Anyone dealing with Atypical Ductal Hyperplasia (ADH)?

Posted by EJ @elsajohnson, Aug 7, 2018

I am sorry if this is not the right forum. I know ADH is not cancer and this is a breast cancer forum, but I can't find another forum that may be more relevant.

I am wondering if there is anyone who is dealing with ADH or has been diagnosed with ADH that can share their experience. I was diagnosed a month ago. While I am relieved that I don't have cancer, I am confused with the radiology report that shows BI-RAD6 - surgical removal is recommended. I have seen a breast oncology surgeon and I don't think she took me seriously because I don't have cancer. It almost feels like I wasted her time seeing her because I don't have cancer. If ADH is no big deal, why BI-RAD 6 (which i understand is for biopsy proven malignancy). I also read up about ADH online and understand that with ADH, my risk for breast cancer is 4x. Should I not worry about it and just do annual check? Should i see another breast surgeon? Should I see an oncologist? Do I need genetic testing to better understand my risk? I feel like an impostor for even posting this on a breast cancer forum but I am genuinely confused and concerned. Any help will be greatly appreciated.

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@elliejk

Are you questioning having the ADH removed or a prophylactic mastectomy?

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I'm not considering a mastectomy. I'm questioning whether it's necessary to have a lumpectomy when my ADH diagnosis was non cancerous. In my research, I found that as little as 20% of women with this diagnosis go on to develope cancer, and that was without doing any preventative strategies such as monitoring with regular mammograms or meds to decrease estrogen production. Even so, the % is even less in the first 5 years. I'm 78 yrs old with no risk factors so I feel unlikely to die from breast cancer. Thoughts?

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I took have just been told I have ADH after a core needle biopsy. I was sent for an MRI and now I have another biopsy scheduled for July 3rd, for another suspicious area. My surgeon wants to have that biopsied so she knows if she needs to remove that tissue as well. My BI RADS score is a 4 which is so vague. Mammogram biopsy on both breast MRI and now another biopsy. My Brain is all over the place. I'm trying to be strong and not let my family see me falling apart but I'm scared. And I know there is a good chance it's nothing and I'm just over reacting. And Im glad my surgeon is being so through. I just don't know how to mentally keep it together. I'm 53 years old and I am feeling like a frightened child.

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@bd2486

I'm not considering a mastectomy. I'm questioning whether it's necessary to have a lumpectomy when my ADH diagnosis was non cancerous. In my research, I found that as little as 20% of women with this diagnosis go on to develope cancer, and that was without doing any preventative strategies such as monitoring with regular mammograms or meds to decrease estrogen production. Even so, the % is even less in the first 5 years. I'm 78 yrs old with no risk factors so I feel unlikely to die from breast cancer. Thoughts?

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I believe the lumpectomy is done to confirm Adh and rule out any hidden cancer. It’s an easy procedure.

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@elliejk

I believe the lumpectomy is done to confirm Adh and rule out any hidden cancer. It’s an easy procedure.

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I understand what the lumpectomy is for, but due to the fact that it was noncancerous and I have no risk factors I'm questioning why I need to have it removed and instead go with the preventative strategies. ADH diagnosis statistically shows a low % of women get cancer. I'm 78 and and after 5-10 yrs, the odds are in my favor.

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Sounds like you made your decision. ❤️ I was 52 and was afraid there was cancer that can’t always be detected but ADH can be a sign that it’s there. Not sure at 78 what I would do. It’s ultimately a very personal decision.

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@elliejk

I believe the lumpectomy is done to confirm Adh and rule out any hidden cancer. It’s an easy procedure.

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I agree.
That is what I was told.

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Hello there. First time poster. Thank you SO MUCH for this group. I'm 52, 5 foot 8, never smoked, BMI normal, didn't eat great (70s kid!) and have stress, light drinking, just now in menopause, 2 pregnancies with 1 breastfed and one miscarriage, no other known risk factors for BC or cancer in family tree. Never been tested genetically.
Nov. 2021: Small lump noted at routine 3D mammogram, then US, then biopsy. Clip put in. Dx is Benign Epithelial Lesion. But I remember the quizzical tone to the nurse's voice as she told me the results. Like . . "this is unusual and we can't quite figure it out." I had been on estrogen pills for 2 months. Stopped them immediately.
May 2022: Followup mammo: Report says there is NOTHING. Return to yearly screening.
May 2023: First mammo since that followup. Lump is now 2.5 cm by 2 cm in same spot. US, biopsy. First they suspected Phyllodes due to size increase. But Dx is now Atypical Ductal Hyperplasia.
WHAT THE HECK.
So . . . meeting with breast health person on Monday. Two surgical consults in the next couple of weeks. Reading over everyone's comments. I need a better look at both boobs before we make plans, to make sure it's really ADH and that it's only in one spot. Also need to get slides sent out for second/third opinion. I have family in Scottsdale so may send to Mayo and do stuff there (I'm in Rhode Island).
I do not feel confident in the radiology team that has been working on me so far. Nice people, but I'm worried that I fell through the cracks somehow. I am not convinced that it's just one spot. And after reading these boards, I see how important it is to get accurate screening. Never had an MRI (and know that I probably now qualify for one). That MBI? Mind Blown! I am fortunate that I have good insurance and also the ability to pay for some things out of pocket if needs be. So the question . . . with this diagnosis, do I get some kind of MRI or additional screening before we head to surgery? Or do I have to advocate for that on my own? 'cause I'm ready to call for that MBI appointment in the next two minutes. And . . hormone levels? Wanna check those immediately, too.
Sincerely, Type A Overachiever Worried in Rhode Island

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The first concern I have for you is that you feel like you can’t trust your medical team. I think finding a new team and a doctor who will explain everything will make you feel less stressed. Don’t get me wrong. It’s stressful even with a good team. I haven’t had my MRI yet. So I am not even sure what it can and can’t see definitively. But for me once I knew I had an area of ADH I wanted it out and to make sure there wasn’t also cancer. The lumpectomy for me was what I wanted asap. I felt like let’s get in there and cut it out and check surroundings for cancer. I was ready to have a double mastectomy. My doctor laughed and basically told me to slow my roll. I forget the statistics but most people with ADH do not get cancer or have cancer. I’m sure you know the statistics because when I was going through it I read everything but feared worst case scenario.
I’m 53 now but was 52 and no family history. Just showed up as abnormal microcalcifications. I was lucky that they found no further sign of ADH or cancer with the lumpectomy. I’m in Massachusetts and loved my doctor. Located in Woburn MA. Not sure how far that is for you. Message me if you want to get more info.

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@maureenmckean

The first concern I have for you is that you feel like you can’t trust your medical team. I think finding a new team and a doctor who will explain everything will make you feel less stressed. Don’t get me wrong. It’s stressful even with a good team. I haven’t had my MRI yet. So I am not even sure what it can and can’t see definitively. But for me once I knew I had an area of ADH I wanted it out and to make sure there wasn’t also cancer. The lumpectomy for me was what I wanted asap. I felt like let’s get in there and cut it out and check surroundings for cancer. I was ready to have a double mastectomy. My doctor laughed and basically told me to slow my roll. I forget the statistics but most people with ADH do not get cancer or have cancer. I’m sure you know the statistics because when I was going through it I read everything but feared worst case scenario.
I’m 53 now but was 52 and no family history. Just showed up as abnormal microcalcifications. I was lucky that they found no further sign of ADH or cancer with the lumpectomy. I’m in Massachusetts and loved my doctor. Located in Woburn MA. Not sure how far that is for you. Message me if you want to get more info.

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Thank you Maureen! That's exactly how I'm feeling.
I know I just need more information about my specific case, and I'll get that over the next fortnight. And until then, trying not to totally freak out. Keeping busy and trying to keep perspective. Using this as a wake-up call for me to take better care of myself in a lot of ways.
I'm so glad you got the treatment you needed and are doing well! . . . I'm in southern RI about 90 minutes from Boston . . . I can't figure out how to message you privately?

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@simmecats

Thank you Maureen! That's exactly how I'm feeling.
I know I just need more information about my specific case, and I'll get that over the next fortnight. And until then, trying not to totally freak out. Keeping busy and trying to keep perspective. Using this as a wake-up call for me to take better care of myself in a lot of ways.
I'm so glad you got the treatment you needed and are doing well! . . . I'm in southern RI about 90 minutes from Boston . . . I can't figure out how to message you privately?

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I sent you a private message. Hopefully you’ll see it. 🙂

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