follow up care after being "released"

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survivor2012
survivor2012 Member Posts: 5

Had a bilateral mast. 2009, DCIS stage 0 grade 1.(had reconstruction also) No chemo or rad. Dr. repeated MRI in 2010. Am now "cut loose", saw my gyno & she is recommending a CHEST MRI, not breast MRI being done as a follow up. Since I wasn't referred to an oncologist, I just thought the breast MRI would always be done so the chest wall could be viewed. Am confused, anyone out there have any similar plans???

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  • cinnamonsmiles
    cinnamonsmiles Member Posts: 779
    edited May 2012

    I was DCIS, Grade 1 as well. I had a BMX w/no reconstruction, no rads. I have not had scan since my BMX on 1/11/11. I was realeased to my family doctor who would show me how to basically do my own chest exam. I don't know if not getting reconstruction has anything to do with not getting any scans or not. I don't have a gyno since I had my ovares and tubes removed as well as a total hysterectomy.

  • survivor2012
    survivor2012 Member Posts: 5
    edited May 2012

    Thank you cinnamonsmiles-- having the implants, as I understand it, an x-ray & maybe the CT also, can't "see" behind the implants to check the chest wall. Before my initial mast. surg., had the breast mri, etc & then  a yr. afterwards another mri.  Yrs. ago I had a hyst. also, but still went to the gyno for mammo, etc & still go, she is the one who is ordering the chest mri. I guess it kind of threw me that it wasn't a breast mri. She said she had talked w/ the surgeon who did my mast. yrs. ago in relation to how do I treat women who come in after they have been released & mri was one of the choices. So. Back in the tube, face up this time, ha.

  • longislandmom
    longislandmom Member Posts: 248
    edited May 2012

    hmm.. i am confused.   I had DCIS and LCIS.  Had a BMX in April.  I had no nodal involvement and the BS said my chances of recurrance are pretty much zero.  My understanding is that my MRIs are to check on the implants vs. breast cancer-- since there is essentially no chance i will get cancer again and, because DCIS is by its nature, non-invasive, there is no risk to chest wall? 

  • BLinthedesert
    BLinthedesert Member Posts: 678
    edited May 2012

    longislandmom -- is it not zero chance, just very small (1% I think).  

  • lisagwa
    lisagwa Member Posts: 232
    edited May 2012

    I had an oncology appointment today so that I could better understand my pathology report and dx. It is my understanding re my dx that there is a 1% chance of bc returning. I was told that most likely, if it retuned, it would be on the skin and not the chest wall. I need to speak with my BS re MRI depending on my recon decision. /p>

    Dx 2/2012, DCIS, 1cm, Stage 0, Grade 3, 0/2 nodes, ER-/PR-
  • crystalphm
    crystalphm Member Posts: 1,138
    edited May 2012

    No doctor has answered this question for me as of yet. I had one mastectomy 2 years ago, my second one was 6 months ago, and I seem to now be 'dismissed" from seeing the doctor other than every 6 months when he presses around. I have not had reconstruction, so I am very unsure how breast cancer could now be detected?

  • cinnamonsmiles
    cinnamonsmiles Member Posts: 779
    edited May 2012

    I know of a woman who had DCIS and it came back in the scar on her chest (she may have had a small lump). You are lucky you have someone watching you every six months. I know that I have read about two or three women that I have read about that had DCIS and came back (now if they had a micro-invasion, I don't know, they stated they had DCIS).I have been forgotten. I just feel my own chest now. I asked my surgeon what I would need, thinking that I would need ultrasounds maybe, but she said just have my primary dr. show me how to check out my chest. Thinking back to that, THAT should have been HER job, seeing she deals with breast surgeries.

    I have wondered and posted here and there what other women who had DCIS and got mastectomies and no reconstruction had for follow up care.

  • survivor2012
    survivor2012 Member Posts: 5
    edited May 2012

    Thanks to all for the replies. I thought maybe it was just me, but it seems after our surgeries, etc., we walk away w/ a lot of misunderstanding. That doesn't seem "right" after all we have been thru. My surgeon's response is that the dr. tries to get as much as possible of the breast tissue removed, but unless it is the radical that they used to do, there is still a miniscule amt. of tissue left, that's why it could come back in the chest wall . Even tho the ca was not invasive & in situ it could come back & on the skin, that's why we need to self check & feel all the way up to neck & around collarbone, under arm, etc. The percent chance IS very small, but still there is that possibility I don't want to just forget about. I don't think when we are dismissed we are given oppportunites or choices to be re-checked by the dr. as cinnamonsmiles pointed out. I had assumed the MRI would be done to check the chest wall & whatever is behind the implants, which cannot be seen on---here I am blank, CT or X-ray. Anyway, I still go to the gyno as she says I need to be checked for vag ca anyway & she feels of the implant areas, etc. She did order a chest MRI, had never heard of that, am waiting for results. In googling that, it seems that MRI would be for heart, lungs, but if it shows behind the implants to the chest wall, I guess that is a good thing. I also had thot I would be followed by the surgeon for the 5 year period I thot was used to follow patients. The plastic surgeon who did my reconstruction also had br ca while in med school & supposedly she is going to follow me every year & says she wants to keep a follow up on all her patients, takes pictures, etc. I hope she does, I just feel like I am out on a limb at times. To repeat myself, my gyno said she had contacted my surgeon a few yrs. back & asked her what do I do & check for my patients coming in a few years out after surgery, etc. & was told MRI's. I think there is some uncertainty out there in the med world & maybe they need to get a better picture of all this, maybe our feedback to them. I know a surgeon is a surgeon, but still we need the professional hands on of someone.

  • linda333
    linda333 Member Posts: 2
    edited May 2012

    After my lump surgery and balloon radiation I was released immediately by surgeon  I will be followed every 6 months by radiation dr and also by oncologist for 5 years.  My rad dr is so good I do not feel I need my oncologist but she said I did.  I have had my first followup which was mamo and blood work.  Everything is a ok.

  • agada
    agada Member Posts: 452
    edited May 2012

    I had mx's two years ago with DCIS.  I was also discharged from the care of on oncologist.  I went out and found a new oncologist who follows me every six months.  so far I have had no follow up testing what so ever. 

  • survivor2012
    survivor2012 Member Posts: 5
    edited May 2012

    Agada, were you referred to an onco. bc you had chemo/rad.?

  • malleycat
    malleycat Member Posts: 49
    edited May 2012

    Agada, please forgive my ignorance (I'm still new here and learning a lot!), but I noticed your Dx says 2 nodes were positive.  Doesn't it cease to be DCIS when there's node involvement? I thought DCIS was strictly non-invasive...? 

    Survivor- I was referred to an onco as well, but I didn't have either (just BMX).  I don't know why though, he just told me they weren't doing anything further and then told me to follow up in 6 months (again, don't know why since they're not doing anything...!)

  • bdavis
    bdavis Member Posts: 6,201
    edited May 2012

    My friend was diagnosed with DCIS, had a MX, no rads or chemo and a year later had a recurrance, this time IDC and with nodal involvement... This spurred me on to get an MRI, even though all doctors said they don't do it for monitoring.. But I asked, and they ordered it for me. I asked that they look at the chest, nodes and skin.

  • malleycat
    malleycat Member Posts: 49
    edited May 2012

    @bdavis- that's what's scaring the crap out of me right at this moment. They tell you "less than 1% chance of recurrance" with BMX, but how do they really know? I just read of someone else on here that had clean margins and negative nodes and is now stage 4 a couple years later.  I've been panicking all afternoon after seeing that! I know it's rare, but still...  How often do you plan to get the MRIs done?  And was your friend's recurrance in the mast. side?

  • bdavis
    bdavis Member Posts: 6,201
    edited May 2012

    My friend had a UMX and yes, it was on that side... she said you could see the lump... and that was less than 18 months after diagnosis... Do realize that she had a scattered effect DCIS, hence the reason she had a MX rather than lumpectomy... I guess they missed some?? For me, I plan to have an MRI yearly. As long as insurance pays, I can't see any reason not to... Its an afternoon per year.

  • malleycat
    malleycat Member Posts: 49
    edited May 2012

    Absolutely, if you can, why the heck not?!  I'll have to look into that.  I know I'll have to have them anyway with the implants, but that's every few years I think.  Thanks for the info (I'll take all that I can get!).  =)

  • lisagwa
    lisagwa Member Posts: 232
    edited May 2012

    Bdavis- I am wondering whether your friend who had DCIS, then recurrence. Do you know if she was ER/PR+?



    Malleycat- I went to oncologist so that I could get more specifics. She advised me to return in 6 months simply for breast exam. This makes me feel better.

  • longislandmom
    longislandmom Member Posts: 248
    edited May 2012

    Bdavis -- that is a SCARY story re: your friend with DCIS.  ugh-- i had this flippin disease.

     i know that my BS wants to see me every 6 months for a few years.  and i believe the PS wants to do MRI every year.

  • bdavis
    bdavis Member Posts: 6,201
    edited May 2012

    I don't think she was ER+ because I don't recall her talking about Tamoxifen... I know that her first diagnosis she was Her2- and the 2nd was Her2+.. so recurrance or new primary??

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