Ask your questions!
Carol Kaplan, MD and Jill
D. Siegfried, MS answered
your questions about breast cancer this month.
Question:
Just went for my yearly mammogram and was called back for microcalcification in my left breast. During the diagnostic mammogram they discovered a cyst that was not seen on the screening mammogram. (The microcalcification were ok-only 2 small spots-no concern if under 5) They did an ultrasound and could not find the cyst. The radiologist even came in and tried to find it. Any reason for concern?
|
Dr. Kaplan, MD responds:
I'd have to see the reports to truly know the situation here, but likely no cause for concern. The ultrasound should reveal a cyst, typically. And a cyst is no cause for concern in and of itself. However, just make sure that the mammogram wasn't saying an abnormality was present (i.e., didn't clearly just call it a cyst). If there's any reason to think there is an ultrasound-negative mammographic abnormality that is not just a cyst, an MRI can be considered by you and your physician.
|
Question:
Have there been any recent developments regarding treatment of DCIS ER-negative cancer with drugs after surgery and/or radiation?
|
Dr. Kaplan, MD responds:
No new developments. This is still an area of controversy - the study looking at tamoxifen therapy to decrease recurrence in DCIS patients included ER-negative and -positive patients. Subset analysis, which is not a necessarily trustworthy statistical method, revealed ER-negative patients to be unlikely to benefit greatly from tamoxifen.
However, there are clinical studies open at Penn, for DCIS patients (ER-positive AND ER-negative): the WISE and MAP trials. These both treat patients with aromatase inhibitors (AI's) - I am excited about these trials, especially because AI's have a better side effect profile than tamoxifen. You could look into enrolling into these if your diagnosis was recent.
|
Carol Kaplan, MD, is a hematologist/oncologist at the Rena Rowan Breast Center at the Abramson Cancer Center of the University of Pennsylvania. She received her medical degree from Washington University School of Medicine in St. Louis where she worked as a Mallinckrodt radiation oncology extern. She completed her residency in internal medicine at the Hospital of the University of Pennsylvania, where she also completed her fellowship in hematology/oncology with a focus on breast cancer clinical therapeutic trials. She is board certified in internal medicine.
Jill D. Siegfried, MS, is a genetic counselor and program coordinator for the Cancer Risk Evaluation Program at the Joan Karnell Cancer Center at Pennsylvania Hospital. Ms. Siegfried received her undergraduate degree from the University of Delaware and her master's degree in medical genetics from the University of Cincinnati. During her graduate studies, she served as a cancer genetic counseling intern at the Abramson Cancer Center of the University of Pennsylvania and in the Hereditary Cancer Program at Cincinnati Children's Medical Center.
|
