Pathology reports differ: ADH on biopsy but no ADH after lumpectomy

Just saw this. I had a very challenging experience w/ a potential mis-dx of DCIS with overtreatment consequences. I won't go into details here, but I highly recommend you check out David Page (if he's not retired yet) from Vanderbilt, who's an expert on something called "florid hyperplasia" and how it's distinct from ADH and DCIS. Of course, these concepts and tx recommendations change by the decade, if not sooner--but trust me. Radiologist from the TOP institutions in the US can disagree about how to "read" DCIS biopsy results--and they can disagree on ADH. AI-enabled radiology is changing this.

ADH at least at present is seen as a risk factor for future invasive or inflammatory breast cancer and so watchful waiting is important. Whether you're willing to go through the challenges of radiation and/or hormonal therapy--well, that's beyond my commentary.

The breast cancer treatment "system" can IMO tend to distort patients' and families decision-making--once dx, you've got this entire culture of dx, typologies, support groups, surgical and pharmaceutical regimens, all in an environment of intensified fear w/ relative and absolute risk. Barring inflammatory breast cancer or highly symptomatic BC w/ mets, I've found it's important to get mentally far away from the system for a little bit--just a week?--and focus on nature, life, love, the minutaie and big goals--to assess whether the treatment plans of the "system" are what one really wants.

I don't think the people working w/in this are ill-intended, but many organizational and industry forces kind of come together to put patients at risk of over-treatment. When it comes to lower risk conditions like ADH, DCIS, BRCA-positive status, etc., it's all the more important that we step back and breathe space around the situation to ensure we're making decisions that are best for our quality of life. God bless.

I just went through the exact same thing. Biopsy says ADH and I had mastectomy because of it. Surgical pathology report can’t find ADH at all. It’s benign. I had biopsy and surgery done at Rush Medical Center in Chicago. May I ask where your treatment is. I wonder whether we end up in the same hospital.

@resort I believe why a biopsy gives a diagnosis of ADH is because there is actual atypia, but the pathology report from your mastectomy came back as no ADH is that the ADH was removed during the initial biopsy. I had a diagnosis of atypical lobular hyperplasia (ALH) from a biopsy, but after an MRI, no ALH was noted. I was told that it might have been removed during the biopsy. Sorry you went through all of that.