MRI to chase down any other affected areas

Ausbear

Hi all,

After a lengthy process that started with a routine screening, a lump was identified in my right breast - not by mammogram but by ultrasound. Several biopsies later, I got my diagnosis yesterday and am in full planing mode to eradicate this from my body. I'm 41 and the cancer is very small which is a very good thing.

My only concern right now is that there could be other very small affected parts that cannot be detected via ultrasound.

I have elected to get an MRI to investigate further but want some advice on whether people have had good success with this and if it changed their treatment or surgical options.

Cheers

SummerAngel

I think it's generally a good idea, even though an MRI can identify areas that look suspicious but turn out to be nothing. I had an MRI after I was diagnosed with IDC in my left breast and it found a 1cm tumor of IDC in the right that was invisible on the mammogram I had just a few weeks prior. It absolutely changed my treatment plan because the MRI not only found the second tumor, but it lit up many areas of concern in both breasts and I was basically told that I should have a BMX.

LisaAlissa

if your surgeon wants an MRI as part of his planning, I'd go with it. I did when my doc wanted one. She didn't find other lesions, so we proceeded as originally planned.

Seemed like a good idea to give the surgeon all of the information they want.

HTH,

LisaAlissa

SpecialK

My 2.6cm, very palpable, mass was not seen on routine (annual) screening, so was immediately followed by US, which showed it, but was not clearly seen as a cancerous mass, just an abnormality. I had hollow core needle biopsy with a breast surgeon, the mass was determined to be both DCIS and IDC, and the surgeon ordered a pre-surgical MRI. The MRI did not show any additional concerns in the breast. I elected BMX even though my BS did offer lumpectomy, because I had a long history of breast issues and mammography was not reliable for me. It turned out that I had both ADH/ALH in the non-cancer breast so I felt I made the right decision. Unfortunately the MRI did not show my positive nodes - it is important to know that every imaging method has potential limitations - both false positives and false negatives. Even though the MRI did not show the nodes it did not change my systemic treatment - I was having chemo regardless - but I did require additional ALND surgery five weeks after my BMX. Wishing you the best!

Ausbear

Thanks all for sharing your information

SummerAngel: The fact my lump is so small makes me highly suspicious there are tiny bits in there that are hiding. I'm already thinking about a double mastectomy to reduce my chance of future cancer and will be taking any advice from the surgeon about this.

LisaAlissa: Great to hear you didn't have more lesions!

SpecialK: My lump was invisible in the mammogram and at first, everybody thought it was a fibroadenoma as it is very hard and moved around during the two FNA and one Core Biopsy I had. Great advice about the limitations of the imaging, Ill keep that in mind.

My radiologist is awesome, he has been so informative and despite the huge shock this news is, he has personally provided very detailed information about all the possible scenarios my diagnosis presents - so I trust that he would not suggest it if he thought it was not worthwhile.

Italychick

My breast surgeon insisted on an MRI before my lumpectomy and the MRI for me was spot on, no false positives. She said it enabled her to get the lump out with wide margins because she knew exactly what tissue to take out. I am doing a follow up breast MRI next week because my surgeon said at this point a mammogram wouldn't find anything, it would be too small

vbishop

Ausbear -

You mentioned that you are concerned about the cancer spreading (who isn't) but I don't see where your doctor has ordered a sentinel node biopsy. If the cancer has not spread to the nodes, odds are it hasn't spread outside the breast. An MRI or PET scan is a nice precaution just in case. Of course it is normal to worry about such things.

Re: BMX, in my case, it wasn't an option. I understand the knee jerk reaction to just lop em off and get rid of the all risk. However, I suggest you check with your surgeon and oncologist before making a final decision. The breast cancer medical community in general are shying away from BMX unless medically necessary or in cases such as SpecialK who has a history of breast issues.

BMX is pretty final...you can't change your mind later. Don't rush this decision. You have time.

Good luck!

gerrib

I had a breast MRI to get a better picture and it showed another small area of ILC in same breast. it is not Medicare or insurance rebatable in Australia but I consider it AUD$350 well spent.

i could not face having another core Bx and waiting around for more results so am having a umx on Wed.

ElaineTherese

vbishop is right about thinking long and hard about BMX. Once your breasts are gone, they're gone. Even though I was Stage III, I was happy that chemo wiped out my active cancer and I could get a lumpectomy. There are more potential complications from a BMX than a lumpectomy, and even more possible problems if you decide on reconstruction. Plus, while your new boobs might look good, they will never have the sensation of the real thing.

vbishop

@gerrib -

I was told that with our type of cancer, ILC, odds are good that the cancer is in the other breast or will be at some point. Couple that with the fact that ILC does not always show up on imaging, it is not uncommon to have a bmx. So your decision to have a bmx, considering the type of cancer, makes sense.

Ausbear was diagnosed with IDC. Different beast altogether and, in my opinion, more treatment options.

Some docs lump the two types together and treat as one tyoe. Lucky for me, my oncologist does not fall into that group.

Heathet

I'm going for my MRI tomorrow. Does any one know how long the test results usually take? I'm hoping my doctor will have them this week . I'm not sure what stage my cancer is but it is a grade 3 so I'm worried about it growing. It's a pretty large lump and I'm ready to have it out !

slg76

MRI results typically take a day or two to get back, depending on how quickly your facility makes the phone calls. I just had an MRI Tues evening and I got the results Thurs morning. I know it's hard not to panic and my first instinct was also to hurry up and get it out. But remember that it's been there a long time so a few days/weeks to make decisions and get a thorough diagnosis is okay. My original mass was almost 3 cm and I could see it in the contour of my breast. In the end I did chemo first and the mass shrunk and I was able to have a lumpectomy that didn't distort the shape of my breast. That was 5 years ago I hope that your treatment goes smoothly and that you get your MRI results quickly...I do think waiting and uncertainty is the hardest part.

ClarkBlue

Heathet - I had an MRI on a Friday night at 11pm and they called me back the following Monday and had me come back for another biopsy the following day. Should be pretty quick.

LisaAlissa

Hi Heathet,

Unless a pathology report finds some IDC to go along with your DCIS, it doesn't matter how large the lump is, at least for purposes of determining Stage. DCIS is always Stage 0.

The Grade 3 means it is more likely that there might be some IDC. At least more likely than if your DCIS was Grade 1.

HTH,

LisaAlissa

Ausbear

Hi Ladies,

Since my earlier post, my pathology report has come in and I have more info. Here goes:

There is a node near the cancer mass that was biopsied by FNA at the same time as my Vacuum Assisted Core Biopsy of the mass. It is borderline suspicious and will be removed during surgery. I will also be having a sentinal node biopsy. Which I should have mentioned earlier vbishop, my bad.

I have In Situ and Invasive Ductal Carcinoma which is e-cadheran positive. The Oestrogen + is 90%, Progesterone + is 80%. HER2 is 3+ and a SISH test is being done.

Vbishop and ElaineTherese, I have found out more about mastectomy and now understand what is involved. It has changed my mind and now I realise that it was a knee jerk reaction. I've had some wild thoughts running through my mind! I'm much more informed now

gerrib, hello fellow Aussie! Wow $350 is a bargain, it was going to cost me $550 and I have already spent more than $1500 on imaging with only a bit of that back on Medicare. I was advised by the Clinical Nurse Consultant at the hospital to wait and see if the surgeon recommends it and it will then be free.

I'm guessing now that if I have Chemotherapy it will blast all the cancer cells left in my body, which would mean and MRI, (knowing the limitations and benefits), would essentially be redundant. Please correct me if this is wrong.

Next step is snagging an appointment with the surgeon, who only does consultations on Fridays and you guessed it, Easter Friday is looming. I really want to get in this week or it will be a big wait.

Thanks so much to all of you who have chimed in, I know so few people in my circle of friends who have had breast cancer and don't really have lots of people to talk the specifics with…

Cheers

vbishop

Ausbear

So happy you are on your way in getting the treatment plan in place. I am sure you now feel somewhat in control and more empowered. Mx or bmx may still be a treatment option, but now you are armed with more info to make a more informed decision.

Listen on your docs, but at the end of the day, the finsl decision is in your hands. Go with you gut instinct

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