Q. Is the lump in breast cancer or cyst?
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.
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:
- Why sentinel lymph node biopsy was not done?
- Hormonal therapy (Tamoxifen) needed.
- To do an X-ray chest and ultrasound abdomen or CT (computed tomography) scan to look for any distant lesion.
- 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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