Not Called BAC anymore? - 1251831

greensmythe
Posts:6

I am confused. I was told by an oncologist in Indianapolis that I have BAC and that my lung cancer is confined to my lungs. Then, my third opinion oncologist stated that doctors do not call BAC- BAC anymore and she wants to do more testing.

I know it is not possible to understand what is going on with me without all of my medical records, and that you can't do this online anyway.-but I just would like to know why all the confusion with the terminology.

Forums

cards7up
Posts: 636

It's called adenocarcinoma which BAC is a subtype of. This like you said is all terminology.
Take care, Judy

Dr West
Posts: 4735

Here's a post about the change in terminology:

http://cancergrace.org/lung/2009/08/06/bac-no-more/

It's not quite as simple as "doctors do not call BAC [i]BAC[/i] anymore." [i]Some[/i] doctors do not use the term BAC anymore, but many do, and plenty really don't care what you call it. I don't think it's worth getting hung up on the terminology, when it's really the behavior that matters. In addition, there is so much variability in the reliability of the pathologic diagnosis that I feel that cases need to be interpreted individually. The main point is that a non-invasive adenocarcinoma, is now called adenocarcinoma [i]in situ[/i] to describe what was previously called pure BAC. These tend to be very slow growing and shouldn't necessarily be lumped into the same prognostic category, size for size, as a more solid, invasive adenocarcinoma.

-Dr. West

lmlb7665
Posts: 48

Dr West, recently I read on this cite that you were including a chapter in a book you are writing that would reclassify BAC. I am searching for that article to read it again, but have been able to find it. Could you give me that link.

Thank you
Louise

catdander
Posts:

Though I think this is different than what you mentioned it may be what you're looking for,

"I’m completing a chapter in a key lung cancer textbook on managing multi-focal bronchioloalveolar carcinoma, a clinical entity that is in the process of being re-labeled lepidic predominant adenocarcinoma (LPA) (lepidic meaning scale-like, which is the classic way that the cells are defined as spreading when looked at under a microscope). I suspect that it will continue to be called multifocal or advanced BAC for a long time (after all, the formal staging of small cell lung cancer goes from stages 1 to 4, but nobody ever uses that, classifying it as just limited or extensive stage). " http://cancergrace.org/lung/tag/bronchioloalveolar-carcinoma-bac/

Dr West
Posts: 4735

I didn't include that chapter. I've written it, but it's still in draft form and hasn't been published; I'm sure it won't be for many months, or even perhaps until next year.

The reclassification of BAC changes solitary smaller non-invasive non-mucinous adenocarcinomas into a designation of adenocarcinoma in situ (AIS), a precancerous condition, which reflects that the prognosis is exceptionally good if there is no invasive component. Larger or multifocal non-invasive adenocarcinoma is now to be called lepidic-predominant adenocarcinoma (LPA), and mucinous BAC is now referred to as mucinous adenocarcinoma, with the implication that the mucinous form doesn't have as favorable a prognosis as the non-mucinous variant.

-Dr. West