LCIS SURVEILLANCE SIX MONTH CLUB

Hello faithhopelove. I was diagnosed with LCIS in 2017 and have been pursuing the increased surveillance since then (no chemoprevention as yet). I have been doing the 6 month rotation between mammo/clinical exam with other imaging. In my first year, I did do an MRI, but had an adverse reaction to the gadolinium (hives) that my BS said would require me to need prophylactic treatment with something like Benadryl before future MRI’s. She also was becoming concerned about the possibility of brain deposition of gadolinium in her high risk patients who take yearly screening MRI’s. With that in mind, together we chose to switch me to an alternative form of ultrasound imaging which is offered at my hospital. It is called SonoCine, and is an automated whole breast ultrasound (AWBUS) technology, a screening ultrasound which covers *all* of *both* breasts. It is not the same as the targeted diagnostic US that we have probably all had for particular areas of concern. Though there are different “brands” of AWBUS technology, I suspect it is not very widely available - my hospital is the only one in the St. Louis, MO area with SonoCine.

I know that no imaging technique is 100% accurate, especially with lobular tumors. But I feel more confident and relaxed using two different types of imaging, and so far, so good. I would, however, go back to having an MRI if something of concern showed up that warranted that particular kindof imaging.

Hi MelissaDallas. Yes, I know that DCIS and ductal tumors are possible, even the more common cancers in women with a prior LCIS diagnosis. But my comment above was in relation to problems with imaging for high risk screenings. My understanding is that ductal cancer cells tend to clump and form lumps which are more likely to be felt or seen on mammography or ultrasound. Lack of e-cadherin can cause lobular cancer cells to form single file columns or sheets of tumor which cannot be easily felt or seen on imaging until they are much larger. Women call ILC a “sneaky” cancer because it so often evades early detection, so it is the thought of ILC that gives me more anxiety about the possibility of being missed by my 6 month screenings

Hi thedisgruntledpatient. I appreciate the reminder that most of the preventative imaging has some risk attached to it, even mammograms. I still feel comfortable with forgoing the MRI’s for the moment, though the imaging itself may be the most detailed and complete that I have had. There is another factor with the MRI contrast that I think it is important to consider - one’s renal function. It is the kidneys that help to filter and excrete the gadolinium contrast. At my hospital they actually do a blood test before your MRI to be sure you have adequate kidney function, and they won’t do the contrast MRI if you don’t. In my own case, I have impaired kidney function, though not so much as to exclude me from the test. But enough that I think that it is another reason to be wary of it, unless I really need it. For now, I am more comfortable with the mammogram alternating with a SonoCine ultrasound