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Q. Is the lump in breast cancer or cyst?

Answered by
Dr. Arshad Hussain Shah
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 28, 2018

Hello doctor,

I found a lump in my breast five months back. Initially, it was told to be a cyst. I followed up after four weeks, and the cyst was unchanged. My PCP recommended a needle biopsy to be safe. My surgeon felt more comfortable with lumpectomy because I have a family history of thyroid tumors, and I have a pituitary tumor. After the lumpectomy, I have been diagnosed with ER/PR positive, HER2 breast cancer. I am confused with my pathology report. It states DCIS, but also states a test was performed to confirm the lesion was invasive. It also calls it an infiltrating carcinoma. From what I have researched, this is contradictory.

Currently, I am on Paxil 40 mg a day, Nexium OTC a day, Trulicity 1.5 mg SQ, Trulicity 1.5 mg SQ a week, Lisinopril 2.5 mg a day, Cabergoline 0.5 mg a day, and Amaryl 4 mg BID.

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I have seen your reports. It looks like early breast cancer, and it is predominantly a cystic lesion. It is staged as pT1c Nx hormone receptor positive and HER2/neu negative. Histopathology is showing low-risk breast cancer as it is predominantly a cystic lesion with a predominance of intracystic papillary components, but there are areas of infiltrating mammary carcinoma and areas of DCIS (ductal carcinoma-in-situ). So, it is an early stage low-risk breast cancer. Have they done sentinel lymph node biopsy to check the lymph node status?

You have a family history of thyroid tumors and previous personal history of a benign pituitary tumor. That may be part of some genetic syndrome. For that, you may need to go for genetic counseling. Your breast lesion is showing ER+, PR+ and HER2/neu negative. These are also good prognostic factors in breast cancer. Discuss with your primary oncologist about few points as follows:

  1. Why sentinel lymph node biopsy was not done?
  2. Hormonal therapy (Tamoxifen) needed.
  3. To do an X-ray chest and ultrasound abdomen or CT (computed tomography) scan to look for any distant lesion.
  4. Genetic counselling because of your young age and thyroid, pituitary and breast lesions.

Overall prognosis is very good in early and low risk breast cancers.

For more information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist


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