Expert: Claes-Gustaf Nordquist, M.D. - 9/3/2006

Question
Hi! I am 41 years old. At age 39, I started mammograms and had ultra sound done which led to a biopsy on my right breast.The pathology report read: "Sections demonstrate breast tissue in which there is stromal hyalinization. Scattered ducts and lobules are seen. Areas of apocrine metaplasia are noted. Many foci of sclerosing adenosis are identified. There is mild ductal epithelial hyperplasia without atypia. Scattered microcalcifications are identified." Does any or all of this raise my chance of developing breast cancer? I am very concerned about it, I have a family history of BC. My maternal grandmother died at 42 from BC, my maternal Aunt was diagnosed with BC at age 68, and last month my Aunt's daughter, my cousin, had to have a double mastectomy because of 2 types of BC, one hereditary, and one invasive. How often should I be checked, or what should I do to help prevent this from occurring? My doctor says I am higher risk to develop BC within the next 10 years, but get Mammo's every year. So don't worry. He only knows about my grandmother. My aunt and cousin were just diagnosed within the last month. Please give me a clue as to what my chances are now?         
                              Thank You

Answer
The pathology report on your biopsy does NOT show anything cancer suspicious! BUT with this family history you have to be careful. With sclerosing adenosis involved (as shown in your biopsy) mammograms will be more difficult to interpret (probably that was why you had the biopsy in the first place - right(?)), so I strongly suggest that all mammograms from now on are complemented not only with ultrasound but also with breast MRI scans and that all suspicious lesions should be checked with thin needle aspiration biopsies and if necessary also with surgical biopsies (since sclerosing adenosis is involved that will probably happen at least now and then). This should be done at least once a year maybe every half year. Discuss this with your dr. after you have given ALL relevant facts to your dr.!