Expert: Claes-Gustaf Nordquist, M.D. - 5/2/2008

Question
After a screening mammogram, a spot mammogram and an ultrasound, the radiologist recommended a biopsy of a cluster of cysts having a slight irregular border. (BI-RAD-4)  I followed orders and saw a surgeon who wanted to perform a stereotactic breast biopsy so I agreed; I didn't know what else to do - this was my first experience with mammography.  I have a few questions:  1.  Why a stereotactic using mammography if the area in question had to be seen using ultrasound?  2.  What does my pathology report mean:  Breast tissue with mild ductal epithelial hyperplasia of the usual type and intralobular fibrosis?  3.  The surgeon told me AFTER the biopsy that because of having it done I am now at an increased risk if getting cancer.  Is this correct?  If so, why?  4.  Does the report mean that I have proliferative breast disease?  

Answer
1. A stereotactic needle biopsy is one of several basic methods of obtaining a breast biopsy without any real surgery. Another is ultrasound guided needle biopsy. So probably both methods could have been used in your case. Probably your surgeon thought that your mammograms gave him good enough pictures for the stereotactic method. I have no principal objections. 2. Well, first of all there are NO signs of any cancer there, not even of any real precancerous changes since there is no mention of any dysplasia. What is seen is only a mild extra growth (thickening) of the lining of your milk ducts and some extra fibrous tissue within the lobes of your milk glands. The biopsy itself does NOT increase your breast cancer risks. This breast pathology itself increases your future breast cancer risk to some extent - really not very much. But with continued breast monitoring that should not be any great problem. 4. This may very well be a sign that you have a fibrocystic breast condition (I do not like to call it a disease since it is so common so it must be regarded as a normal variant). Good luck!