Hello, my wife had her annual physical and (apparently) has a calcium deposit in one breast. The doctor said chance of malignancy >10% but

 

She had a biopsy yesterday, and will get the results Saturday afternoon and while I have done what I can to comfort her, she is a basket case. I have a few questions:

 

1. In the event the test shows benign, should we retest? If so, where?

 

2. In the event the test shows malignant, who is the best doctor and hospital in Thailand for treatment? We are in Bangkok.

 

3. She had the physical and biopsy at Bumrungrad, but does not seem to like the doctor. Any doctor recommendations at Bumrungrad would be helpful as well.

 

4. Is there a Thai language support board for women with breast cancer where she could get some support?

 

Thanks in advance.

 

Dave

 

 

 

Odds are this will be benign. Most breast calcifications are.

 

Most women of a certain age have at least some calcifications and usually no need to biopsy if there is no change seen on mammogram from year to year.

 

One wonders if there was some special reason why biopsy recommended in your wife's case  (unusually suspicious pattern of calcification) or if it was because she was unduly worried, or the doctor was not confident she would come back for annual follow up. Thai women tend to be unusually ill-informed regarding breast cancer (compared to Western women) and may both over-react and fail to get regular preventive check ups so Thai doctors often mange them differently than they do western women.

 

You do not need to retest if the biopsy is benign, as it probably will be. Just annual mammograms.

 

In the unlikely event this proves malignant, I recommend the Queen Sirikit Center for Breast Cancer at  Chulalongkorn Hospital. She should try to get a letter for referral to there from whatever hospital she is registered at under the government system since private treatment will be extremely expensive.

 

That center has support groups but you should not think along those lines now. Wait until the biopsy results come back and try in the meantime to calm your wife down. Odds are she does not  have cancer. Try to explain to her that calcifications are a common finding and usually benign.

 

 

 

 

 

 

Odds are this will be benign. Most breast calcifications are.
 
Most women of a certain age have at least some calcifications and usually no need to biopsy if there is no change seen on mammogram from year to year.
 
One wonders if there was some special reason why biopsy recommended in your wife's case  (unusually suspicious pattern of calcification) or if it was because she was unduly worried, or the doctor was not confident she would come back for annual follow up. Thai women tend to be unusually ill-informed regarding breast cancer (compared to Western women) and may both over-react and fail to get regular preventive check ups so Thai doctors often mange them differently than they do western women.
 
You do not need to retest if the biopsy is benign, as it probably will be. Just annual mammograms.
 
In the unlikely event this proves malignant, I recommend the Queen Sirikit Center for Breast Cancer at  Chulalongkorn Hospital. She should try to get a letter for referral to there from whatever hospital she is registered at under the government system since private treatment will be extremely expensive.
 
That center has support groups but you should not think along those lines now. Wait until the biopsy results come back and try in the meantime to calm your wife down. Odds are she does not  have cancer. Try to explain to her that calcifications are a common finding and usually benign.
 
 
 
 
 
 

Thanks Sheryl, I’ve been reading up on it and trying to comfort her but it’s tough.

Thanks for the Chula recommendation...

Dave

Well the core biopsy was inconclusive in that “atypical ductal hyperplasia and foci of microcalcification” was found, so the doctor wants to do a surgical biopsy Monday.

Is this common?

Thanks

Yes, it is.

 

The result you mention is not inconclusive per se -- it is a common finding and likely the surgical biopsy will find the same.

 

ADH is not breast cancer but women with it have an elevated risk if developing breast cancer than women without it. That is elevated compared to other women, it does NOT mean will probably develop breast cancer. Only 7% of women with ADH develop breast cancer within 5 years (93% do not) and even 25 years later, 70% have not developed cancer. But since this is higher than average incidence women with ADH need regular follow up.

 

Because ADH indicates higher than average risk of breast cancer, when it has been discovered via less extensive biopsy, doctors will sometimes recommend a biopsy of a larger tissue sample just to be sure that the initial biopsy did not miss cancerous cells.

 

The "microcalcification" part is nothing, typical finding in older (ish) women.

 

The doctor is being ultra thorough and ultra cautious. As I mentioned this is may be influenced by the fact that she is Thai and having trouble understanding the medical information/putting it in context and making an informed decision. To not biopsy further the doctor would want agreement from an informed patient s/he was confident understood the findings and was going to folliw through on annual follow up.

 

I am not on my computer at present so can't paste the link but google "atypical ductal hyperplasia" + "mayo clinic" and you'll find a good article explaining all this.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

 

 

 

 

Thanks for all the help Sheryl, I read the article and I showed it to my wife and I think she feels a little better about it. Looks like we’re going to move ahead with it..

Sorry to about your wife, Dave.

 

My wife had excess bleeding & uterine pain, & the Doc needed to of course rule out Cancer. It's all ok happily.

 

But, it was a very traumatic & naturally emotional time for her, which required more patience & understanding.

 

Wishing her & you the best.

Good one Dave, keep supporting her. This event emphasises the importance of regular check ups, regardless of whether the lump is benign or not.