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What Does This Pathology Report Of Breast Indicate?
Question: I had a breast bx done which the path report states Breast tissue demonstrating fibrosis and ducts with usual ductal hyperplasia. the ducts are partially filled with overlapping cells with slightly enlarged nuclei of different shapes that exhibit moderately abundant cytoplasm. these cells extend into some of the lobules present. there are no calcification. There is no atypia appreciated and no malignancy. This was biopsy last year. This year I have enlarged lymph nodes on same side as biopsy. US showed hilum and but the cortical thickness was 3 mm. I am concerned that something was missed last year. My mother and MGM both had breast cancer. what do you think?
Brief Answer:
Biopsy is the only way to be sure about it.
Detailed Answer:
Hi.
Thanks for your query and an elucidate noting the patho report and mentioning your worries and US report of the lymph node.
The last years biopsy is certainly negative for Cancer / Malignancy.
Now you have enlarged Lymph nodes on the same side which showed hilum but the cortical thickness was 3 mm on US. Since you have a strong family history you are worried about malignancy .
My thinking:
Last years breast biopsy was negative for cancer.
Ultrasonography guided FNAC of the lymph nodes or still better open biopsy is the only way to make certain that there is no malignancy.
Get MRI of the breasts as specificity and sensitivity is very good.
I hope the breast/s are normal as you have not mentioned about it.
Since you have a strong family history as well as strong suspicion, I would recommend to get the final diagnosis which is possible ONLY by a Biopsy report so that the mind is cleared and the anxiety and the stress are gone.
Medicine is an evidence-based science.
I hope this answer helps you to get an early and clear-cut diagnosis which will help to negate the effects of the suspicion as there is a strong family history.
Please feel free to ask if you feel there is a gap-of-communication.
Biopsy is the only way to be sure about it.
Detailed Answer:
Hi.
Thanks for your query and an elucidate noting the patho report and mentioning your worries and US report of the lymph node.
The last years biopsy is certainly negative for Cancer / Malignancy.
Now you have enlarged Lymph nodes on the same side which showed hilum but the cortical thickness was 3 mm on US. Since you have a strong family history you are worried about malignancy .
My thinking:
Last years breast biopsy was negative for cancer.
Ultrasonography guided FNAC of the lymph nodes or still better open biopsy is the only way to make certain that there is no malignancy.
Get MRI of the breasts as specificity and sensitivity is very good.
I hope the breast/s are normal as you have not mentioned about it.
Since you have a strong family history as well as strong suspicion, I would recommend to get the final diagnosis which is possible ONLY by a Biopsy report so that the mind is cleared and the anxiety and the stress are gone.
Medicine is an evidence-based science.
I hope this answer helps you to get an early and clear-cut diagnosis which will help to negate the effects of the suspicion as there is a strong family history.
Please feel free to ask if you feel there is a gap-of-communication.
Above answer was peer-reviewed by :
Dr. Raju A.T
Is the path report more indicative of usual ductal hyperplasia or atypical hyperplasia. I thought atypia has different shapes of nucleus. I had the MRI which showed the enlarged lymph node. The radiologist said the lymph nodes looked fine and didn't recommend biopsy. Last year the MRI showed borderline lymph nodes and US at different facility showed cluster of lymph nodes. she did biopsy but didn't get sample. I go back to see surgeon on the 15 XXXXXXX for fol.
Brief Answer:
Usual ductal hyperplasia
Detailed Answer:
Hi.
The Path report specifically mentions - ducts with usual ductal hyperplasia and also - There is no atypia appreciated and no malignancy...
There is Ductal Hyperplasia.
Noted your history related to MRIs and an opinion of the Radiologist and unable to get samples at biopsy and an appointment to see a Surgeon on 15 th XXXXXXX
This all things put together are indicative of cancer at the moment.
But it is always better to get certain about it.
If the facility is available - the best and the least troublesome is ultrasonography-guided FNAC. Please discuss about this with your Surgeon.
It is always better to be most precautious as you are, but do not be over-stressed. I can understand what you may be feeling once you have a family history of breast cancer.
Usual ductal hyperplasia
Detailed Answer:
Hi.
The Path report specifically mentions - ducts with usual ductal hyperplasia and also - There is no atypia appreciated and no malignancy...
There is Ductal Hyperplasia.
Noted your history related to MRIs and an opinion of the Radiologist and unable to get samples at biopsy and an appointment to see a Surgeon on 15 th XXXXXXX
This all things put together are indicative of cancer at the moment.
But it is always better to get certain about it.
If the facility is available - the best and the least troublesome is ultrasonography-guided FNAC. Please discuss about this with your Surgeon.
It is always better to be most precautious as you are, but do not be over-stressed. I can understand what you may be feeling once you have a family history of breast cancer.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
The Radiologist that did the US didn't recommend biopsy of lymph nodes. She just assumed that the appearance did not represent lymph node with malignancy.
I did start in Oct having a greenish brown discharge from one duct in the same breast.
Do you believe that asking for excisional biopsy of the lymph node to be to aggressive. The lymph nodes that are enlarged are deep.
I did start in Oct having a greenish brown discharge from one duct in the same breast.
Do you believe that asking for excisional biopsy of the lymph node to be to aggressive. The lymph nodes that are enlarged are deep.
Brief Answer:
Sentinel LN biopsy if seen or palpable. Test of discharge.
Detailed Answer:
Thanks for your feedback regarding the opinion of the Radiologist, greenish brown discharge from one duct in the same breast.
With the recent high resolution ultrasonography, the Radiologist can have better opinion, so let us go with it and have a regular follow-up as per the protocol they have for you.
There are other reasons too for the greenish brown discharge from one duct only. This can be due to infection and other causes including duct hyperplasia / ectasia
( let us not go into details of the terminology please).
Was the discharge tested in the laboratory ?
If it is still present please get this checked.
May I please know about your status / children / breastfeeding etc.
This is a great question- I think with the history you have provided asking an excisional biopsy of the nodes is not too aggressive, being deep is not much of a problem for a Surgeon who does this regularly. Sentinel Lymph node biopsy is proved to be sufficient at this stage if it is visualized in ultrasonography / MRI or is palpable. Dissecting the whole axilla for lymph node biopsy has its own dangers, hence not advocated.
Please discuss about this wit your Surgeon whether the sentinel lymph node is seen or palpable and whether it can be biopsied in your case ( possible only if found)
I hope this help you.
Sentinel LN biopsy if seen or palpable. Test of discharge.
Detailed Answer:
Thanks for your feedback regarding the opinion of the Radiologist, greenish brown discharge from one duct in the same breast.
With the recent high resolution ultrasonography, the Radiologist can have better opinion, so let us go with it and have a regular follow-up as per the protocol they have for you.
There are other reasons too for the greenish brown discharge from one duct only. This can be due to infection and other causes including duct hyperplasia / ectasia
( let us not go into details of the terminology please).
Was the discharge tested in the laboratory ?
If it is still present please get this checked.
May I please know about your status / children / breastfeeding etc.
This is a great question- I think with the history you have provided asking an excisional biopsy of the nodes is not too aggressive, being deep is not much of a problem for a Surgeon who does this regularly. Sentinel Lymph node biopsy is proved to be sufficient at this stage if it is visualized in ultrasonography / MRI or is palpable. Dissecting the whole axilla for lymph node biopsy has its own dangers, hence not advocated.
Please discuss about this wit your Surgeon whether the sentinel lymph node is seen or palpable and whether it can be biopsied in your case ( possible only if found)
I hope this help you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I have not breast feed for 5 yrs and they did not due cultures. I still have the secretion. The lymph node was not palpated just seen on US. They did see another enlarged one beside it.
Brief Answer:
Breast feeding reduces cancer risk.
Detailed Answer:
If you still have secretions, please get this tested for gram staining, culture and sensitivity.
It is possible that if infection is suspected a course of an antibiotic and anti-inflammatory medicines may just change the whole picture positively.
Breast feeding reduces the chances of cancer, that is the reason I asked about.
Discuss about sentinel node and biopsy if possible with your Surgeon.
Breast feeding reduces cancer risk.
Detailed Answer:
If you still have secretions, please get this tested for gram staining, culture and sensitivity.
It is possible that if infection is suspected a course of an antibiotic and anti-inflammatory medicines may just change the whole picture positively.
Breast feeding reduces the chances of cancer, that is the reason I asked about.
Discuss about sentinel node and biopsy if possible with your Surgeon.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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