FREQUENTLY ASKED QUESTIONS

Q. My doctor discovered a fibroadenoma in my breast, and I am very nervous about it. He told me that it's very common.

A. About 80% of breast disease is "benign" or not life threatening, and this is the group where you most likely find yourself.

Most discrete lumps in breast tissue of women your age are fibroadenomas. Most of these lesions have a characteristic appearance on a mammogram, which is seen by the radiologist who read your mammogram. However, you only know for sure what each lesion is by having a biopsy, either a needle core biopsy or an actual excision in which a surgeon removes tissue.

Please look in the "Images" section of the web site. Here you'll see what fibroadenomas look like, both with the naked eye as well as under the microscope.

Breastpath.com is pleased to announce the new Breastpath.com Report on Fibroadenomas. This comprehensive new report contains a detailed discussion of the nature of fibroadenomas. Included are images of actual fibroadenoma tissue seen by Breast Pathologist J.B. Askew, Jr., M.D., with the naked eye as well as under the microscope. Each image includes a description and the important details that help determine the diagnosis, as well as a comparison with breast cancer cells. This will help you better understand how these designations are made. Also included--a full Internet resource guide, a medical glossary and more. To find out more or order your report, just click here.
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Q. What is a papilloma?

A. Recently we have noted a lot more questions from women with non-malignant breast disease. This makes sense, because about 80% of breast disease is benign.

Simply put, the breast papilloma is a growth composed of the lining cells of a breast duct as well as the underlying stroma, or supportive tissues, including blood vessels. Such growths may bleed or secrete fluids, and either may cause nipple bleeding or secretion problems.

Breastpath.com has a colorful image of a papilloma with an explanation that may be of interest to you. Just click here.
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Q. Do you know the standard treatment for patients with a diagnosis of calcifications? Should I have surgery?

A. When you have a diagnosis such as this, the most important relationship is between you and your surgeon. I encourage you to explore all of your questions and options with this physician. As a pathologist, I am a consulting physician and should not interfere with this relationship.

However, I can inform you of several options. One possible avenue for you to pursue is a second opinion at a comprehensive breast center. You might visit the John Hopkins web site: www.med.jhu.edu/breastcenter/. This site will explain what happens at a comprehensive breast center and includes a list of the top ten centers in the U.S. Our center in Houston is very good, but has not reached the top ten…yet. One thing that distinguishes these centers is the pre-treatment conference attended by mammography-dedicated radiologists, pathologists, surgeons and radiation and medical oncologists. A woman's diagnosis is discussed by all of these specialists until her treatment plan recommendations and options have been determined. You could choose a center from the John Hopkins list. Of course, there are other centers available that aren't on the list that may be closer to you. Another place to look for a center is the National Consortium of Breast Centers web site:
www.breastcare.org/.

There is some good news for you, and that is that you have time to collect information, better understand what the diagnosis means and make plans for what you and your surgeon finally decide is the best treatment approach for you.

Good luck on your search for the right answers for you. I hope you understand why I need to respect the relationship between you and your surgeon, who is the treating physician. Should you need any further help from me in my capacity as a pathologist, please contact me again at Breastpath.com.

For more information, see our Guest Commentary by Randy A. Birken, M.D., on The Importance of a Multidisciplinary Breast Team.
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Q. What is the significance of the findings noted in the pathology report from my breast surgery?

A. What I can offer you is the following: I can write a detailed, personalized report for you that explains your recent pathology report. If you wish, I will also print images of your disease from the actual pathology or histology slides from your biopsy and will write detailed explanations for those. All of this information will help you to understand how the pathologist came to your diagnosis. If you are interested in such a report, I would be pleased to write one for you. Please click here to order your report.

You may also want to consider a second opinion from a comprehensive breast center. Such centers are scattered across the USA. There are two good resources: the Breast Center at John Hopkins Medical School and the National Consortium of Breast Centers.
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