REQUIRE BREAST BIOPSY

[Lilian12]

Hi Medical Community

I'm sick and tired of going yearly breast mammography and ultrasound and been depressed for many unhappy things, feel like giving up on life. I had made a bad dream that I had breast cancer, just feel depressed for my whole entire life. I had my report review on yesterday. The result is as follows:-

MAMMOGRAPHY, BILATERAL BREASTS
Standard MLO and CC views of both breasts were obtained. The mammogram of 29/8/11 was reviewed.

Both breasts demonstrate heterogenously dense fibroglandular tissue.

No suspicious mass, clustered/pleomorphic calcification or architectural distortion is seen.

The skin and subcutaneous tissues are unremarkable. No enlarged axillary lymph node is identified.

US Breast
An U/S of both breasts was performed. The U/S of 3/4/12 was reviewed.

Architectural distortion is seen in the periareolar region of both breasts and in both upper outer quadrants, due to previous surgery.(History form Isoft: status post lumpectomy in both breast on 24/1/08 and 9/2/09).

Right Breast
Multiple cysts are again seen in the (R) breast, some containing internal septations. The largest cyst is located at 6 o'clock 4 cm fROm nipple measuring 0.7 x 0.5 x 0.4cm.

Left Breast
The previously noted 1.2 x 1.1 x 0.5cm cystic lesion with internal echoes in the (L) breast at 3-4 o'clock 4cm from the nipple is now seen along with branching tubular ducts. There is also interval development of an avascular solid component within the cysts.

Multiple cysts are observed in the (L) breast, some containing internal septations and internal echoes.The largest cyst is located at 8 o'clock 4cm from the nipple measuring 0.8 x 0.5 x 0.5cm. There are largely unchanged since before.

No enlarged axillary lymph node is seen in either breast.

CONCLUSION
Suggestive of an intraductal lesion or ductal debris. Suggest histopathological correlation.

Multiple cysts in both breasts, largely unchanged.

Doctor suggest either excisional biopsy or monitor for 3 months.  I request for biopsy but do I make the right choice? Just scare that is Intraductal lesion which contain cancer cells but hopefully is just debris. Very sick as this is the third time operation. Previous two operations luckily was benign lumps. But I do not know this time will I be as lucky as before? Frustrating with all these nonsense.

Please advise.

Thank You.

Best Regards.
Getting Frustrating

[ncmichigan]

Hi, Lilian,
Be HAPPY---you don't have cancer! As zouzi said, a follow up mammogram in six months after a biopsy is routine, so don't keep worrying. We're not doctors here, so if you want a detailed explanation of your pathology report, you need have your doctor go over it with you.
You have no control over the results of the next mammogram, so worrying doesn't help. I still hope you'll get some mental health care for your anxiety and depression. Your life could be so much better without all the fear
that you have now. Please reread my post from Nov. 1st.
Wishing you all the best,
nc

[zouzi]

Hi,
First of all,please understand that the terms used by radiologists to describe findings in the breasts are very hard to analyze unless a medical professional explains it to you.All I can say is that your  biopsy results clearly indicate that NO malignancy is seen in the tissue.
Your report states that you have  fibrocystic breast changes which is a benign condition affecting a lot of women.
Your radiologist has recommended a follow up in six month,because this is standard procedure to make sure that there are no changes.For now you have nothing to worry about,but if anything suspicious is detected in the future,your doctor or radiologist will let you know if any abnormality needs to be biopsied or removed.
All the best..

[Lilian12]

Hi Medical Community

DIAGNOSIS
LEFT BREAST LUMP 3 O'CLOCK
-Fibrocystic Change with Brest Cyst and Tubular Adenoma, No Malignancy is seen.

GROSS DESCRIPTION
SPECIMEN LABELLED AS "LEFT BREAST LUMP 3 o'clock
Received fixed in formalin is an irregular piece of fibroadipose tissue mesuring 2.0(SI) x 2.0(ML)x1.2(AP) cm with sutures. The long suture marks lateral, short suture marks superior and medium-length suture marks medial margins respectively. The specimen is passed from superior to inferior. The margins are inked as follows: Super-Red, Medial-Green, Inferior-Yellow, Lateral-Blue and posterior-Back. The entire specimen is passed without reserve.(5 blocks) pwt.

MICROSCOPIC DESCRIPTION
LEFT BREAST LUMP 3 O'CLOCK
The entire specimen has been processed for evaluation and it shows fibrocystic change featuring stromal hyalinization, adenosis,
fibro-adenomatoid hyperplasia, presence of cystically dilated ducts and apocrine metaplasia. A cyst measuring 1.0 cm in diameter lined by single layer of cuboidal epithelium is present. Mild surrounding acute-on-chronic inflammatory infiltrates accompanied by sprinkling of eosinophil is noted around the cyst. There is also 3 3 x 2 mm tubular adenoma(A04) and a few other breast ducts show surrounding chronic inflammatory infiltrates of lymphocytes mixed with a few mature plasma cells and eosinophils. Rare duct show moderate epithelial hyperplasia (A04). Dystrophic calcification is noted.(A03).No malignancy is seen.

Kindly advise as seems like my report don't sound good right? I'm fearful of cancer cells will develop eventually as my next mammogram doctor advise to be scheduled half year this time after this operation done.

Thank You.

Best Regards
Frustrating

[ncmichigan]

Hi, Lilian,
Zouzi gave you EXCELLENT advice about your breast issues, but I'd like to just add a note about your depression. I would recommend you call your doctor as soon as possible and get a referral for some mental health treatment. If you feel "like giving up on life", that's a very serious sign and you really need to seek help. There are medications and counseling that can help depression, but "giving up on life" is a permanent solution to a temporary problem. Please do get some help with this---we do care about people here on this forum. You mental health is just as important as your physical health, if not more so. I truly believe a positive attitude can help many people get through physical problems and have a better outcome than those with a negative outlook. I've had three biopsies of five areas and some breast issues, too, but I never stop trying to stay positive that all will work out in the end. There's a saying, "It'll all be OK in the end---if it's not OK, then it's not the end." Please try to believe that and take care of your depression as soon as you can, OK.
I'll be thinking of you and wishing you better days ahead.
Hugs,
nc

[zouzi]

You welcome,
Well,I guess if eliminating caffeine worked for you in the past,then you should try to avoid it again.
No one knows for sure what causes breast cysts but there is some evidence suggesting that excess estrogen in your body may play a role in breast cyst development.
Unfortunately there isn't much one can do about these cysts,many women have this problem.Cysts usually disappear after menopause,but you can try changing your diet and hopefully your cysts will at least shrink and lessen the discomfort
A low-fat, high-fiber diet high in whole grains, vegetables, beans, and fruit will help keep your estrogen levels stable.It is also recommended to avoid dairy products.
Also consuming less salt reduces the amount of excess fluid retained by your body and may help alleviate symptoms associated with a fluid-filled breast cyst.
You should talk to your doctor if medication could alleviate your symptoms and if you could take certain Vitamins,like Vitamin A and E so that he can prescribe the proper dosage for your particular situation.
Take care..

[Lilian12]

Thanks for your reply and advice.

I'm aware of caffeine intake will cause my problem for multiple breast cysts. Long time ago, I had quit coffee, tea intake and I can feel my breast less tense and pain. But these few years I give up and continue daily intake of caffeine related products. If I stopped all these caffeine drinks will my breast cysts shrink smaller or disappear? I have all these cysts for years and sometimes cause pain,discomfort and heavy. I also quit on intake of Evening Primrose. I do not know will strict diet helps to solve my cystic breast problem or not?

Please advise.

Thank You.

Best Regards
Frustrating
  

[zouzi]

Hi,
FYI, in this community Forum, most of us are not doctors,but members who have some knowledge concerning breast issues and I hope I can help a little.
First of all,breast cysts are very common .Unfortunately some women have multiple cysts which have to be monitored regularly especially if they contain debris which describe particles found that are not fluid in the cysts.
Cysts are related to the increasing hormonal fluctuations and can be classified as either simple or complex.It's highly rare to have cancer in a cyst, and in the cases that it occurs, the cyst walls tend to be thick and irregular, which can be noted on ultrasound; also, there tends to be dense tissues surrounding the cysts.There is a very very small chance that a complex breast cyst could be associated with malignant breast cancer, so they merit a higher degree of scrutiny.
Usually complex cysts are aspirated and have the cells examined to better evaluate the nature of the cyst and the  majority will results in benign findings when biopsied..However I would want you to be on the safe side and follow your doctor's recommendation and have the suspicious  lesion removed ,because it could on rare occasion be an intracystic cancer. Please try not to worry so much by thinking you have breast cancer..  your dream is just reflecting what you are worried about but it doesn't mean it will come true.
Best wishes..

P.S Avoiding or limiting foods and beverages containing caffeine, such as coffee, tea, chocolate and soft drinks and salt can decrease water retention and may help shrink the cysts and alleviate discomfort if you have breast pain.