Mammogram, ultrasound, MRI

Nancdancer

so had mammogram, ultrasound on both breastand biopsy just on right breast came back positive for cancer in right breast. When I met with surgeon she wanted to get MRI to confirm it did not travel to left. Got letter in mail saying found abnormality but did not mention which one. Is it possible not to see it on mammogram or ultrasound?

kcat2013

I had several tumors found by MRI that were not seen by mammo or ultrasound. But not every abnormality seen on an MRI turns out to be cancer. Sorry you had to join us here, but hopefully it will be a place of encouragement!

Kendra

ddbaker

I had mammo on 3/17/15 with ultrasound right after. ultrasound shows dense fibroglandular pattern with mild distortion of architecture and areas of posterior acoustic shadowing. Radiologist recommend I have an MRI. I had to wait 30 days for the MRI because I have been on HRT for 10 years (I am 42) and had to be off of it for 30 days. I stopped the HRT and MRI is scheduled April 18. My questions is, will the radiologist or MRI tech be able to tell me anything? I have heard of radiologist informing patients of abnormal MRI results.

MelissaDallas

I think it depends on the facility. I was talked to by the radiologist after abnormal DIAGNOSTIC mammogram and during ultrasound, but they never talked to me after MRI.

ddbaker

Could you tell me a little about your path to your diagnosis? What were the concerning terms on the mammo/ultrasound? What kind of imaging have you had and what kind of biopsy? I really appreciate your reply!

eaglemom

I found a lump on my breast last fall and had a mammogram and ultrasound in November. I have very dense breasts and the mammogram did not show the lump. The ultrasound showed it but was inconclusive as to what it was. My doctor referred me to a surgeon and for an MRI. The surgeon told me he was pretty sure it was a fibroadenoma but scheduled a biopsy for after the MRI. We didn't have results from the MRI at the time of the biopsy and my surgeon said he still thought it was benign when he removed the lump. The results of the MRI showed the tumour as probably malignant and the biopsy confirmed IDC, grade 1. So, in my case, only one of the 3 non-invasive diagnostic methods showed my cancer.

Nomatterwhat

Yep, been there/done that!!!  My MRI showed a small lump in my right breast and micro-calcifications in the left breast.  Both the mammo and ultrasound were inconclusive.  The stereotactic biopsies I  had showed DCIS which called for a lumpectomy.  However, when I woke up from the lumpectomy, both my BS and DH were standing over me to tell me that the blue dye showed that my right breast was 98% full of cancer.  My pathology report showed "large and bizarre formations with signets".  I didn't have much of a choice and with pre cancer in the left my BS said I would probably be back with cancer in that breast in 3-5 years, so I decided to have a BMX. 

ddbaker

My area of concern is hard to detect as well due to dense breasts. Tomorrow is step 1, with the MRI, then it will be more waiting. I initially thought that since I had to wait 30 days for the MRI it must not be serious. But I am not sure if that is accurate. Hormone replacement therapy can alter the MRI picture. After reading and doing research I have decided to proceed with biopsy most likely whether it is recommended or not. It sounds like ILC is slippery to detect. I appreciate all of the responses, it helps with the waiting.

ddbaker

I initially thought since my BiRads score was 0, that I was in the clear but from what I have read that isn't correct. Has anyone had a pinching/squeezing sensation behind the nipple and into the area where the BC was found? I do not have any dimpling or retraction.

NATSGSG

I've had all three, indicating tumor. MRI IS THE MOST ACCURATE of all.

Ultrasound showed 2.6 cm tumor size. MRI showed 2.5 cm tumor size, and Mammogram showed 3.0 tumor size. Biopsy was done within a week of tumor identification to determine if it was benign or malignant. The sooner it is done, the better, esp if one's cancer is of the most aggressive grade like mine turned out to be.

Biopsy was a 10-15 painless, outpatient procedure. My SO used an ultrasound guided fine needle biopsy to make a 0.5 cm incision to take out 6 cores from various angles of the tumor for pathological analysis. The incision heals within 24-48 hours. Can shower within 24 hours. Please ask your SO to explain his/her method/process to you as I was shocked to read one patient has a 1 inch incision for biopsy when her tumor size was the same as mine.

Pathological report came back within 4-5 business days. That's when my SO and OPS discussed the results with me (please see my PJ Hamel post on how to read your pathology report). We discussed my lumpectomy surgery, SLND, ALND, breast reconstruction techniques and so forth. Mine was Stage IIa, Grade 3, ER/PR-  HER2+, IDC, 2.5 cm tumor. (SO = Surgical Oncologist, OPS = Oncoplastic Surgeon)

During surgery, the actual size of tumor was 2.5 cm. Margins taken out around tumor was 1 cm all around = 1 + 2.5 + 1 = 4.5 cm.

She also took out one 2 cm size sentinel node during surgery. No axillary lymph node dissection consent was given. Thereafter, my Oncoplastic Surgeon (OPS) did my breast reconstructive surgery using the ROUND BLOCK TECHNIQUE. It was an amazing and beautifully conserve my right breast. My OPS said any tumor size less than 5 cm can use this technique if one's breast is large. If not, then neo-adjuvant to reduce tumor size first is generally recommended to preserve and reshape the entire breast. Now, my right breast is one size smaller than my left breast (36D versus 38D), and still looks good. I mean I can wear a bikini still.

The hospital policy at my Cancer Center is to attempt to conserve breast (wherever possible) using the various combinations of techniques employ by Plastic Surgeons unless patient specifically request mastectomy. Generally, if a patient's breast can be saved, they would made that recommendation.

>>> This link has a video explanation of MRI procedures and equipment used:

http://www.cancerresearchuk.org/about-cancer/cancers-in-general/tests/mri-scan

>>> This link below discusses the different Breast Conserving Surgical (BCS) methods suitable for your type of tumor location/size should you choose lumpectomy, and then re-construction. Great to know so you can discuss with your surgeon your option. If they choose a method different from what you want, be sure to ask why and what benefit their method is for your breast, and recovery time, and how it will be affected by other therapy (I am having 12 weeks weekly chemo now, but is supposed to have radiation thereafter for which I am still considering.)

http://www.hindawi.com/journals/ijbc/2011/303879/

 >>> If you like to explore immunotherapy (currently a hot topic in the cancer treatment world as of this writing) that seemingly has lesser side effects than chemotherapy,  please click on this link:

https://community.breastcancer.org/forum/62/topic/831945?page=1#idx_13 

>> If you are interested in reading about my cancer journey thus far, please feel free to visit this link below. Yours will/could be different from mine, of course. It could give you some more idea, and mine is only of many others out there.. 

https://community.breastcancer.org/forum/147/topic/831038?page=1#idx_7

NATSGSG

Update:

This government link has a lot of info on above if you are interested:

http://www.cancer.gov/resources-for/patients

NATSGSG

Hello Again:

There's another method of cancer treatment called IMMUNOTHERAPY, besides chemo and radio therapy. If you are interested in reading more about this method of treatment, here are several links for more information:

(1) This article discusses the progression of using immunotherapy in breast cancer treatment:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3587160/

(2) This article talks about combining immunotherapy with other therapies for better cancer treatment outcomes;

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608094/

(3) This article talks about combining chemotherapy with immunotherapy aka chemoimmunotherapy:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919833/

(4) Below link discusses using our own immune system to treat cancer:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3587160/

(5) This link talks about how immunotherapy can impact how cancer is being treated:

http://www.cancerresearch.org/cancer-immunotherapy/impacting-all-cancers/breast-cancer