Mammograms after Unilateral MX

40wDCISnowIDC

Reading the Times Magazine piece has me very stressed out about undergoing unilateral MX for DCIS in a matter of days.

Going forward, when screening on the remaining breast, will I be able to demand sonogram?  Mammogram missed one area of DCIS so I went from a planned lumpectomy to a planned mastectomy - a sad and dramatic difference in the surgical plan. Only the MRI picked up the 2nd DCIS before surgery. For me, mammogram wasn't enough.  I'll want something better for the next screening.  What should it be?

Thanks

mrenee68

I don't have an answer for you but I feel your stress. In July I will have my first mammogram since my unilateral MX. I'm starting to feel the stress worrying that they will find something and I will be in the same boat as last summer. Hang in there and do whatever works for you.

ballet12

40wDCIS--that's a tough question. And the NYTimes article also shook me up a bit, not that I didn't know that mammos had significant limitations.

I would say that, at a minimum, you should have a sonogram in addition to the mammo.  Your surgeon or oncologist may also recommend MRI.  Mine isn't going to do that.  She was actually just going to have me do a mammo, but I reminded her of my very dense breasts (she broke a scalpel during surgery on my breast!), and she added the sono. I did also have a follow-up MRI recently because of an area of concern on the contralateral breast, but it's now been down graded to BIRADS 2 (from BIRADS 4 at another institution and BIRADS 3 at my current treating facility), so I won't be having serial MRI's.  It's all a bit anxiety-provoking, for sure.  I was told by the surgeon that the mammo is good at picking up calcs and the sono is good at finding small tumors.  Maybe you can get an MRI, especially since the MRI picked up the additional DCIS in your case.  I'll never know if I had more, just hoping the Rads got it.

You might want to get a sense of the risk of recurrence to the other breast.  That might help you as you address further screening issues.

bluepearl

No use worrying. After two mammograms, second primary showed up in contralateral breast...smaller than first, but a bit more aggressive. The worrying didn't stop it from happening (I also declined tamoxifen the first time...not now). It's scary going for follow-up...even now I'll have to go every six months for a palpatation to scars etc....no more mammograms though....but worrying just takes the "good" out of the days you spend worrying and it accomplishes nothing. Strangely, the second sucker punch isn't as bad because you kind of know the path and pitfalls now...and you know you cannot control everything that happens to you so THAT burden is removed. I was also more informed and made, what I think, were better decisions but STILL not in control because after two months, I still don't know the hormone status of tumor!!! (which influences treatment decisions and I am close to the time when chemo won't be of any use if I need it....go figure.) 

LAstar

What grade is your DCIS?  I read some research about MRI being better for determining the extent of high-grade DCIS, and it did do that for me.  I had high-grade DCIS that was too extensive to be removed with two lumpectomies, so a MX was my only option (watch-and-wait was not an option to me).  That Times article had great points but over-simplified the DCIS issue.  I hope MX is an outdated treatment for DCIS very soon, but I'm not waiting around until research catches up!