Monitoring
Prolonged surveillance is crucial. Risk of invasive disease and breast cancer death following a diagnosis of ductal carcinoma in situ (DCIS) is increased for both screen-detected and non-screen-detected DCIS, which lasts for ≥25 years after diagnosis.[3]
For post-surgical follow-up of patients with DCIS, the National Comprehensive Cancer Network (NCCN) recommends:[66]
History and physical examination every 6-12 months for 5 years, then yearly.
Annual diagnostic mammography (initial mammogram 6-12 months post-radiotherapy for DCIS, if given, or after breast-conserving surgery if no radiotherapy is given, then yearly).
For follow-up of patients with lobular carcinoma in situ (LCIS), the NCCN recommends:[53]
History and physical examination every 6-12 months beginning at diagnosis.
Annual mammography with digital breast tomosynthesis beginning at the age of diagnosis but not before age 30 years.
Consideration for annual breast magnetic resonance imaging (MRI; with and without contrast) beginning at the age of diagnosis of LCIS, but not before age 25 years. Consideration of contrast-enhanced mammography (CEM) or molecular breast imaging (MBI) for those who qualify for but cannot undergo MRI. Whole breast ultrasound may be done if CEM or MBI is not available.
Consideration of risk reduction strategies.
Breast awareness (women should be encouraged to be familiar with their breasts and report changes to their healthcare provider).
High-quality evidence indicates that, in women with early breast cancer, follow‐up programmes based on regular physical examinations and yearly mammography alone are as effective as more intensive approaches.
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