9619 and ask to be connected to him. Tell him that "Lillie requested that you call." |
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Question:
#10557
10/22/2002
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Q: |
I am interested in a good paper on lobular neoplasia/LCIS. It makes a difference on risk assessment. |
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check on www.breastcancer.org website for more information as well as call 410-614-STAR for help. |
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Question:
#10558
10/22/2002
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Q: |
I have crusting around the nipples and discoloration (skin is getting lighter) and my Dr. suspected Pagets Breast. He sent me to a surgeon who said she didn't feel any lumps(!)but said she would biopsy if I would point out where I wanted the biopsy. I didn't have it and now its worse & sharp pains shoot through my breast. How do I find a surgeon knowledgable about breast disease? I'm in the metro Denver, CO area. Also, do the symptoms sound like further investigation is necessary? |
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A: |
yes, you need to pursue this. you need a surgical oncologist who specializes in breast cancer. There are many in your area. The komen foundation as well as the american cancer society in Denver can probably give you names of specific doctors. Don't delay. |
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Question:
#10559
10/22/2002
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Q: |
Can a GP remove or help to remove a third nipple. If not would a plastic surgeon have to be paid? |
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A: |
A general practitioner is not a surgeon who would necessarily know how to do this. You should see a plastic surgeon or a breast specialist. yes, payment would probably be expected. |
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Question:
#10560
10/22/2002
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Q: |
I am a 44 year old woman with no family history of breast cancer. Two mammotome biopsies revealed a diagnosis of ALH in my right breast. I am scheduled for a lumpectomy. I'm unsure of whether to consider tamoxifen. My breast surgeon said she does not recommend it. What do you think about taking tamoxifen when ALH has been found? |
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A: |
It is dependent on many other factors-- presence of family history of breast cancer; other known risk factors the patient may have; previous biopsies and those results. See a medical oncologist regarding considerations for tamoxifen. you mentioned lumpectomy being done-- i assume this is actually an excisional biopsy to rule out the presence of precancer or cancer there near the ALH and not a true lumpectomy which by definition is done FOR a diagnosis of cancer. |
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