Question: Hello, I have a question. What does flat epithelial atypia mean and if it isn’t cancer, why do I need surgery? I am scheduled for surgery next week and I don’t feel comfortable. Thank you.

I recently gave a talk on second opinions in breast pathology at the 21st Annual Conference of the National Consortium of Breast Centers in Las Vegas. A modified version of that talk is available here as a pdf:
Second_Opinion_Pathology
The first part of the talk covers some of the data in the literature and the second part [...]

Nine of my colleagues and I who specialize in breast pathology from the US and Australia reviewed 21 difficult consult cases which were sent in for second opinion with a question of cellular fibroadenoma vs. phyllodes tumor.  Our abstract was accepted for presentation at the USCAP’s 100th annual meeting in San Antonio, TX. We attempt [...]

Question: I had a stereotactic biopsy on 11/23/10 for pleomorphic clustered microcalcifications. These were identified on additional view mammogram. US also noted at least 15 small simple cysts, a 7mm benign appearing solid mass such as fibroadenoma or fibrocystic mastopathy and no masses in the region of the pleomorphic clustered microcalcifications. My Dr. [...]

If you haven’t seen this recent article from the New York Times it’s worth a read.
I have posted before about the importance of getting your breast biopsy diagnosed from a pathologist who specializes in breast pathology.  This article points out how subtle the distinction can be between atypical ductal hyperplasia and low grade ductal carcinoma [...]

Question: Hello, I just received the results of my core biopsy, I would like you opinion on it. Proliferated fibrocystic changes comprised of ductal epithelial hyerlasia with focal atypia, duct single minute microcalcification seen in benign fibrotic tissue. Patient needs surgery consult for breast biopsy. At this point, what do you think my risk is for cancer? I [...]

Question: Four weeks ago I had a core biopsy with ductal carcinoma in situ and recently had a lumpectomy. My doctor said there was 2.2 cm of DCIS, high grade with necrosis, margins negative, estrogen receptor negative. He is suggesting radiation therapy but when I went for a second opinion, the pathologist said [...]

Question: I had a stereotactic core biopsy of cluster of calcifications in the upper inner left breast. Path diagnosis columnar cell change and hyperplasia with focal atypical micropapillary hyperplasia with microcalcifications. surgicial excision is recommended. From my understanding this is not cancer but has the potential to be cancer down the road. I [...]

I hope you read this article on the importance of having a breast pathologist read your biopsy.  I have posted this before, but it’s such an important “white paper” report from Komen that I think it deserves more discussion.
When confronted with a breast health issue, many patients seek out a particular breast center or a [...]

Question: I had a core biopsy for calcium in my right breast that showed “focal atypical lobular hyperplasia” – my doctor recommended surgery but I chose to get a second opinion and that said my biopsy was benign and said there was no atypical lobular hyperplasia. I would prefer not to have surgery but [...]