Is a Mammogram needed after BMX for DCIS??

Leesamarie

Hello Ladies,

I've just passed the 2 year date of my skin-sparing bilateral mastectomy for DCIS. Last year at my 1 yr check, my GYN said he still wants me to have mammogram screening because I still have residual breast tissue, lymph nodes and skin. My BS disagrees and says there is no need for any type of screening. He says in the remote chance of a recurrence, it would be palpable under the skin and regular self exams and annual physicals are enough. I'm not sure which advice to go with. I'm curious to know what other BMX ladies have been advised.

LAstar

Did you have reconstruction?  If so, what kind?  Are you seeing an oncologist?  My BS also said that I will need no imaging at all.  I just got the standard reminder card from radiology reminding me that it's time for my annual mammogram.  I asked them to take me off the list! I had flap reconstruction and there is no way they are squeezing these babies.  

Leesamarie

Hi LAstar, I have silicone implant reconstruction. I saw a MO & RO at the time of my diagnosis, but after my BMX the BA said I didn't need to see the oncologist further, unless I wanted to for my own peace of mind. However, this past summer I was sent back to the MO by my internist after bloodwork from a physical showed a very low white cell count. After an extensive exam & Q&A session, she determined I was fine. I'll go back soon for a follow up with her just to be conclusive, & I'll ask her about the mammogram issue.

Beesie

Leesamarie, I had a single MX with implant reconstruction.  For years I never had a mammo done on the reconstruction side but the last time I went in for my annual mammo for my natural breast, the tech told me that they were now doing mammos on implant reconstructed breasts. Since my doctor hadn't ordered a mammo for the reconstruction side, she gave me the choice on whether I wanted it done or not.  I decided "why not?" but I reserved the right to stop it if it got painful. I was curious more than anything about how it would be done and whether it would hurt. It turned out to be perfectly fine, no pain and I feel good that I was checked. 

So are mammos necessary after a BMX?  I think most docs would say no but there have been a few women who've come through this board who've had them done.  Now that I've had one and it turned out to be so easy, I plan to continue to have them. 

Leesamarie

Thank you, Beesie, for your response. I learned so much from your very knowledgeable posts throughout my diagnosis & decision making 2 years ago. I appreciate the time you take to share your experience with all of us.



I'm curious as to what type of implant you have. Mine are silicone, so as much as I usually have the "better safe than sorry" attitude, the silicone makes me uneasy about the possibility of rupture of an implant. I'm considering inquiring about MRI screenings, which I seem to remember them saying is how they check silicone implants for leakage anyways. DCIS does not show on MRI's, from what I was told, but surely there are no ducts left now anyway...right??

owlwatcher

At one of my last appointments with ps he told me to have a mammogram after 1 year then every two years after that. I assumed that was to check for ruptured silicone implants. I too am paranoid about any squeezing that a mammogram might do.

dogsandjogs

When I had my silicone implant, the surgeon told me I would not need mammograms on that breast, only on the other. The reason he gave was "You have no breast tissue left.

Now this was many (30!) years ago, but since then nobody has recommended them.

SpecialK

I had BMX with silicone implants - no recommendation for mammograms.

Nanam

I was told mammogram for non cancer side every year and physical exam every six months for the cancer side. However, I found a lump in my cancer side just before the exchange surgery last week.  A mammogram, ultrasound and needle biopsy were prescribed.  I thought, good luck with a mammogram, but it turned out to be OK.  Seemed to me they didn't compress as much as they did before.  It turned out it was a cyst between the expander and my skin so it was drained and my surgery went ahead.  I also had a biopsy a few months ago on the non cancer side for a lump that turned out to be fat necrosis from breast reduction.  So my take on it is that mammograms don't really seem to do any harm.  Have them or not but know that you will need one if anything develops that needs further investigation.  

JLH64

I hope folks are still reading posts for this topic.

I wanted to comment on something in one of Leesamarie's posts: an MRI is able to show DCIS - or at least enough of something that would warrant a biopsy.

In November, my mammogram showed some calcification in the right breast. They biopsied the spot and I was diagnosed with LCIS. Because I had dense breasts, the doc ordered an MRI to make sure they weren't missing anything. The right breast showed the same thing as the mammogram. The left breast, however, showed a spot that was not on the mammogram. This spot was also biopsied. Ten days after my LCIS diagnosis I was diagnosed with DCIS in my left breast. Ultimately, I had a BMX in January.

I've asked my doctors about whether I still need my annual mammogram. I'm getting mixed recommendations.

My breast doc and primary care doc suggest that an annual mammogram would be a good thing to get, since I still have breast tissue - even if it's just a minuscule amount. My BS and oncologist say that it's not necessary. I have not yet asked my PS.

My PS did tell me that the FDA recommends MRIs every 3 years to check the integrity of the implants. I would assume that this would show something.

My BS said that I would see her annually in lieu of getting my mammogram. I'm not sure how her pallpating me would allow her to detect something. I'm leaning towards getting a mammogram, if only to give me peace of mind.

The breast clinic I go to has mammography equipment specifically for reconstructed breasts. I don't believe this type of mammogram squishes the breast. It will be a nice change to have a mammogram that doesn't hurt!