For Those with Dense Breast Tissue

twona61

I'm 50 years old and I have dense breast and I went for a mammogram last Thursday and it came back abnormal. They called me back in yesterday and they done several different x-rays and ultrasound. Found something on the right breast to me it was a white spot with little lines around it. But they told me they was going to let someone else look at my x-rays, they said they didn't thinkkkkk it was nothing to worry about and said I probably should wait and come back in 6 months. My mom has had breast cancer 5 years ago. Do you think I should demand a mri? I'm a little scared thinking about this since my mom has had breast cancer. Can you give me some advise?

Thanks,

Sherbear

Hi Twona, I'm a little younger than you and didn't have yearly mammo's, but when I found a lump I was sent for an ultrasound and told since I'm young and have dense tissue it was probably fibrous tissue (fibroadenoma) and to reschedule another appt. in 6 months.  Well, almost a year went by when I finally remembered to book and went in and it was bigger.  All I'm saying is that if it's something abnormal, maybe it's best not to wait for more tests, just in case.  I hadn't thought of it that way at the time.  No regrets, but I try to be more diligent now.  

toni30

Hi Twona: Yes, I owuld ask for an MRI. If they don't do it, I would get a second opinion, if you can afford to pay yourself (if insurance doesn't cover it). Good luck!

bdavis

Get the MRI

LtotheK

I went for a second opinion, and the doctor said absolutely,I should be having MRI.  She also said it is going to be an ongoing battle for insurance.  They don't reimburse enough for the reading time on the MRI, which is up to two hours according to my oncologist.  That is much more than the standard mammogram/ultrasound.  It's a double-whammy:  the insurance companies don't want to pay, the hospitals don't want to offer them.

I fought like a devil, and my oncologist said it was going to be an annual war.  This won't change for a while, so get your gloves on, ladies.  Another one I'm hearing a lot about:  they'll give an MRI at the beginning, and then by the second and third year out, they won't offer/cover them.  

I'm like many of you:  the mammography was literally a collosal waste of time.

Sherryc

Get the MRI and as far as schedule goes.  I have had a hystercomy but have my ovaries.  There is no way to know what my cycle is.  They just did the MRI to rule out cancer of the calcifications but ended up finding a tumor that did not show on my mammo.

toni30

The insurance story is typical - and  why some of us are working to get our state legislatures to change the law and require insurance to cover MRIs for woman with dense breast tissue.

soccermomofthree

Hello Ladies I have a question...does anyone know how long you should wait after nursing a baby till you have a baseline mammogram?  I have a friend with a strong family history and is past thirty five years of age and wants a baseline for future reference but she just stopped nursing in Jan of this year.  Any thoughts or info?  Thank you!

Gracieface

Regarding dense breasts-Has anyone ever had a Breast-Specific Gamma Imaging (BSGI).  I came across this article on how they have perfected it by reducing the radiation dose.  I have an appt with my breast surgeon in two weeks and having very dense breasts and history of ADH with excisional biopsies, I thought I might ask to be referred to an Imaging Center that offers it.  I googled the one mentioned in the article and it said many insurances cover BSGI and they have been doing them for years.  Any comments, concerns, thoughts! 

Latest Clinical Evidence Supports Promising Outlook for Low-Dose Molecular Breast Imaging (MBI)

PRNewswire

05-13-11

NEWPORT NEWS, Va., May 13, 2011 /PRNewswire/ -- The possibility of low-dose Molecular Breast Imaging (MBI) looks promising according to the most recent clinical evidence revealed this past month at the National Institutes of Health (NIH). Dr. Marcela Bohm-Velez and her colleagues from Associates in Pittsburgh, Pa., shared preliminary results from a prospective study on low-dose MBI, specifically Breast-Specific Gamma Imaging (BSGI), at the SNM Breast Cancer Imaging: State of the Art 2011. Their results suggest it may be possible to reduce the radiation dose patients receive from a BSGI procedure by up to 60 percent.

The tracer used in this procedure, Technetium Tc99m Sestamibi (MIBI), has commonly been used in cardiac studies for years and was cleared by the FDA in the mid-1990s for diagnostic breast imaging. The recommended dose (20 - 30 mCi) was established using an older, larger, less sensitive whole body imaging system. Newer breast-optimized imaging systems have an inherently higher photon sensitivity that may allow a lesser dose to be used.

At the Weinstein Imaging Center, BSGI has become a valuable diagnostic tool, especially for patients with dense breast tissue that limits the effectiveness of mammography. "In order to optimize care and use BSGI to screen specific populations, we wanted to examine the possibility of using a lesser dose," said Bohm-Velez. "The present challenge for the clinician is that the use of lower doses is currently an off-label use of the pharmaceutical."

Their study compared breast tissue uptake at low-dose levels of 5, 10 and 15 mCi to those obtained with the conventional 20 mCi (740 MBq) injections. According to Bohm-Velez, "Although these are early results, we were quite surprised to see that we can reduce the dose to 15 mCi without any substantial impact on breast tissue uptake or image quality. In addition, a 10 mCi image still provided a very good, clinically viable image. The good news is that at lower doses, the breast tissue uptake is still sufficient; leading us to believe that a dose of 8 mCi is likely possible with the current instrumentation."

Bohm-Velez also mentioned current investigations are underway at the University of Virginia to potentially allow doses as low as 2 - 4 mCi to be used, making the radiation dose a patient receives from a BSGI/MBI study equivalent to that from a mammogram. According to Bohm-Velez, "The next steps are to gain the funding needed to expand this to a multicenter trial, investigate the impact of these optimizations and hopefully, in the end, change the drug insert package to include low-dose breast imaging."

About Dilon Diagnostics

Dilon Diagnostics, a brand of Dilon Technologies Inc., is bringing innovative new medical imaging products to market. Dilon's cornerstone product, the Dilon 6800(R), is a high-resolution, small field-of-view digital gamma camera, which provides the high photon sensitivity needed for low dose BSGI/MBI studies. The examination images the metabolic activity of breast lesions through radiotracer uptake and the Dilon GammaLoc Localization device allows Gamma Guided biopsy to be conducted. Many leading medical centers around the country are now offering BSGI to their patients, including: Cornell University Medical Center, New York; George Washington University Medical Center, Washington, D.C.; and The Rose, Houston. For more information on Dilon Diagnostics please visit www.dilon.com

astra1215

can anyone tell me what medication you are allowed to have before/during an MRI, i have severe allergies so my nose is constantly running and I am hacking up a lung every two seconds and when I called the imaging center to ask what I was allowed to take because the woman who confirmed my appt rattled off the list of verboten meds so fast I never heard them! I know I cant take any pain meds but can I at least take sudafed? I talked to one of the doctors and she didnt even know they tell ppl not to take pain meds!! Freaked me out a little...

sarah08

hi nashville thx for ur post...i agree with it...i think every women should know proper information about breast cancer...i read so many articles about it n recently i found a interesting one..if u have tym u can check this http://www.livewithyourself.com/ i think it will help u to know more about breat cancer...:)

thenewme

Spam - be gone.

pinkrose1958

Hi Ladies,

I posted here in Feb. 2011 about my dense breast tissue and could not get the proper imaging studies through my insurance. I had a mammogram in Sept. 2010, came back the same as all others. No malignancy, heterogenously dense tissue-both breasts, hard to read with mammography. I requested to see the breast surgeon due to a lump I felt...she ordered a partial U/S, from 12:00 to 3:00 position. I was surprised, I thought she would do a complete U/S; when I met with her she said I didn't need one...everythng is normal. I called member services and asked if I could get a full U/S and was turned down. I was sent to another breast surgeon at another facility only to be Abused by the Breast Surgeon. We bickered back and forth and she requested I do not return to her clinic. It has taken me this long to get an U/S, I paid out of pocket at a community clinic which takes walk-ins and explained my circumstances. I got my order for a bilateral U/S which I will pay for myself. My feelings are, money well spent for peace of mind or early detection.

To all of you going through the same, seems this is what we must resort to in order to get quality healthcare.

Take care,

Maggie

Springtime

Same for me, clean mammograms led me to believe I was "safe". I was not. Huge lump - ~5cm. Not seen by mammogram, diagnostic mammogram, or ultrasound. Was told , "your tissue does not lend itself ti diagnositic imaging". I have heard that up to 30% of cancers are missed by mammogram. WHAT IS WRONG WITH THIS PICTURE?

I do believe there is more focus here now, but NOT ENOUGH.  

pinkrose1958

Hi Springtime,

I'm so sorry you're going through this. If I may ask, how are you doing at this time?

I feel the screening process needs to be changed, unfortunately this won't happen until someone with great pull fights for changes. If women cannot be read with mammogram due to density then this needs to change. It's a waste of time year after year to get a mammogram with the same results. The insurance companies should be more forth coming regarding diagnositic imaging.

Yes I agree there are changes going on at this time. I'm hoping for the changes that took place in CT to take place all over the U.S.

Take care,

Maggie

Fearless_One

I agree with Pinkrose.   Hopefully there will be further legislation on this issue.    It is so odd to me that people are so concerned with MRI's giving "false positives" (you read about this often), yet you hardly ever read about mammos giving false negatives.   At least a false positive won't kill you.

Anonymous

Gracieface, have u been able to get referred for a BSGI ? Please let us know how it goes

bdavis

I had been told that mammos miss 10% of cancers, but it does seem higher than that.. and if it is 30%, then we do need to remember that for 70% of people it is a valuable tool... I think there should be a determination if it will work for you or not (by it being all white)... I think doctors know whether we are good candidates or not as soon as they see the pictures.. and for those with WHITE mammos, we should be allowed to have further and better testing... and yahoo for the 70% who benefit from mammos... I say, don't stop giving mammsos, but start giving MRIs to those in need,

Fearless_One

Bdavis, I agree.   Mammos have certainly saved lives.   But I don't think they have saved many lives in women with grades 3-4 breast density, and we should be allowed to have access to more definitive tests.  

Springtime

I'm with Fearless One - False negatives are horrible! You have cancer and don't know it! Puhhhleze! Much worse than a "falst positive".

Maggie, I am doing okay. Although my "mass" was "massive", I had nothing in my nodes. I've done all the medical treatments that were recommended and surgery (Chemo, radiation, hormode blocking drugs, bilateral mastectomy) and I  also am doing every homeopathic thing I can find, dietary changes, exercise, serenity practices, supplements including cancer fighting things. I am almost three years out. 

But it does drive me crazy that for all those years, I had (as BDavis puts it) "white" mammograms and reports with disclaimers all over them about dense tissue. They. Saw. NOTHING. and yet year after year I had those dumb mammograms when I should have been having MRIs. It makes me really mad, and it is STILL GOING ON!!!  Do you think this would be the case if we were talking about Men's Balls?? Sorry, but really. This isn't just about losing breasts, it's about losing lives. So wrong.

Anonymous

Springtime, am having this picture in my mind of men,s balls being squished in a mammogram machine, and the look on their face, LoL Forgot to add that if that were the case, don,t u worry that they would have come up with something much better a loooong time ago

kcpups

Hi everyone,  

I'm relatively new here, but did post once asking a question for my 73 year old mother, she's a breast cancer survivor, diagnosed in 2009 with IDC, ER+, PR+, HER2+, mastectomy left breast, couldn't tolerate the taxol, but made it through 1 year of herceptin and doing well.

I just had a routine mammogram (I'm 49, turning 50 in two months) and I think I fall into this category - please let me know! I just received my results today and the initial mammogram findings were: Breast Density: The breasts are relatively radiodense with a moderate amount of fibroglandular tissue.  Within the later aspect of the left breast an area of nodularity is recognised, and more defined than at the time of the prior examination."  Impression states: Asymmetric nodularity is noted within the left breast as described, and the findings appear altered from the prior comparison examination. Recommendation: a futher evaluation via spot magnification imaging and ultrasound.

The results of the spot and ultrasound state : Breast Density: Scattered fibroglandular elements.  Findings: A tiny, 5-mm nodule persists laterally on the additional mammographic views.  No suspicious microcalcifications or areas of architectural distortion are identified.

On ultrasound, there was a 4-mm cyst at two o'clock, and a 2 x 4-mm cyst at 6 o'clock, the former of which could potentially account for the mammographic nodule.  There was also a focal horizontally oriented solid structure at 730 measuring 6 x 3 x 6 -mm, probably a lymph node with an echogenic hilum.  (I think this is why I had to hum during the ultrasound) This is difficult to appreciate mammographically.  No concerning sonographic lesions are demonstrated. Impression:  Negative for malignancy.  There are a couple of tiny cysts and probable intramammary lymph node.  As a precaution, a 6 month follow-up sonogram can be performed to reassess the solid structure at 730.  Bi-Rads Assessment Category 3.  

Does this recommendation seem reasonable, given my circumstances, or do you believe I should be requesting more at this time?  

Thanks for any input you can give me!  I'm not totally worried at this point, but it makes me wonder if I should be insisting more be done or wait the 6 months.  

Thanks,

Joanne 

Anonymous

Hello Joanne, i would probably have a second u/s done at another facility to see whether results are consistent, just love when they say "probably", but would take comfort when they say "neg for malignancy". Is your mom positive for Brac ?

pinkrose1958

Springtime, glad to hear your better. I believe in taking care of ourselves with Healthy eating, Exercise, and supplements.

I agree with the others that Mammograms work for some, but those of us who have White Mammograms should be referred for other diagnositic tests.

My mother used homeopathic remedies along with her chemo...she had stage IV colon cancer and is alive today. She followed an Organic Diet. Remission for 7 years.

Springtime

Joanne,  What Joycek said: GET AN MRI!! Sorry, I would NOT trust mammograms or ultrasound if you have dense tissue. At the very least, get an appointment with the best breast surgeon in your area and get a second opinion. Maybe they will want to do an MRI or biopsy. Good luck to you. It is likely nothing, but don't you want to know for sure? 

Pinkrose - Wow! God Bless your Mom!! Yep, I think there is a lot we can do to help create a non -condusive environment in our bodies for Cancer. I read "Anti-Cancer, A New Way of Life" to start and then just took it from there. I also see an Osteopath for help with the supplements and other homeopathic stuff.  

Anonymous

Springtime, love your sentence "there,s a lot we can do to help create a non conducive environment in our bodies for cancer", very empowering when everything seems out of control in our bodies and minds.



If that is your horse, you are a verrryy lucky woman, what a beautiful, majestic animal

208sandy

I am three years out from diagnosis and my last onc appointment in January they told me I have dense breasts - what have two oncs in two different countries been doing - no one thought to tell me that sooner - I was lucky that I had an MRI and this time around a US - frankly it outta be a law no mamos for dense breasts - this is the kind of stuff Komen with all it's pink money should be working on.

suzanneinphoenix

I totally agree with everyone here.  I wish I had pushed for an MRI.  I had "markedly dense fibroglandular breast tissue".  That's why I opted for bilateral MX, I didn't want to still have to worry about dense breast tissue.

kcpups

Thank you so much for your replies!  I'm going to push the doctor to send me for an MRI opposed to Mammograms and Ultrasound from this point forward.  

Thanks!

Joanne 

Springtime

Suzanne - same here. BMX just because I did not want to manage that dense tissue any more, heck, nobody could manage it. That was the whole issue!! No regrets. I persoally had Stacked DIEP in NOLA so kept all my skin and nipples, etc, just got "restuffed" with other fat...

Luan, that book I mention above (Anti-Cancer, A New Way of Life) IS empowering. The whole premise is all the things you can do to create a hostile environment to cancer in your body. The western diet is out! Exercise and serenity is in! I made changes slowly over time, bit by bit.