Newly diagnosed with LCIS? 1 year of surveillance, then decide

That was the advice I got today from the nurse practictioner at a high risk breast clinic. So I thought I'd share it here.

That one year's worth of surveillance, in her opinion, should be mammogram and MRI, spaced 6 months apart, which is fairly status quo. She said she had not seen any problems with MRIs being covered by insurance when LCIS was the diagnosis. Not the case with Medicare coverage, though. But the Medicare supplements that can be purchased vary with what is covered. She also said that within a few years, the cost of MRIs should come down to about $500. Right now, through the hospital she is associated with, they cost around $3,000. She knew of a few stand-alone spots that did breast MRIs for the $1000 range, but they are not common. (All the places I called prior to seeing her did not do breast MRIs, even though they did other types.) The 2 questions to ask the stand-alone MRI places she said are (1) qualificaitons/background of the radiologist and (2) if the equipment has a dedicated breast coil.

I asked her how many Stage IV or bad cases of cancer she sees that started with neoplasia. She said almost none and not just none from neoplasia but that with the screening that is now routinely done, Stage IV is rarely seen in her practice.

She also recommended chemoprevention drugs, but whether that is done or not, she said to see how you do mentally/psychologically with the screenings and how you feel at the end of the year. Her advice was don't plan a PBMX before that for a diagnosis of classic LCIS.

Most recommendations for LCIS say something like "you have time to make a decision." This NP quantified that advice to the specific time frame of a year.