ADH at Surgical Margin

Question: I recently had surgery after my core biopsy for ductal carcinoma in situ. The pathology report said the cancer measured 4 mm but there was “focal atypical ductal hyperplasia at the lateral inked margin”. My doctor said not to worry about that, but that worries me that there is more tumor left in my breast.

Answer: Based on the report you mentioned, I would agree with your doctor. It seems you have a small focus of ductal carcinoma in situ (DCIS) with some associated atypical ductal hyperplasia (ADH). I’m not sure why they mentioned that there was ADH at a surgical margin as that shouldn’t have an impact on any of your further therapy. If it was DCIS at a surgical margin then yes, it would affect whether you need further surgical treatment. One thing you might consider is getting a second opinion on your biopsy. Sometimes distinguishing DCIS from ADH can be difficult and it can significantly affect what next treatment steps to take. You want to be sure your diagnosis was made by a breast pathologist.

Overall, based on what you’ve said, it sounds like you have a very small area of DCIS. No invasive cancer was found based on your report which is good news. Depending on the grade of the DCIS some doctors wouldn’t even recommend radiation therapy for a 4 mm focus of a low grade DCIS with clear surgical margins.

Let us know if we can be of more assistance.

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