Clinical care after a Biopsy

Papilloma

Often found to be in relation to nipple discharge. The majority are benign. After a thorough history and physical exam the discussion of implications and the risks of this lesion are discussed. Treatment recommendations wound follow. If surgical excision is considered for this papilloma the procedure would be explained in detail at this time.

Radial scar


The significance of this type of lesion is explained and the treatment modalities. If surgical excision is considered for this lesion the procedure would be explained in detail at this time.

ADH- Atypical ductal hyperplasia

Is not cancer but it is considered a precursor of ductal carcinoma. It is recommended to be excised. There is no cancer treatment following excision of this lesion but a discussion of the new risk for cancer and the reduction of this risk is recommended. At the time of consultation the surgical procedure would be explained in detail as well as the follow up after the surgery.

DCIS- Ductal carcinoma in situ

DCIS is a localized breast cancer that does not have the potential of metastasis. This lesion needs excision with negative margins; meaning the cancer needs to be removed with a rim of normal tissue to ensure the complete removal of all the cancer. This lesion does not need to have lymph nodes sampled because by definition this type of cancer does not metastasize. The natural history and the treatment modalities for this cancer will be discussed at the time of consultation. The surgical options and the process itself will be described in detail.

IDC- Invasive ductal carcinoma

This type of cancer is the most common one. This lesion requires surgery to excise the cancer with negative margins; meaning the cancer needs to be removed with a rim of normal tissue to ensure the complete removal of all the cancer. In the case of invasive carcinoma of the breast lymph node sampling is needed to determine if the cancer has spread because this type of cancer does have the potential of spreading. Sentinel lymph node biopsy would be recommended if there are no clinically obvious lymph nodes. The natural history and the treatment modalities for this cancer will be discussed at the time of consultation. The surgical options and the process itself will be described in detail.

ILC- Invasive Lobular carcinoma

This type of cancer is less common but its behavior, treatment and outcome are quite similar to the ductal type. Therefore it is treated in similar fashion as the ductal cancer: it requires excision with negative margins; meaning the cancer needs to be removed with a rim of normal tissue to ensure the complete removal of all the cancer. In the case of invasive carcinoma of the breast lymph node sampling is needed to determine if the cancer has spread because this type of cancer does have the potential of spreading. Sentinel lymph node biopsy would be recommended if there are no clinically obvious lymph nodes. The natural history and the treatment modalities for this cancer will be discussed at the time of consultation. The surgical options and the process itself will be described in detail.

ALH- Atypical lobular hyperplasia

ALH is not considered a precancerous lesion as its counterpart the atypical ductal hyperplasia. This type of lesion is considered a high risk lesion; meaning its presence is indicative of a higher risk of developing breast cancer. This lesion is most often followed closely but surgery is not indicated in all patients. In some instances, however, excision is indicated the reasoning behind these recommendations will be discussed during consultation.

LCIS- Lobular Carcinoma in situ


This lesion similar to the ALH – Atypical Lobular Hyperplasia- is considered a high risk lesion. In the past excision and even mastectomy was carried out for lesions like this. However, it has been shown that these extremes are not necessary in most patients. This lesion although its name suggests cancer it is not. It is not even a precursor to cancer. It is only a marker for high risk of developing any kind of breast cancer and in either breast. However, there are some instances when the LCIS is recommended for excision and these recommendations would be discussed at the time of the consult.