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| 3/26/2012 | 2 years ago my friend was diagnosed with DCIS and underwent a lumpectomy and has been on Evista. She did not have radiation as both her oncologist and radiation oncologist told her that due to the pathology of her DCIS, she was extremely low risk for recurrence. She is 60 years old . Now she has what looks like a recurrence of DCIS on her latest mammogram (suspicious calcifications) and will undergo a biopsy soon. Her oncologist is suggesting an oncotype dx genetic test for DCIS. I have several questions: 1) Isn't this particular test done to tell you the chances of a recurrence of DCIS, and if this is indeed a recurrence of DCIS, why should she do it?, 2) What is the percentage of DCIS that goes on to become an invasive cancer? Does anyone know? and finally, 3) In your opinion,, what would be a better option for her now, radiation or mastectomy? Oh, one more question, 4) In your opinion, should she continue with the Evista? Thank you so much for your time and consideration. You are wonderful! | ||
| Replied | JHU's Breast Center Reply | ||
| 3/27/2012 | Thank you for turning to the Johns Hopkins Breast Center. According to the NCI National Cancer Institute 2009, "The addition of radiation therapy to breast-conserving surgery halves the risk of a tumor recurrence compared with surgery alone in women with noninvasive breast tumors (DCIS), according to a pooled analysis of results from four randomized clinical trials." Not sure why no radiaiton with first occurrence. Oncotype DX (a breast cancer assay) is indicated for newly diagnosed patients with node negative, or ER positive, HER2 neu negative, invasive breast cancer. It is to assess a risk of recurrence score, and then the benefit of chemotherapy. At this juncture your friend has not been diagnosed with any cancer, although you mention DCIS suspected? So first step is minimally invasive biopsy to indeed diagnosis DCIS, which if positive, would then be followed by the lumpectomy. From the results of the final pathology, treatment decisions will be made. The Oncotype assay is available for DCIS. The assay provides an individualized estimate of the 10-year risk of local recurrence (DCIS or invasive carcinoma) to help guide treatment decision making in women with ductal carcinoma in situ treated by local excision, with or without tamoxifen. However, you are correct that if this turns out to be DCIS, could be recurrence. All of this must be sorted out after biopsy, surgery and final pathology, with a breast medical oncologist. Hope this helps and best wishes. | ||
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