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Breast Cancer

Treatment of DCIS



I was diagnosed with IDC in my rt breast in Sept, 2004 (ER 50%, PR neg and Her2+. One + node with only 2 micromets). I also had a 3mm dcis on the LEFT breast - ER 50%, PR 30% - too small to do anything else. Deemed grade 2, crimform with no comedo necrosis. Naturally, at the time, I was far more concerned with the right breast. The Herceptin trial results hadn`t been announced yet and my main goal was trying to get it some way or another (and I did). My IDC treatment was the standard at the time: dense dose 4 AC followed by 4 taxol. I had been premeno at diagnosis but had my ovaries removed to take Arimidex. I had the double lumpy so I got radiation on the right but not the dcis left. In the meantime, I was able to secure Herceptin and after rads, took Herceptin and Arimidex. Now, all this time later, I know the weak link in everything is this no rads dcis. It is the only part of treatment I didn`t get a second opinion. Now everywhere one turns studies say that no dcis is too small not to radiate. I found many studies prior to Feb 2005 (when I started rads) that also say this -especially for women under 50 which I was and still am. How vulnerable am I and what follow up tests besides mammos would you recommend? Do you know of the new screening test with the Dilon? Is this better than mammography?

Thank you in advance


I do not think that you should be overly concerned with the DCIS. Your arimidex may reduce contralateral recurrence and we sometimes do not recommend radiation for a very small area of DCIS if there are good margins. Regular mammography and possible MRI breasts would be standard, along with surgical follow-up with a breast specialist. Is there a family history, and if so, have you considered genetic counseling/testing? I am not familiar with Dilon. I am a little concerned that you are on arimidex and are <50 years old. Are you definitely menopausal as is required for arimidex? Even if you stopped having periods with your chemotherapy, you may not truly be in menopause.

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Response by:

Paula  Silverman, MD Paula Silverman, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University