Follow-Up Recommendations for Breast Conditions

Here are some recommendations for follow-up of different breast conditions. Please note that these recommendations do not substitute for consulting with your physician!

• Invasive Breast Cancer and Ductal Carcinoma in situ (DCIS)
• Ductal Intraepithelial Neoplasia (DIN 1a)
• Atypical Ductal Hyperplasia (ADH or DIN 1b) and Atypical Lobular Hyperplasia (ALH)
• Breast Masses
• Breast Cancer Screening Recommendation

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Invasive Breast Cancer and Ductal Carcinoma in situ (DCIS)

You will be referred to see the oncologists (cancer specialists) at the BC Cancer Agency. We fax all of your reports to them and you will get a call either from our clinic or the Cancer Agency directly. If you don't get a call with an appointment time within three weeks please call your nurse navigator.

After all of your cancer treatments we recommend the following:

• That you perform a monthly breast self examination looking for changes or new lumps. If you find a lump or change you should see your family doctor.
• That you see your family doctor for a breast exam every six months for the first five years and once a year after that
• Report new symptoms to your doctor (e.g. headaches)
• That you have annual mammograms (not needed if you had bilateral mastectomy)
• Follow up with your oncologist as recommended by them

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Ductal Intraepithelial Neoplasia (DIN 1a)

The diagnosis of DIN 1a is new and our understanding of this condition is changing. At the present time we think that women who have DIN 1a in their breast may have a small increased risk of developing breast cancer.

When DIN 1a is identified on a needle biopsy your surgeon will discuss either removing the whole area to be sure that there are no cancer cells in the area (risk thought to be 5-10%) or close monitoring of the area with mammograms every 6 months for two years. You should consider these recommendations for breast cancer screening.

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Atypical Ductal Hyperplasia (ADH or DIN 1b) and Atypical Lobular Hyperplasia (ALH)

When ADH (or DIN 1b) or ALH is found in a woman's breast, we know that woman has an increased risk of developing breast cancer in her lifetime (about 20-25% chance).

We recommend that you should check with your family doctor about current recommendations for women at higher breast cancer risk. You should consider these recommendations for breast cancer screening.

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Breast Masses

When a woman has a breast mass your doctor will do a number of tests to see if it needs to be removed or is considered safe to watch. If you were not advised to remove the mass it is unlikely to be or become cancerous but it is still very important that the breast mass be monitored for changes, just in case.

If you can feel the mass we recommend that you check it once per month, the best time is after your period. Any breast mass that is growing or changing needs to be re-evaluated and likely needs to be removed. Be sure to see your doctor.

Some women choose to remove a breast mass for peace of mind, even if nothing worrisome is found on testing.

You should consider these recommendations for breast cancer screening.

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Breast Cancer Screening Recommendation

Participate in breast cancer screening:

• Perform a monthly breast self examination
• See your family doctor for a breast examination every year
• Have mammograms as recommended for your age group
• BC Screening Mammography Program

Maintain a healthy lifestyle:

• Have a well balanced diet rich in fruits and vegetables
• Maintain a healthy weight
• Get enough exercise
• Don't smoke and drink alcohol in moderation

Have your mammograms and breast ultrasounds at the same place to make it easier to find changes from year to year.

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