>>> DR.
JAY K. HARNESS: Monitoring for the recurrence of DCIS typically involves mammograms, if
breast conservation has been done.
Diagnosing in situ breast cancer, in the first place, is typically done because there’s
an area of suspicious looking micro calcifications in the breast, which I have explained in other
videos is a byproduct of calcium precipitating out in the ductal system as the cells lining
the ducts overgrow and then die in the center.
So the most typical way that DCIS (Ductal Carcinoma of the Breast) is originally diagnosed
is with mammograms.
Now, can DCIS be associated with the mass and not have micro calcifications?
You bet, the answer is ‘yes’.
“Doctor, I just had a patient in her early 70s this past week, that that’s exactly
the way her DCIS was diagnosed.”
DCIS can present as a mass, and the more firmly replaced the breast is, the easier it is to
see such masses.
So the overriding question now is intense breast, how do we monitor for a recurrence
of DCIS?
Well fundamental after breast conservation is clearly digital mammograms.
If the mammograms are stable, they are typically done once a year.
A lot of interesting data is coming out of Europe about using MRI as not only a way
of diagnosing DCIS in the first place but also then monitoring it with the breast for
the recurrence of DCIS.
Unfortunately, that data has not really taken hold here in the US but has certainly taken
hold in places like Germany, and we will be fascinated here to follow their reports as
they keep progressing.
There’s also been a recent report in a big national radiology meeting in November
2011 from the University of Washington in Seattle, again about using MRI as a way of
monitoring patients for recurrent cancer after the treatment of both invasive and DCIS, and
their data, quite frankly, was positive and that they diagnosed the recurrence earlier
and more effectively.
Now, that sort of small study is going to have to be replicated at other sites, certainly
here in the United States, before MRI becomes a standard component of monitoring the recurrence
of DCIS in densely breasted patients.
Susan Denver: I am a breast cancer survivor.
Katherine Stockton: I am a breast cancer survivor.
Coree: I am a breast cancer survivor.
Susan Denver: And I want every woman to know…
Katherine Stockton: …about personalized breast cancer treatment…
Susan Denver: …and the genomic test.
Coree: A test that helps guide a woman and her doctor…
Katherine Stockton: …to the best treatment options for her.
Susan Denver: Pass it on!