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Does Malignant Tumor Reduce In Size?
Question: Dear Dr XXXXXXX
Thanks a lot for your expert advice earlier re. my previous thread
http://www.healthcaremagic.com/yyyyyyyyyyyyyyyyyyyyyy
I have done fine needle aspiration recent and am now awaiting reports. When the doctor performed ultrasound scanning before needle aspiration, he told me that the size of the concerned lesion has become smaller as compared to the May 2015 ultrasound and is more or less the same size compared to Nov 2014 ultrasound. He said that malignant lesion does not shrink on its own.
My questions-
1. Is it that malignant lesion, whatever types. will not shrink on its own? Can I be relieved now or should I need to await test result before I could really be relieved?
2. The doctor who did my ultrasound scan and needle aspiration this time is the same doctor responsible for my Nov 2014 ultrasound scan. Could the size increase of the lesion (10 mm x 5mm x 12mm in Nov 2014, 18mm x 8mm x 15mm in May 2015) detected from ultrasound earlier be due to operator difference?
3. Should I consider that the lesion is highly likely benign? If so, what are the possible reasons explaining the significant growth of the lesion within 6 months from Nov 2014 to May 2015 and then become smaller now?
4. Can fine needle aspiration confirm what type the lesion it is if the lesion is benign? e.g. whether it is atypical ductal or lobular hyperplasia (ADH/ALH), fibroadenoma, lipoma etc.?
5. Is ADH/ALH regarded as pre-cancer or breast cancer zero stage? What are the differences between ADH/ALHO, pre-cancer, breast carcinoma in-situ and breast cancer zero stage?
6. If my lesion is found to be ADH or ALH, what are the next steps? excision by surgery? Or close monitoring?
Best regards,
Thanks a lot for your expert advice earlier re. my previous thread
http://www.healthcaremagic.com/yyyyyyyyyyyyyyyyyyyyyy
I have done fine needle aspiration recent and am now awaiting reports. When the doctor performed ultrasound scanning before needle aspiration, he told me that the size of the concerned lesion has become smaller as compared to the May 2015 ultrasound and is more or less the same size compared to Nov 2014 ultrasound. He said that malignant lesion does not shrink on its own.
My questions-
1. Is it that malignant lesion, whatever types. will not shrink on its own? Can I be relieved now or should I need to await test result before I could really be relieved?
2. The doctor who did my ultrasound scan and needle aspiration this time is the same doctor responsible for my Nov 2014 ultrasound scan. Could the size increase of the lesion (10 mm x 5mm x 12mm in Nov 2014, 18mm x 8mm x 15mm in May 2015) detected from ultrasound earlier be due to operator difference?
3. Should I consider that the lesion is highly likely benign? If so, what are the possible reasons explaining the significant growth of the lesion within 6 months from Nov 2014 to May 2015 and then become smaller now?
4. Can fine needle aspiration confirm what type the lesion it is if the lesion is benign? e.g. whether it is atypical ductal or lobular hyperplasia (ADH/ALH), fibroadenoma, lipoma etc.?
5. Is ADH/ALH regarded as pre-cancer or breast cancer zero stage? What are the differences between ADH/ALHO, pre-cancer, breast carcinoma in-situ and breast cancer zero stage?
6. If my lesion is found to be ADH or ALH, what are the next steps? excision by surgery? Or close monitoring?
Best regards,
Brief Answer:
Decrease in size is in favour of benign lesion.
Detailed Answer:
Hello
Thanks for writing again,I am aware of your last query.
1.It is right that malignant masses generally doesn't shrink.Decrease in size may be in favour of benign lesion.
2.Size variation may be due to two possible causes either operator variation or hormone sensitive mass.It is really difficult to comment on exact reason and it is also not very important for our treatment protocol.
Our main concern is FNAC finding which will guide further treatment.
3.Mass is probably benign in nature and hormone dependent mass may vary in size.
4.FNAC can differentiate between benign or malignant lesion.
5.Atypical ductal or lobular hyperplasia (ADH/ALH) is a precancerous stage.
Carcinoma in-situ or Stage 0 breast cancer means cells are not infiltrating and remain confined to the area where they start growing.
6.Staging of cancer is done after considering many factors like size of mass,lymph node status,spread to local or distant organs etc.
I don't expect you will fall in this group,most likely you have benign lesion.
6.If there are any signs of malignancy then staging is done and treatment options will be surgery or chemotherapy.
Please don't worry.We should wait for FNAC results which I expect will be fine.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Decrease in size is in favour of benign lesion.
Detailed Answer:
Hello
Thanks for writing again,I am aware of your last query.
1.It is right that malignant masses generally doesn't shrink.Decrease in size may be in favour of benign lesion.
2.Size variation may be due to two possible causes either operator variation or hormone sensitive mass.It is really difficult to comment on exact reason and it is also not very important for our treatment protocol.
Our main concern is FNAC finding which will guide further treatment.
3.Mass is probably benign in nature and hormone dependent mass may vary in size.
4.FNAC can differentiate between benign or malignant lesion.
5.Atypical ductal or lobular hyperplasia (ADH/ALH) is a precancerous stage.
Carcinoma in-situ or Stage 0 breast cancer means cells are not infiltrating and remain confined to the area where they start growing.
6.Staging of cancer is done after considering many factors like size of mass,lymph node status,spread to local or distant organs etc.
I don't expect you will fall in this group,most likely you have benign lesion.
6.If there are any signs of malignancy then staging is done and treatment options will be surgery or chemotherapy.
Please don't worry.We should wait for FNAC results which I expect will be fine.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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