Difficulty measuring size/shape/location of cancer?

glowing_light

Hi all -- my mom was diagnosed this week with IDC. (And apparently also a little DCIS and LIS? Still learning all this.) It was spotted just through some architectural distortion on a screening mammo. She then had a diagnostic mammo and an ultrasound , and then the biopsy. After the biopsy we changed to a new hospital (NYU Langone Cancer Center in NYC); she did an MRI yesterday, and after all this they're still having trouble seeing/figuring out the dimensions of the tumor. They now want her to repeat the mammogram and ultrasound to see if the NYU radiologists can get more information.

Just wondering if anyone else had this kind of difficulty locating and measuring a tumor due to dense breasts, and how it was handled. I'm also wondering -- if they're having trouble seeing a tumor we know is there, are there issues down the road with detecting any new cancer? Should that impact my mom's decision whether to have a lumpectomy vs mastectomy? Thanks for any info you can provide -- this is all so new.

Moderators

Hi Glowing-

We want to welcome you to our community here at BCO. We're so sorry for what brings you here, but we're glad you've found us, and hope this community is a source of support and information for you and your mom throughout this journey.

We're sure someone from our very knowledgeable community will be around shortly to offer their advice or experience, but in the meantime, we also wanted to direct you to our forum for Caregivers, Family, Friends, and Supporters. It's a great resource for our members who're supporting a loved one through breast cancer.

The Mods

dtad

glowing light. Dense breasts are tricky especially with lobular cancer. It sound to me that they are doing everything right so far. MRI's are the best tool for detection in dense breasts. Good luck to you guys. Keep us posted.....

Lumpie

hi glowing light - I have very dense breasts. My tumor was estimated to be 1.7 cm via mammography and ultrasound. Turned out to be 2.5 cm upon excision @ 2 weeks later. I also had two small satellite tumors that were not picked up on mammogram or ultrasound. I asked the surgeon whether she thought the discrepancy were owing to the limitations and imperfection of the technology, actual tumor growth or some combination. She was very confident that it was owing to a the inherent limitations of the technology. It's just not perfect. This seems plausible to me because I happen to work in an office that performs a great deal of ultrasound. It's great but it's not perfect. There are limitations to this technology. Unfortunately, my margins were positive so ... more re-excision surgery for me. We have not done an MRI. I am not confident that an MRI would provide net/net benefit in my particular (post-op) case. But some docs certainly deem it useful. Your mom will probably hear A LOT about the cosmetic aspect of her surgery choice. I sure have. It might be beneficial for her to give careful consideration to how important this aspect of therapy is to her so she can incorporate it into her decision making process. If I had choices and had my lumpectomy to do over again, I would find a surgery center that offered some tool for intraoperative assessment of margins. From studies I have reviewed, this can cut the need for re-excision by 50%. Improving the likelihood that I would not have to re-do the surgery would be BIG.

All the best to you and your mom!

glowing_light

Thanks all. The MRI unfortunately didn't tell us anything other than the tumor may be bigger than they were expecting and an unusual shape -- they said it's enhancing in a sort of sheet shape across the breast? They're doing the additional tests on Wednesday (just in time for an extra-tense Thanksgiving!), and then my mom will have to decide whether to have the lumpectomy or mastectomy.

And Lumpie, that's helpful to know, thanks. Our doctor is apparently one of the ones using the margin probe scanner, so we'll talk to her about that on Wednesday.

Brutersmom

glowing light. You will know better after surgery. The initial diagnosis for me was 1.7 architectural distortion. It did not show up on the ultra sound. They did a biopsy and confirmed the CA. The Surgeon believed the cancer was really 2.1. When the surgery was all done it turned out to be smaller because there was an area of fatty necrosis. Hang in there. I sounds like you and your mom are making some good decisions.