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ALH found in biopsy, what's next?
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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@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?
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%.
Thank you for sharing, @kayleenchilds!
My breast density is Grade B and I do not have any other risk factor. What do you think of preventative medication, like baby Tam?
I am still waiting for the appointment with the surgeon which is next week. Hope to find more by then.
@pipi2026 I do not think you re overthinking at all! It’s good news that you do not have dense breasts. As far as medication goes, it was recommended that I take Anastrozole which I did but after 9 weeks I had an allergic reaction. I switched to Raloxifene which I have been tolerating very well for about 21 months. I considered baby tam which was also recommended but I am post menopausal and Raloxifene has a positive bone density component. My sister takes tamoxifen and is tolerating it very well. I have so much anxiety when the 6 months rolls around and it’s time for a test….MRI now scheduled for September. I hope you like the surgeon and get all of your questions answered. I went to 2 surgeons and decided on the woman ……so much better with a woman for me.