Finding a Doctor You Trust
After receiving a DCIS diagnosis, the next step is finding a doctor to guide your treatment. Typically, this doctor will be a breast surgeon. Some women may also meet with a medical oncologist, but this is less common unless there are factors indicating invasive breast cancer.
The importance of finding the right doctor in your care and management of DCIS cannot be overstated.
If the medical community were to reach consensus about one thing with respect to DCIS, it would be that there is vast uncertainty about the natural progression of the disease. In the face of that uncertainty, different doctors take different approaches in counseling their DCIS patients. Doctors, after all, are human too.
While there is a standard of care for treating DCIS, the standard does not account for different types of DCIS (i.e., low vs. high risk), or other factors that you might consider in making treatment decisions, including age, genetics and lifestyle. Different doctors may have different opinions as to your optimal care depending on how much weight they give to these and other factors.
Furthermore, many DCIS patients have more than one option when it comes to treatment. Examples of some of these options may include:
- Lumpectomy vs. mastectomy
- Single mastectomy vs. double mastectomy
- Choice to pursue or decline radiation
- Quantity and type of radiation
- Choice to pursue or decline hormone therapy
- Type and dose of hormone therapy
- Choice to decline adjuvant therapies (i.e., radiation and hormone therapy) in favor of more aggressive surgery
- Reconstruction – timing and types
- Choosing active monitoring, with or without hormone therapy
Different doctors may be more or less willing to discuss these various options with you, along with the pros and cons for your unique situation.
Through the latest research and clinical trials, there is new information emerging about DCIS that may inform your treatment decisions. Different doctors will have varying levels of knowledge about the most up-to-date research findings, and different levels of willingness to share what is known (and unknown) with you.
If these factors are important to you, you will be well-served to take your time in finding the right doctor. Keep in mind that when it comes to treating DCIS, a doctor’s communication style can be just as important as their training and experience.
It is common for DCIS patients to get multiple opinions, so do not hesitate to get more than one. (And any doctor that pushes back against your wish to get another opinion is probably not one you would want to stay with!) The more you trust your doctor, the more you will trust in your own decision-making around treatment.