其实这些该是记下来的，无论是从档案的角度还是从家事的角度。
LD前些年妇科体检还正常，这几年就不爱去。说过好几次，就是拖着。
一次吃饭时把女儿拖出来，让她压压她。
9月26日，去妇科查体。做了Mammogram。过了两天来电话，说有阴影，需要换个角度再做一次，并且需要做B-超。
26日的报告：
FINDINGS:
Benign calcifications are noted in the left breast. In the left breast on MLO view, a questionable 0.9 cm nodular density is noted anteriorly, 2.4 cm posterior to the nipple along the nipple line. There are no pleomorphic microcalcificitions or areas of architectural distortion. The overlying skin and axillary tissue are within normal limits.
CONCLUSION:
1. A questionable 0.9 cm ndular density is noted in the anterior left breast on MLO view. Further evaluation with spot compression left MLO and 90 left ML views is recommended.
2. No mammographic evidence for malignancy in the right breast.
基本的意思是，左乳房乳头后发现大至2.4厘米的结节性密度异常。建议换个角度再做一次Mammogram。
诊所给约了10月9号（星期五）。
LD觉的时间不好，我也觉的有点拖。10月3号就又去诊所，去之前找了另外的 Image Center，说当天就可以做啊。到诊所一说，再联系说4号可以。
于是第二天（周日）又去做Mammo和B超。
10月17号拿结果。
FINDINGS:
LEFT BREAST: At the 3 o'clock position, 1 cm from the nipple, an ovoid hypoechoic nodule measures 9 x 5 x 7 mm.
In the areolar region of the left breast, a 3 x 3 x 4 mm hypoechoic nodule is noted.
CONCLUSION:
1. Unremarkable right ultrasound.
2. Hypoechoic nodule in at the 3 o'clock position of the left correlates to the nodular density described on mammogram. This nodule may resent a fibroadenoma. Recommend follow up ultrasound in six months to assess for interval change.
3. Subcentimeter hypoechoic nodule in the areolar region of the left breast, likely a debris-containing cyst versus small fibroadenoma. Attention on follow up is recommended.
基本的和上次差不多。B超看的更清楚。直径小于1厘米。估计是乳腺纤维腺瘤。
回到诊所，建议看外科医生，由外科医生决定。
给的外科医生都不好约。于是自己在报纸上找了一家乳房外科。
10月29号看外科。十分钟吧。说需要拿出来做活检。属于微创手术：管子插进去，小刀剜小，真空吸出。决定做！
11月5号做小手术。有15分钟？很快。
有点疼。但只开一天假。
加上周末，歇了4天。
结果11月16号拿。
LD自己去的。
Surgical Pathology Report
FINAL DIAGNOSIS:
LEFT BREAST, MASS AT 3.1, ATEC CORE BIOPSY:
- FRAGMENTS OF INTRADUCTAL SCLEROSING PAPILLOMA WITH USUAL DUCTAL HYPERPLASIA.
- CALCIFICATIONS IN TERMINAL DUCTS.
Note: Excision is recommended for the evaluation of the entire lesion.
检查的结果是导管内硬化性乳头状瘤，不是纤维腺瘤。建议把整个病变部分切除做进一步的评估。
LD有点不想做了。我还是劝她做，不然总觉的是个雷。毕竟它有转化癌的危险。
于是体检。
手术约在12月2日（星期三）。
希望一切顺利
Updated on 12/16/2015
12/11/2015到诊所复诊和取病理报告。
SURGICAL PATHOLOGY REPORT
TISSUE SUBMITTED: LEFT BREAST 3:00 1CM FN
FINAL DIAGNOSIS:
- FRAMENT RESIDUAL PAPILLOMA SEEN AT THE PRIOP BIOPSY
- FIBROCYSTIC CHANGES WITH USUAL DUCTAL HYPERPLASIA AND CALCIFICATIONS IN TERMINAL DUCTS.
最终的诊断是：在导管端处纤维囊性改变，并有通常的导管增生和钙化。
GROSS:
Received in formalin labeled with the patient's name and accession number, labeled "LEFT BREAST 3 O'CLOCK 1CM FN, SHORT = SUPERIOR, LONG = LATERAL", and consists of 15.3 g, 4.5 cm (medial to lateral) x 3.3 cm (anterior to posterior) x 2.0 cm (superior to inferior) oriented, fibroadipose tissue with a long suture designating lateral and a short suture designating superior. The specimen is inked as follows: superior = yellow, inferior = orange, lateral = blue, medial = green, anterior = red, posterior = black. The specimen is sequentially sectioned from lateral to medial into 10 slices. Within slices 7-8, there is a 1.0 x 0.8 x 0.6 cm ill-defined, gritty, white fibrous tissue containing a 0.2 x 0.1 cm cylindrical, metallic biopsy clip. The biopsy site is directly involving the anterior margin, is 0.7 cm from the interior and posterior margins, 1.0 cm from the medial margin and greater than 2.0 cm from the superior and lateral margins. The remaining breast parenchyma is comprised of 90%, lobulated, homogenous adipose tissue and 10% interventing, fibrous tissue. The specimen is serially sectioned and entirely submmitted as labeled:
......
有点惊异的是切下了大约 4.5 x 3.3 x 2.0 cm大小的组织。不小啊！
