Followup Mamo, MRI or get a second masectomy?

JudyO

I know my doctor will suggest a mamo for my 1 year checkup. I am afraid of this since my original tumor never showed on the mamo for years. When it finally did show up it was just a shadow. I did have a MRI before surgery and the other breast was clean at that time. I have very dense tissue. I never knew before all this happened that I probably should have had an MRI all along...no one ever mentioned that. Now I am starting to question if an MRI will see everything. Maybe I should just push for the second breast removal. Any thoughts out there?

ittybittyme

I am still in treatment, but finished chemo. Dr. recommended masectomy even though I had lumpectomy last july. (I have very small breasts) the margins were not clean. I had MRI before starting chemo and operation. MRI is schedualed for next week b4 masectomy/RADS begin. I was told this is standard procedure since MRI shows better than mammo. I would assess your risk factors for recurrence and insist on an MRI for peace of mind. I too, have very dense breast tissue. ILC tends to recur more frequenly in the other breast than most others, so I would be diligent in your own breast heath. Good luck you. I will push for removal of both breasts in my case because of high risk factors, but we don't always get what we want.

paige-allyson

I ultimately chose to have a second mastectomy in September, after being called back for an ultrasound following my first post- tx mammogram. The radiologist said she "thought" the ultrasound was okay. I told her right then and there that I had every intention of pursing a second mastectomy. I was just done with it. My initial cancer evaded detection (except me feeling something was there the my doctors, 2 mammograms, and 2 needle biopsies were unable to detect). I am satisfied with my choice and relieved that I don't have to deal with MRI or mammogram every 6 months. My oncologist did not particularly encourage this choice but he didn't stand in my way either. I didn't care what he or anyone thought- it's my life and my quality of life.

You can take all the time you want to come to a decision about what's best for you. I waited a while. I can say that I am happy with being the same on both sides and actually feel better about my body this way.

Good luck with your treatment.

dianaon

I can relate, as my mamo 9/2/08 (w/ spot compressions) was "negative", but as I had a lump- the sono was done...PS the 2nd radiology read on the mamo did show suspicious areas. The surgeon told me that if you have a film and are told it it BX pos, you can always see where, in retospect..

My Onco rec. althernating mamo/sono's w/ MRI's. Said I had a clear case for getting MRI approved by ins., given the ititial "negative" mamo. I am not too concerned about them missing ANYTHING on mamo/sono again, as they will be made aware of my hx of CA, and "neg" mamo, (each time I go, by me, personally) and be more suspicious (and afraid of being sued).

I really don't trust anybody, or anything i read, with reasonS. But I am also not going to get a 2nd  mast. Even though the rate of bilat CA at time of Dx is higher in ILC, I had pre-op Bx's of any areas they could justify biopsying on the other breast- all neg.  

At this point, the risk is not great enough, the suspicion/early detection is high, and I am much more concerned with "distant" recurrence (METS), than with a local breast cancer. Amazing how your perspective can change after Dx, huh?

I am also not all that scared about distant recurrence, given the grey area of tx options for early stage, node/vascular neg. ILC.  I had on Oncotype of 18 and chose TAM only (rather than be randomized into the TAM only vs. CMF + Tam trial).

Kleenex

My thoughts run similar to Diana's, in that I'm more concerned with possible distant mets than with new ILC popping up in my breast. Lumps in breasts don't kill you, and I will be under surveillance...

My ILC was outside the field that gets squeezed into the mammogram equipment - high up on the chest. Who knows if it could have been seen if it was inside the field they can see? I was able to feel it, and that led to them being able to see it on ultrasound. The MRI showed only that one area on that one breast as being a concern. So I figure I can go a while before I'll need another MRI to feel "safe." In the meantime, I'll have mammograms (one in a couple of weeks) to check for other things - calcifications, whatever - and try not to freak out. I am taking Tamoxifen and had radiation after my lumpectomy.

Some of my perspective comes from the fact that, prior to this, I'd never had a biopsy or even a suspicious area on a breast. So I think I can go through this a few times before I really go nuts. If I have my breasts removed and this is determined to get me, it has no choice but to show up in the chest wall or elsewhere in my body, and that's a whole different ball game. I'd rather stick with this one. We each have our own tolerance for different types of risk, I guess.

Of course, we'll see how this goes in real life - I have my first follow-up mammogram and exam in a couple of weeks.

Coleen

paige-allyson

Just realizing I should add a bit to clarify. I TOTALLY agree that the real thing to be concerned about is distant recurrence. As someone dx with locally advanced breast cancer I am at high risk, even after chemotherapy, radiation, and hormonal therapy. I did not view having the 2nd mastectomy as something that would save my life. I did it because I don't (with good reason in my particular case) have the level of confidence I'd need to be comfortable the if I had a cancer in the (former) healthy breast that it would be detected. I noticed an "area of concern" in 2000 and again had a concern about the area in 2004. Both times nothing showed up on mammograms or in subsequent needle biopsies. Fast forward to 2007 when I go for a screening mammogram and end up being dx with Stage III breast cancer. Any doctor I have talked to agrees that it was likely there for a LONG time.

I do all I can to prevent distant recurrence- take Femara religiously, exercise, don't drink alcohol, keep my weight in low normal range, eat 9+ fruits and vegs daily, etc. I just feel better not having the ongoing monitoring for local recurrence to deal with. It's a relief to me to be able to forget about breast-related issues and focus instead on my overall health and enjoying my life.