In this episode, we interview Erika Bell, PhD from the Bay Area Cancer Connections (BACC) patient advocacy community about ductal carcinoma in situ (DCIS). Erika discusses the role of BACC in supporting cancer patients, the challenges of finding support during the pandemic, and the importance of patient advocacy organizations. She then dives into a detailed explanation of DCIS, its characteristics, and how it differs from invasive ductal carcinoma (IDC). We also delve into the decision-making process for treating DCIS, discussing options such as lumpectomy and mastectomy, and examine the role of sentinel lymph node biopsy in DCIS. This includes a detailed discussion on the findings of a study regarding sentinel lymph node biopsy in DCIS patients and its implications for treatment decisions. Above all, this conversation underscores the complexity of decision-making in cancer treatment and the need for personalized support and information for patients.

This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this study by Dr. Shiyi Wang.

Key Highlights:

1. DCIS is known as stage 0 breast cancer because it hasn’t spread outside of the breast ducts. However, there is not enough research to determine the conditions that increase the chances of DCIS evolving into IDC. 

2. Sentinel lymph node biopsy is not necessary for most DCIS patients as the risk of lymph node involvement is low.

3. Personalized support and information are crucial for patients to make informed decisions about their treatment.

About our guest:

Erika Bell is the Director of Cancer Information and Education at Bay Area Cancer Connections (BACC), a community-based non-profit that supports people with breast or ovarian cancer. In this role she provides health education, personalized research, and medical decision-making support to clients. She has been with the organization for 14 years and is passionate about her work and the positive impact that it has on empowering people during a difficult time in their lives. She also serves as the Vice Chairperson for the California Breast Cancer Research Program Council. Erika earned an undergraduate degree in Biology from Cornell University and a doctorate degree in Molecular and Cellular Biology and Biochemistry from the University of California, San Francisco.

Key Moments:

At 13:43 “There are a lot of people where maintaining as much breast tissue as possible is the most important thing to them in addition to still having feeling in their breast, so they opt for a lumpectomy. Other people really have a strong urge to just get everything out, “I don't ever want to have to deal with this again, please remove everything.” Those people also tend to be thinking about double mastectomies, which in the case of DCIS and no inherited genetic predisposition to breast cancer or no strong family history really is not medically indicated, but there are still women who make that choice, either driven by their anxiety or future screenings or symmetry that they want to achieve, etc.”

Manta Maps are coming! Step-by-step subway maps that guide you through the entire cancer experience. Learn more here!

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