Hello doctor,
My pathology results from the biopsy are as follows:
1. Right breast - 5 o'clock 4 cm from nipple, pseudoangiomatous stromal hyperplasia, (PASH). This is concordant with imaging findings. A short-term follow-up right breast ultrasound is suggested.
2. Left breast - 3 o'clock, 14 cm from the nipple. Usual ductal hyperplasia and focal Pseudoangiomatous stromal hyperplasia, (PASH) and dense stroma. This is concordant with imaging findings. A short-term follow-up left breast ultrasound is suggested.
Please note that there is a pending left breast stereotactic biopsy of the asymmetry and calcifications in the lower outer quadrant. I have a few questions.
1. If anything else was present in the ducts in another part of the breast, would it show on this sample?
2. Could UDH showing be a temporary result of being in the 2nd half of my cycle at the time of the biopsy due to cyclic breast changes? My biopsy was about 7 to 10 days before the start of my period. I also attached two mammogram photos that they took after the biopsy was done to be sure that the clip is there.
3. Does the focal asymmetry or calcifications look any different from the old photo?
4. They want me to have a stereotactic biopsy on the calcifications. I am not comfortable doing this right now because of radiation from mammograms so close together. I have had other opinions that think a biopsy is not necessary and that the calcifications from the last mammogram had fat lucent centers suggesting fat necrosis. My doctor said it might be the milk of calcium. Do you agree with either of these? Which is more likely and why or why not?
5. Are the calcifications associated with the ducts or are they not near them?
6. I might go ahead with the biopsy for peace of mind. Is it risky to do another mammogram with the biopsy since I just did one in October, and last week they took 2 pictures after the other biopsy? I am worried about radiation as well.
7. Are there any cysts on the ultrasounds in the area where the focal asymmetry or calcifications would be? Were there any other cysts like a group of cysts associated with this area on the mammogram?
8. Could there be micro cysts that are not visualized on an ultrasound or mammogram?
9. If a calcified cyst disappears, would the calcifications stay?
10. Could you tell me what the bilateral line is that I circled that the focal asymmetry sits on? Is this an internal scar? Why is not it visible on the ML view?
Thank you.