MRI

sarajaneevans

Hi Ladies, and husbands too- I am wondering if it's pretty standard procedure to have an MRI ordered before surgery- if so why is it done, if not, why do some surgeons want it and others do not require it...

Thanks, sje

Dyvgrl

I had one done to ensure they could see everything as I have very dense tissue. Turns out they found 3 other questionable areas within the same breast and verified via ultrasound. I could have done biopsies on these areas but decided to opt for mastectomy instead. Basically, the MRI results changed my surgical plan and may have prevented a recurrence. Who knows, but in my opinion it's better to have more information than less.

Colt45

What kind or surgery are you having? My wife had an excisional biopsy that showed malignancy and so she had an MRI before the re-excision to see if there was anything else to take out... and to check the other breast.



Maybe they are just trying to make sure they will be getting everything out when they do the planned surgery.

sarajaneevans

My diagnosis is IDLC- Left breast- I have atypical cells in the rt breast- so will have a Jwire biopsy the day of my surgery- The surgeon I have chosen was my second opinion- he did not mention an MRI- but he didn't mention any of the pre-op tests necessary before surgery for that matter- it seems that many here have had an MRI before the surgery- my first opinion surgeon said that I would need an MRI - the fact that the surgeon I have chosen did not mention it just has me thinking.  Is it a standard order of procedure, if so, for what purpose-- I don't mind one way or the other I am just curious- I know that each patient is an individual, and that each surgeon has their own method of treatment...

I am scheduled for a Left Partial Mastectomy W /SNCBx; Right Breast Biopsy W/jwire

I'm concerned about the fact that this cancer is not detectible on a mammogram - I have yearly check ups-but it apparently has done little good-my surgeon said this lump has been growing probably two to three years-and is only detectible by self exam when it has gotten big enough to feel on self exam- one day it was not there, the next it was- he said even as large as it is, it was still hard to read on the mammogram..

sarajaneevans

Thanks Dyvgrl- and so the questionable areas were not picked up on the mamo, but they were through the MRI? I agree that we arm ourselves with as much info as possible..

Jelson

I don't think MRIs are standard because they are expensive (in the US!!!) and many insurance companies balk at paying for them. I wish I had known about them before my lumpectomy for DCIS, although as it turns out nothing would have changed for me. When I learned after my lumpectomy about MRI's I asked for one - my thoughts were: more information about the breast with DCIS and the status of the other breast. The lumpectomy surgery - being recent, obscured some areas of the lumpectomy site but it basically looked ok - My lump was not detected by mammo, so why believe that nothing was brewing in the other side? but according to the MRI it was clear - so I proceeded with radiation.  going forward, I get one mammo and one mri every year now.

netty46

The MRI lets them see what they are working with.  If its down in pectoralis, if its in the nodes, ribs, etc.

If you had chemo before surgery its shows if the tumor has shrunk.

AnnBR

sje, I don't have the answer as to why some doctors request MRIs and others do not, but my oncologist typically orders them. My tumor was difficult to detect, so I was relieved when she ordered the test. I was also nervous about it because I was afraid of what it would show (like cancer everywhere). I know that was silly, but I had just been diagnosed and was still processing everything that was happening to me.



Ann

sarajaneevans

AnnBR-It is not silly, or if it is, I am standing right behind you- this is exactly where I am right now--My surgeon said my tumor had likely been progressing for 2-3 years- this kind of tumor does not show up on a mammogram -it is first noticed when large enough to be felt by self exam-- so I think it is logical to be concerned that it might be everywhere so not silly to me all...glad your worries were not confirmed.. I feel better now- thanks for the response.......

wenweb

For me, the MRI let the BS know that a second questionable area did not need to be excised.  They also checked to see whether there was anything in the other breast that did not show up on the mammo.

sarajaneevans

I'm wondering if MRI'S might be better than a mammogram at detecting early breast cancers? I know they are expensive-but I wonder in the long run  if the expense might be less especially with concern to human lives?

AnnBR

sje, I've wondered that too and I'm sure it's a cost issue. MRIs take longer than a fairly simple and less time consuming mammogram but they are much more accurate. My breast surgeon warned me that MRI's pick up everything, causing a lot of false positives which lead to uncessary biopsies. To me that didn't matter since I was going to have surgery anyway. I'm just thankful my oncologist ordered the test.



Ann

ironmagnolia

After several mammos and US of both breasts, I was diagnosed with IDC on the right. My BS said she always orders a pre-op MRI so she knows everything that is going on in BOTH breasts before she goes into the OR and sent me for one before my Rt lumpectomy with rads to follow.

Well, diagnostic mammo and US did NOT find the LEFT IDC, but MRI sure did! And it was even LARGER than the tumor on the right. Game changer for me. Seems I now fell into the 3-5% of women diagnosed with BC who actually have bilateral or synchronus BC. I had BMX with recon in March.

Later my BS told me she presented my case to a group of physicians recently and created an uproar (her words) because pre op MRI is NOT the standard of care due to not being considered cost effective. Until then I assumed it was a standard procedure.

I don't care what anybody says, my BS saved my life by ordering my pre op MRI.

Anonymous

Another option pre-surgery, rather than an MRI, is a BSGI (breast-specific gamma imaging) test.  It works kind of like a PET scan does, but only focuses on the breasts.   It's a lot cheaper and quicker than an MRI and picks up even very small DCIS cancers.  It's done in the nuclear medicine department of the hospital and, basically, you have a little of the radioactive-isotope-tagged glucose inserted IV, wait about 10-15 minutes while the cancer cells suck that stuff up (they are much more active than regular cells) and then sit in a chair while a mini-mammogram-like camera images each breast and your axillary areas.  Not much pressure--way less than a regular mammogram.  The hardest part is that you have to sit still for about 10 minutes per picture they take.  I left the hospital with my own copy of the films on CD and it was reeeaalllly obvious where my cancer was (and also very interesting--especially the color enhanced picture). It was also really obvious that it was the only thing like that in either breast, and also showed nothing in the axillary region.  It basically looks at the cancer at the moleular level.

It's a fairly new test and I don't see a lot of them being given, as I read on these boards, but my surgical oncologist thought it was a great alternative to the MRI, especially for those who are a little claustrophobic (like me!)