Expert: Claes-Gustaf Nordquist, M.D. - 5/9/2005

Question
Hi Dr. Nordquist,

I will try to type out full report to you when I get home from work, but this is not a follow up from previous surgery, this is current pathology report, I have never been diagnosed with cancer before, I do however have 2 blood family members who have breast cancer now. I am 46 years of age and am still having my periods regularly. My doctor said NO Cancer found, but my primary doctor suggested I get 2nd opinion,as to him this pathology report makes so sense at all, and makes no determination at all they were even looking for NEW diagnosis of any cancer types, they seemed to have been only looking for residual cancer that might have been diagnosed from previous surgeries, which there were none. Thank you very much for your assistance to me, I have 2 co-workers at work also who have breast cancer, and one who lost the fight this last December, so I am concerned..

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Followup To
Question -
 
Hi I enclosed a portion of my pathology report:

on my path report , it states
Pre ope diagnosis - Bilalteral breast cancer
Post op: same

My docter states thats not the case. COMMENT on report states: atypical apocrine epithelium - moderate, specimen received in multiple sections, no clear margins it cannot be clearly ascertained whether this focus of atypical apocrine is completely excised. 2 samples stained by immunoperoxidase in order to attempt to identify residual malignancy.

supp disci - 1 - immunoperoxidase stains are evaluated in parralell with satisfactory positive/negative controls
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slide A4 (LB) NEGATIVE FOR IMMUNOREACTIVITY IN AREA UNDER STUDY, THERFPRE NEGATIVE FOR RESIDUAL INVASIVE OR INTRADUCTAL CARCINOMA.
Slide B5 (RB) POSITIVE IMMUNOREACTIVITY FOR BRST-2 INDICATING RESIDUAL BREAST EPITHELIUM WITH APOCRINE ATYPIA.

POSITIVE IMMUNOREATIVITY FOR p63 INDICATING ABSENCE OF RESIDUAL INFILTRATING DUCT CARNINOMA

Does this indicate, there is NO cancer of any kind including DCIS?

It also states atypia apocrine ductal hyperplasia of both breasts. moderate category

If no cancer why is he looking for residual malignancy? Is he saying there was before removal of 2 lumps?

Do I need to be concerned that there is residual epithelium with apocrine atypia in ducts? Should I consider having addl surgery to have this removed? I have 2 blood family members who have breast cancer now.
I have 2nd opinion on 5/17...  If you have any email addres, I can email you the complete report if it will allow you to better answer.

Pls left me know thank you
hokuw@cox.net


Answer -
I have just answered this! I'm somewhat astonished that your dr. did not take the time to explain all this! Good luck!


Answer
That was strange! Do not understand then why they wrote as they did! Mistake? Need to see the full report! Yes a second opinion is good. Discuss then also your future options. You are obviously at high risk! So either you should have breast check ups OFTEn - including MRI-mammography if possible, or a double prophylactic mastectomy!