Expert: Claes-Gustaf Nordquist, M.D. - 6/24/2008

Question
I found a lump in my left breast 4 months ago.  I had a core biopsy performed last week and just received the pathology results.

"Proliferative fibrocystic change without atypia, with mild intraductal hyperplasia, apocrine cyst formation.  Pigmented macrophages suggestive of previous hemorrhage and stromal fibrosis with evidence of previous fat necrosis."

My OBGYN recommended I see a breast specialist due to the "intraductal hyperplasia" on the report.  

Can you translate this into simple terms?  It seems the lump is not a concern, but they have found some cells in the ductal area that are a little more active then they should be, correct?   Is this something that gets treated with surgical biopsy/surgery or is it a wait and see kind of thing?  I've read that this can show a higher risk for breast cancer later on.

Also, the cyst itself is extremely painful.  Would it be okay to ask for it's removal?  It is not fluid filled and didn't aspirate during the core biopsy.

How active should I be in follow up on this?

Answer
You are correct. This includes an EARLY precursor to a cancer, but there is NO cancer at present. I suppose that the specialist will suggest that it should be removed. That will remove the pain as well. You could wait and see too, but since it causes you immediate problems (pain) you can have it removed. Good luck!