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ADH - Atypical Ductal Hyperplasia
Questions about atypical ductal hyperplasia.
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AskedPublicly Submitted Question
8/7/2011Hello. I recently had bloody nipple discharge. This led to an ultrasound that showed a 1 cm mass intraductal mass. An experienced breast surgeon took me to surgery where the mass ended up being more than 5 cm, extending down to the chest wall. Path was consistent with a papilloma with two focal areas of atypical ductal hyperplasia. The deep margin, at chest wall, had papilloma but not the atypia. I don't know how concerned to be about the lack of "clean margin". The surgeon and oncologist think it is okay because it was not a malignant lesion. The surgeon recommended MRI in two to three months (time for the post op changes to settle down) She ordered another bilateral US and this time, they saw two more intraductal masses (one on each side). Both of these were just biopsied percutaneously. The results are pending. The surgeon thinks if more papilloma, maybe I should have bilateral mastectomies because of how extensive the other was. (I also had a papilloma removed 2 years ago). I requested a second opinion on the pathology. The second opinion was a papilloma, but no atypia. (I suppose the focal atypia can be missed wlth slides going back and forth). I am really confused and don't know what to do. I have no family history of breast cancer. I am 44. Thank you in advance for any input.
RepliedJHU's Breast Center Reply
8/7/2011time for a second opinion. consider coming to us. 443-287-2778. the 5cm mass must be more than just a papilloma since papillomas don't grow that large. perhaps a benign phyllodes?? in any case, definitely warrants a second opinion with a breast surgical oncologist. Standard of care BTW is to do a core biopsy BEFORE a patient is to be taken to surgery to remove anything from the breast.

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