ALH found in biopsy, what's next?

Posted by pipi2026 @pipi2026, Jul 31 1:47pm

Hello, All!!

I am 45 and completely new to this. This year, annual mammogram found a focal microcalcification. I went through a vacuum based mammogram guided biopsy and found ALH. Microcalcification was all removed during biopsy. I did Tyrer-Cuzick risk calculation and my lifetime risk is 25%.

I researched quite a bit online. Some of resource recommended a surgery biopsy to make sure while others say just do imaging to monitor. Anyone has previous experience? I feel I am sitting on a bomb which I do not know when it will go off. It is a very uneasy feeling. Am I overthinking?

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Colleen Young, Connect Director | @colleenyoung | 3 days ago

@pipi2026, your post sounded so similar to the discussion @kmcb1117 started last year, I had to check. See here:
- Right breast biopsy confirmed ADH, ALH & LCIS what’s next? https://connect.mayoclinic.org/discussion/right-breast-biopsy-confirmed-adh-alh-lcis-whats-next/

I'm tagging @kr2025 @fronterae @kayleenchilds @leesal123 and others who have experience with atypical lobular hyperplasia (ALH) and can share their thoughts.

@pipi2026, have you made any decisions or had a chance to discuss the options with your doctor that are right for you?

kayleenchilds | @kayleenchilds | 2 days ago

I was diagnosed with ALH 2 years ago through biopsy but I went ahead and had a lumpectomy just to make sure there was no invasive cancer. There was not but they found LCIS. That was two years ago and I have been alternating mammogram and ultrasound with MRI every 6 months. I don’t know if you have dense breasts but if you do I might consider a lumpectomy or maybe very diligent screening. Because of my dense breasts they didn’t see the LCIS until the pathology from the surgery. My 10 yr risk is 39%.