MRI right after biopsy

Luvspuppies

I am newly diagnosed with DCIS - Grade 3 and if I am reading the pathology report correctly, estrogen and progesterone negative. I was on the fence about lumpectomy with radiation vs mastectomy, so my Dr. suggested an MRI to check the other breast and for other areas of concern, basically in order to help me decide.

The first ultrasound biopsy report stated the tumor was 1.3 cm in size. The MRI report stated a suspicious area 5.7 cm which surrounded the original area. Lymph nodes seem clear. I figured the larger size tumor area was due to swelling and blood inside my breast from the biopsy as the MRI was taken just two days after the biopsy. Now, the Dr. said if I want a lumpectomy, I would have to go through an MRI guided biopsy to see what the rest of the area is and if the lumpectomy would be possible. I didn't want to go through more biopsy so I said I would do the mastectomy. Now I am second guessing myself but how would a tumor grow that quickly and not show up on the ultrasound just two days prior to the MRI?

I also feel that since it is diagnosed as grade 3, I should move quickly, but the soonest I can get in to speak to a surgeon is March 10. Thoughts? Should I try to get in sooner? Does anyone have insight about the MRI report?

LisaAlissa

Hi Luvspuppies!

I'm so sorry you have to be here. And this reply is a bit brief because I have a meeting to get to...but I didn't want to leave you with no replies this morning. So I'll try to be back later. But in the meantime, deep breath. There are other possibilities beyond "the tumor has grown."

First, each imaging tech sees different things...that's why they use different ones. ;-) And many of us have more than one thing going on in their breast. Your "other thing" could well be benign. That's a very good reason to do another biopsy. And whether or not the newly ID'd area is benign,it will give your surgeon more info about what they should be doing.

March 10th isn't that far off. Plenty of time to do the biopsy and consider your plans.

Ask your team how long the tumor they have biopsiedhas been growing. The usual answer is years. Sometimes as much as 10 years. If that's your answer, a few more weeks shouldn't make a difference.

HTH,

LisaAlissa

massa93

Hi Luvspuppies,

My initial biopsy also showed a small area of grade 3 DCIS. I had an MRI done to evaluate both breasts (no lumps, 0therwise healthy, micro calcifications in one small area of left breast only found on routine annual screening mammogram). I talked to 3 different surgeons-2 at large metropolitan hospitals and one at a local hospital. 2/3 advised against MRI, saying it would just worry me more. Like yours, the MRI showed a larger area of possible disease-more like 5.5 x 3.5 x .5 cm. I wanted a mastectomy anyway so this just validated my decision; however, after my unilateral (I would have preferred bilateral but would have had to wait longer for the surgery and just wanted to get the disease out ASAP) mastectomy with SNB the final pathology showed DCIS in a single area, .8 cm in diameter. My lymph nodes looked normal on the MRI and were negative on the sentinel node biopsy as well (4 removed). Hopefully this will be true for you too. My surgeon did say if I had wanted a lumpectomy he would have had to get MRI-guided biopsies of the larger area that showed up on the MRI. Nothing showed up in my right breast.

Good luck!

Luvspuppies

Thanks for the replies! I was able to speak to a surgeon and she thought the MRI was most likely due to the biopsy as I had a lot of swelling and bruising, and thought the lumpectomy would still be possible. Massa93, may I ask why you chose mastectomy over lumpectomy? I am still considering it mostly to avoid radiation. They have my permission to go ahead with mastectomy if they can't get clear margins

massa93

Sorry for the delay-I wanted mastectomy from the initial diagnosis because I am a very anxious person and knew I would worry more about recurrence. Plus I am fairly small breasted and I thought that the lumpectomy plus radiation might result in a pretty deformed-looking breast. I am having the reconstruction surgery tomorrow-exchanging the tissue expander for silicone plus some fat grafts. Hope your procedure goes well!