Monitoring and surveillance following DCIS treatment
Currently, more than 20% of breast cancers diagnosed in the USA are ductal carcinoma in situ (DCIS; Brinton et al., J Natl Cancer Inst 100:1643-1648, 2008; DeSantis et al., CA Cancer J Clin 64:52-62, 2014; Ernster et al., J Natl Cancer Inst 94:1546-1554, 2002). Early detection and a low breast-cancer-specific mortality (1-2%; Ernster et al., Arch Intern Med 160:953-958, 2000) have resulted in an increasing number of patients that require clinical follow-up and imaging surveillance after treatment for DCIS. As this population continues to grow, clinical evaluation and management patterns are also evolving, including advances in breast imaging, surgery with or without reconstruction, radiation therapy, and systemic therapies. Clinicians must determine long-term follow-up for patients that have taken a variety of pathways to survivorship. As treatment patterns become more individualized for tumor biology and patient preference, surveillance practices must also evolve and be tailored appropriately for survivorship programs. In this chapter, we review the current guidelines for surveillance after treatment for DCIS and discuss a practical application of these guidelines for a spectrum of DCIS survivors.
