Has anyone had an MRI miss their cancer?

oceangirl654

I'm done with treatment now and I'm just wondering about the future. I'm wondering if I have MRIs am I going to be totally safe going forward. They seem to catch everything. But has anyone had an MRI miss their cancer? Thanks for letting me know!

leaf

I haven't had a false-negative MRI, let alone any breast MRI. But there are MANY different settings on an MRI machine, and different MRI machines have different strengths, so one breast MRI machine or study may or may not be comparable to another. There are things like contrast enhancement, which some MRIs don't have. The physics is beyond me, and its too complicated by my brain. I think the false negative breast MRI rate is quite low, but it is possible.

I also don't know if these studies are representative of expert opinion, or how much controversy there is about MRI false negatives.

This study showed a zero false-negative rate. http://www.ncbi.nlm.nih.gov/pubmed/25454098

This study showed a (roughly) 20% underestimation rate http://www.ncbi.nlm.nih.gov/pubmed/25148176

This paper cites one false negative MRI (figure 18) when there is a lot of 'background parenchymal enhancement' (which is a high background level). http://pubs.rsna.org/doi/full/10.1148/rg.341135034

There is little in breast cancer that is 100%. There is not a perfect screening tool, as much as we want one. There are always exceptions. But we do the very best we can.

oceangirl654

Thanks- this is helpful!

labelle

My pre-surgery mammogram with contrast showed DCIS. Final pathology showed none. MRI showed tumor to be 1.5 cm, it was 7mm (exactly what the radiologist who did my needle biopsy said it was) at the time of surgery. But my MRI also showed no node involvement. 1 node was found to be cancerous at time of SNB. MRIs are a good screening tool, but far from perfect. Nothing is, unfortunately.

SpecialK

Pre-surgical MRI (with and without contrast, done at a breast only imaging facility) missed my axillary half centimeter tumor, but did see the 2cm tumor in the breast. So I batted .500

Edited to add:  The 2cm tumor was palpable but missed by mammogram, plainly visible on ultrasound.  Imaging is not perfect and this is often why different modes are employed before biopsies are done and surgical decisions are made.  Each type of imaging uses a different methodology and may show different, or enhanced, pictures of what is happening - or may not see things.  That is why diagnosis is made by biopsy, and final pathology info comes after surgery.  I have a personal history of imaging not showing issues - it is one of the reasons I did not opt for breast conserving surgery.

Moderators

All the screening tools - mammogram, ultrasound, palpation, MRI, and others, all see/find different things in different types of breast tissue. They are tools but none are infallible and that is why a biopsy, if warranted, is the strongest diagnostic tool, and biopsies are not 100% perfect either. Technician skill, quality of equipment and power used are all factors.

The Mods.

Bounce

Hello Mods

If possible please elaborate on "the question of too many MRIs being a risk factor, as with X-rays,".

I thought MRI's did not use radiation of any type and were risk free.

Thanks

Bounce

jenlee

Bounce,

good question, I was just thinking the same thing...

Moderators

Oops!, Thanks Bounce and Jenlee for your question.

We confused MRI's with CT's.

Our bad! We've edited our post.

Best wishes to you all,

The mods.

oceangirl654

I know that the contrast dye that they put in with an IV might not be the healthiest thing to put in your body. But is the magnetic field ok? I hope so! With my diagnosis, nothing showed up on mammogram and ultrasound by the techinician. It was only by chance that the radiologist decided to have another look on ultrasound right before I walked out the door and she found something. My breasts aren't dense so an MRI wasn't called for, but there was a tiny area of dense tissue on the mammogram and that is where she found the cancer. I don't know if she looked there especially but she found it almost right away. Then she ordered an MRI and they found a second area of cancer in the same breast. There was a third suspicious area on the MRI as well, but it turned out not to be cancer after the surgery. I kind of wish I'd had that area needle biopsied because now I had a lot more tissue taken out there than necessary, behind my nipple

MRI does seem to be the way to go if you're high risk though. Mammogram only finds something like 30-40% of cancer- that is pretty pathetic in my opinion. MRI finds 95% from what I last read.

snorkeler

The literature from the imaging center I go to says that MRI is sensitive starting at 4-5mm, which explains why the pre-op MRIs I had (breast and chest, with and without contrast) missed the 1.5mm micromet in one of my sentinel nodes.

Moderators

Sorry for the confusion folks. We made an oversight in our post and instead of furthering the confusion, have removed the incorrect post and subsequent posts referencing it.

For any questions about these types of tests, what they show and any risk involved, please visit the main Breastcancer.org site's pages on Breast Cancer Tests: Screening, Diagnosis and Monitoring.

We hope this helps and again apologize for the confusion!

--The Mods

crazystupidbreastcancer

I did. I had two primary tumors in the same breast. One of them was invasive ductal carcinoma. The other was DCIS. The DCIS tumor showed up on the mammogram but not the MRI. This was in May 2013. The breast surgeon and radiologist thought that the DCIS must have been benign, since MRIs are supposed to have higher specificity than mammograms and ultrasounds. They also didn't trust the results of the mammogram because I have very dense breasts (I was 23 at the time).

Anyway, I did 8 rounds of chemo, and did a post-chemo breast MRI in October 2013. The breast surgeon and radiologist could not see the IDC tumor. Since I was planning to have a lumpectomy, my surgeon wanted to do a mammogram to see if I could do a wire-guided lumpectomy. The mammogram did not find any signs of the invasive ductal carcinoma, but it did find linear calcifications which are indicative of DCIS. One week later, I had a stereotatctic biopsy. And the results came back as DCIS.

We asked my breast surgeon how did the mammogram catch the DCIS, and not the breast MRIs? She said grade 2 DCIS tumors can be hard to detect with breast MRIs. Also, she said the DCIS could have not been large enough to be detected by the MRI.

farmerlucy

I had a 1.1 cm IDC show up on a preventive Mx, a pre-biopsy MRI showed a mass of that size but a wired guided excisional biopsy showed ALH and ADH. Thus either it was missed in the biopsy or missed in the MRI. In any case it is outta there

JohnSmith

Someone above mentioned "parenchymal enhancement". This appears to be the technical term for the MRI findings discussed in the following news article called: "MRI Might Predict Breast Cancer Risk in Some Women"

Women at high risk of breast cancer often have routine MRI scans to try to detect any tumors early. Now a new study hints the scans might also predict which women are most likely to develop cancer in the near future.

gkodad

After two bouts with IDC, and multiple "all clears" on mammograms and ultrasounds, MRI found my ILC when nothing else revealed a problem.  While not perfect, my understanding is that the false negative rate is quite low.  They do provide higher false positive rates, which can lead to unnecessary biopsies and anxieties. 

dlb823

I did -- after one lesion had been found, but when they were checking both breasts to see if there was anything else going on. But it was clearly the fault of an inexperienced local imaging center/staff because it was picked up on a better MRI when I went for a second opinion. The whole experience is detailed on my bio page. Just be sure you go to a very reputable medical institution that preferably specializes in breast cancer -- not some local place that just bought a breast MRI machine and has techs who don't know what they don't know.

I also just read a post on another thread about the dye contrast possibly being more of a problem than previously believed -- something about it accumulating in our heads. Sorry, I didn't note the thread, but you can probably search for it here with "MRI contrast dye," look up the research, and ask your onc or BS. (((Hugs))) Deanna

oceangirl654

Does anyone know if their tumor showed up on the MRI without the contrast dye? I wonder if you can skip on the contrast dye since it's probably not good for you.

MandyP

They use the contrast to watch the uptake of the area. That can help determine a bad lesion from a harmless one. I've had quite a few MRI's and while the contrast can be hard on your kidneys, I don't refuse it. I have healthy kidneys tho and just drink a ton of water after to flush everything out.

lulu2533

My pre surgical MRI showed no ax lymph involvement. After my bmx this past Tues, I know I have at least 1 node involved.