Do you see a medical oncologist?

LAstar

Two people have recommended that I see a MO for the next 5 years.  I see my BS tomorrow and will talk with him about it.  Do any of you do follow-ups with a MO?  My impression was that a MO is useful for drug treatments like chemo and AI.  My treatment has been BMX for DCIS so I shouldn't need any of this.  What would a MO do for me?  Thanks!

jill47

LAstar:  You should be seeing either your BS or MO for at least the next few years.  My BS has been the lead on my case since the beginning. Her plan for me is to see her or my MO (they'll share the responsibility) once every 3 months for the next 2 years then once every 6 months for 5 more years = 7 years closely monitored.  It's easy for them to share the responsiblity since they are in the same oncology dept at my hospitals cancer center...literally 200 feet away from each other and interact face to face often.  Ask your BS tomorrow what his/her your long term plan is for you.  In addition to therapy treatment, a MO's role is to assess risk for future bc (recurrance or new primary). Good luck and let us know what your game plan is 

BLinthedesert

Hi LAstar - I don't have an MO (since I was pure DCIS, and ER- so no tamox).  I am followed by my BS and my RO.  They "trade off" seeing me so I am seeing one of them every 6 months.  If I did not have a RO - I would likely only see my BS (every 6 months).

They will do a breast exam (or a mx exam in your case) - and just check up to see how you are doing.  There are some women (like Jill) that have a breast center and share follow-up with MO's ... for me, every 6 months is a good time (I really don't feel the need to go to doctors more often than that) - some people feel more comfortable with less frequent follow-up, and some with more.  You need to make sure that YOU feel comfortable with your level.  I believe NCCN guidelines are manual exam every 6 months or 1 year for the first 5 years.   

Beesie

My case is a bit different because I had a microinvasion along with my DCIS.  So I had to see the MO.  But he recommended against Tamoxifen for me and after giving it some thought (and a lot of research!), I agreed.  So I went back for a second appointment to tell him that I wouldn't be taking the Tamox.  He offered to continue to see me but we both agreed that since I was not doing any treatment and since I had only a microinvasion (and therefore only a tiny amount of risk of mets - which likely wouldn't show up for many years, if it were to happen), it really wasn't necessary.  I didn't think it was a good use of his time, or mine. I left with the agreement that if I ever had any concerns or questions, I could set up an appointment to see him.  We left the manual checks to my BS.  He did the manual checks every 6 months for a couple of years and then turned it over to my PCP, with strict instructions to me to continue to get alternating mammos and MRIs (for my "extremely dense" remaining natural breast) every six months at his hospital, so that he can access the results and see me should there ever be a problem. 

I think it's very important to get mammo and possibly ultrasound and/or MRI screenings (for those who've had lumpectomies) and manual exams (for all of us) but honestly I think some of the follow-up of DCIS patients by breast surgeons and oncologists is excessive, particularly for those who've had a MX or a BMX. The NCCN guidelines do mention a manual exam every 6 months for 5 years but they don't say that it needs to be done by a BS or MO.  They also seem to be referring more to women who've had lumpectomies rather than a MX or BMX since they also reference annual mammograms, which obviously aren't needed after a MX.  NCCN Guidelines for Patients - Breast Cancer  

That's just my opinion.  It all comes down to what BLinthedesert said... there are no hard and fast rules and you have to be comfortable with your level of follow-up.  

LAstar

Thanks so much for your replies. My BS thinks I don't need to worry much about follow-up and just have my PCP do manual exams twice a year. He thought imaging was unnecessary because it is usually interpreted relative to breast tissue, of which I have almost none. He said a PET scan might be useful but didn't recommend it for DCIS. My local MO doesn't consider DCIS to be cancer (um, yeah), so I am seeing a MO in another city (who has some online materials about DCIS so hopefully takes this more seriously) to get another opinion on monitoring.