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LCIS - Lobular Carcinoma In Situ
Questions about lobular carcinoma in situ.
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AskedPublicly Submitted Question
2/19/2011I wish I could come to Johns Hopkins, but alas, I am far away and on a tight budget. I had a breast reduction in November. Twelve days after my surgery, my surgeon received a pathology report that was not good news. I have Lobular Carcinoma in Situ, Atypical Ductal Hyperplasia and Ductal Hyperplasia. He sent referred me right away, but to the wrong doctor - a general surgeon. I have sufficiently laid into about this. Go directly to an Oncologist. Indeed, I thought I was seeing one until about two thirds into the appointment. She knew nothing more than what I knew at that point and sent me an oncologist. I checked her out and was encouraged because she had been with a top Cancer Center previously, one that has a good pre-cancer program. So I was relieved. I saw about a month and a half following the diagnosis. She recommended a mammogram followed by an MRI every six months barring any changes in one or the other exam. She also put me on Evista. I had my first mammogram a week ago. There was an order for a sonogram as well, but the Radiologist declined to do it and instead wanted me to have an MRI soon. I spoke with her and she showed me first that the fibroadenoma that bothered me last year had "melted away" and then also showed me white blotches that had been caught on prior mammograms, but it seemed to be getting smaller (or perhaps moving and thereby becoming thicker and maybe something..?). She said that she would like me to have the MRI as soon as possible or as soon as it gets approved. She also said that I should have another mammogram in six months. Mostly cause of my new, small breasts. Two days later, my oncologists assistant called. She stated that my mammogram was normal. I said, no it was not. She then said that the doctor would discuss with me moving up the MRI when I see her in May. I said OK, but was not 100% about the whole thing. Also, I was about to change over to Tamoxifen (for financial reasons) and I did some extra reading. I could not avoid it if I wanted. My pharmacy sent me a letter about it! So I read that Tamoxifen only works on "Estrogen Receptor-Positive Proliferating Cells" and that I should have a biopsy to determine if my horrid pre-cancers are Estrogen Receptive... I hated the Evista. I understand that Tamoxifen is much harder on the body. I emailed my oncologist, but she has not replied. I don't believe I can wait until May, but I am under the impression that she has no time before then. I can call her and will, but I would like to know if my information is right before I call. Or, should I move on to UCSF, which is the closest really good cancer center? Thank you very much.
RepliedJHU's Breast Center Reply
2/19/2011it's important to be in the hands of a medical oncologist who specializes in high risk. the good news is that they only have markers for increased risk and they didn't actually find any evidence of cancer cells. that said, it is not unusual to get an MRI for comparison to a mammogram or women who are high risk and/or have dense breast tissue. commmonly mammogram will be done then MRI 6 months later, then mammogram again... it would be odd to get an MRI every 6 months. Tamoxifen is the primary drug used for breast cancer prevention for women who are high risk. it is also used for women who have hAD breast cancer and their cancer was hormone receptor positive. no additional pathology tests need to be done for you since you didn't have breast cancer. no tests are done nor can be done on markers for breast cancer-- ADH or for LCIS. hope tht helps you.

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