Yearly MRI

lola12

Hi All,

It is currently that time of year when I get my MRI scan of my remaining breast. I am 6 years NED from ILC/IDC stage 1 cancer. Unilateral mastectomy and so far no complications with my remaining breast.

I was just wondering if you all still get yearly MRI's? My oncologist left this decision in my hands. My breasts a mildly dense and my original cancer was found with MRI, but I am told sometimes the false positives outweigh the likelihood that something would be wrong.

What is your thoughts? Do I keep getting the MRI as long as the insurance will approve it or is 6 years enough?

Lola

Lily55

I would keep doing them as lobular is so sneaky and hard to find in any other way.......................

wallycat

My oncologist suggested that my twin get MRIs because she had a pre-cancer found incidentally during breast reduction surgery (ADH/LCIS). MRI was the only thing that picked up my cancer even though I had years of mammograms.

Mammos can also give false positives but unfortunately, there's really no screening method that is 100% correct.

Best to you.

Lab-girl

I had the same cancers and UMX as well. I am insisting on MRI. If I ever can't get one I would consider getting a mastectomy on the other side because the ILC did not show on the mammogram

stephincanada

A screening MRI likely saved my life. I would never decline one. No radiation exposure, either. The risk of false positives seems a small price to pay for the insurance that an MRI affords.

Meow13

yes, I still have yearly MRIs, extremely dense tissue.

lola12

Thank you everyone for your responses. You make an excellent point. I guess I was just getting tired of scan worry every 6 months.

Lola.

Meow13

lola, it is hard to get used to being on the lookout for cancer but try to remember if they find it, it will probably be small and easier to treat.

vlnrph

I decided to skip my annual MRI last fall, nearly six years from diagnosis, due to worry about repeated exposure to the gadolinium used as a contrast agent. Various formulations of that injectable have been on the market but I had a flushing response to one of them and therefore restrict myself to a less reactive version. The potential for heavy metal accumulation in sensitive tissues (other than the effect on renal function which is well known) is a concern. Another topic for ongoing research.

My hope is that tomosynthesis/3D mammography will be better at detecting small changes than the older digital scans - forget about film technology, it was worthless for me. I'm also less dense than in the past.

My prior insurance did attempt to deny coverage however I won on appeal.

Anonymous

I would like to continue with yearly MRIs, but my new oncologist is concerned about the long term affects of the gadolinium contrast, says we don't know enough about it, and feels the 3-D tomosynthesis mammos are just as good due to my very low density breasts. (radiologists agrees with her on the recommendation). so I guess that is the course I will take, unless anything suspicious turns up.

anne

Optimist52

This is worrying about the gadolinium. MRI is very important for those of us with ILC as mammograms and ultrasounds regularly miss ILC tumours. I'm on 6 monthly surveillance alternating MRI and mammo/US. Would like to know more about it.

Meow13

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I haven't seen any data on the contrast solution causing harm. I guess it is damned if you do damned if you don't. My radiologist said my mammograms are useless with my dense breasts. So tired of of all of it. Maybe not getting any exams is the answer. So sick of it.

momand2kids

I have moved to an MRI every other year (my choice) along with an annual mammogram. It reduces stress and I think given that I have ILC an they thought it was there for 8-10 years anyway, and was never picked up in a mammogram.. It took me a while but I realized that annual MRI's for me, were not really helpful--- I figure it will take 2 years for something to show up!

I am 9 years out this year!!!

lola12

Hi All,

I friend sent me this study, do you think it would be notably different for ILC vs Ductal? On a a side not, 6.5 years out, my MRI is Thursday and I am already with high anxiety. Say a prayer for me

BOSTON — The risk for local recurrence of breast cancer decreases as event-free survival lengthens, according to an analysis of a large database from the Netherlands.

The study, which also demonstrated that recurrence risk varies substantially by subtype, should help physicians counsel women with breast cancer.

"The risk of local recurrence as a first event within 5 years after diagnosis was low overall, at 3%. It differed by subtype, with ER-positive, PR-positive, HER2-negative breast cancer with the lowest risk and triple-negative with the highest risk," said Martine Moossdorff, MD, who is currently a doctoral candidate at Maastricht University Medical Center, in the Netherlands.

Dr Moossdorff presented the study here at the Society of Surgical Oncology (SSO) 2016 Cancer Symposium.

"The risk of local recurrence decreased with event-free time. Overall, it was 1% after 3 event-free years," she said.

The prognosis of patients after treatment for breast cancer is often expressed as a 5-year or 10-year probability of event-free survival. Various studies have shown that the 5-year local recurrence rate for breast cancer is around 3%, but is the rate affected if a patient visits a clinic 2 years after treatment and is found to have had no events?

"Is her chance of developing a local recurrence within 5 years still 3%, or has it decreased, because the event-free years are prognostic, and does it matter what kind of cancer she had?" asked Dr Moossdorff about such a clinical scenario.

To answer these questions, the researchers analyzed data from women diagnosed with breast cancer between 2005 and 2008 in the Netherlands Cancer Registry. This database includes all newly diagnosed breast cancer patients in the Netherlands. The primary endpoint was local recurrence as a first event.

Of the 34,453 patients in the analysis, more than half had estrogen receptor–positive (ER+), progesterone receptor–positive (PR+), HER2-negative (HER2-) breast cancer (51.6%).

Overall, the risk for recurrence at 5 years was 3.0%. The risk varied by subtype: ER+, PR+, HER2+, 2.2%; ER+, PR-, HER2-, 2.4%; ER+, HER2+, 2.8%; ER-, HER2+, 4.7%; and triple negative, 6.9%.

The investigators selected patients who were event free at 1, 2, 3, and 4 years after diagnosis, and then recalculated the risk for recurrence.

After 1 event-free year, the risk for recurrence dropped to 2.4%. After 2 event-free years, the risk dropped to 1.6%. Further decreases were seen 3 event-free years (1.0%) and after 4 event- free years (0.6%). The risk varied by subtype (see Table). "The decrease was observed in all subtypes, but the decrease was most pronounced in the first few years in subtypes with the highest baseline risk, those who were ER-/HER2+ and those who were triple negative," reported Dr Moossdorff.

Table. Local Breast Cancer Recurrence Rate Varies by Subtype

	At Diagnosis, %	After 1 Event-Free Year, %	After 2 Event-Free Years, %	After 3 Event-Free Years, %	After 4 Event-Free Years %
ER+, PR+, HER2-	2.2	2.0	1.5	1.0	0.6
ER+, PR-, HER2-	2.4	2.0	1.4	0.9	0.5
ER+, HER2+	2.8	2.2	1.5	1.0	0.4
ER-, HER2+	4.7	3.4	2.0	0.7	0.2
Triple negative	6.8	4.6	2.7	1.6	1.1

Dr Moossdorff said that the data can be used to counsel individuals who are anxious at follow-up visits and that the low rates call into question the use of follow-up after a few event-free years.

This is outstanding work. Dr Jeffrey Drebin

"This is outstanding work and a beautiful use of a big dataset," said Jeffrey Drebin, MD, PhD, chairman of the Department of Surgery at the Perelman School of Medicine of the University of Pennsylvania, in Philadelphia, who was not involved with the study. "I think it is something we can use to reassure our patients."

Dr Drebin pointed out that even more than being concerned about recurrence, patients with breast cancer are worried about metastatic disease and death, so future research efforts should also include these outcomes.

Dr Moossdorff and Dr Drebin have disclosed no relevant financial relationships.

Society of Surgical Oncology (SSO) 2016 Cancer Symposium: Abstract 4. Presented March 4, 2016

wallycat

Everything I have read indicated that ILC has a greater chance of recurring/mets the longer a woman survives. I hope I read bad studies.

rrs

I was having mammo, MRI and Ultrasound every year. My cancer was detected with ultrasound and did not show up on mammo. They weren't doing MRIs at the time. I read about the concerns with the MRI contrasting agent and decided to stop having them. I am still having digital mammo and ultrasound. Now I wonder about 3D mammo.

Mommato3

My gyn has been wanting me to alternate every six months with a mammogram/ultrasound and an MRI. I finally agreed to have an MRI in December. Unfortunately something lit up in my left breast. Mammogram and ultrasound didn't show anything so I had to have an MRI guided biopsy. The first injection didn't get the right spot so she had to do it again. The results came back benign. Now they are wanting me to have another MRI in six months. I'm pretty sure I won't be going back. For me, the stress from a false positive was too much.

kar123

I had a mammogram, ultrasound, and MRI and nothing found the 7cm tumor except a biopsy.

lola12

Hi All,

Well I got my MRI today- thankfully all ok. But my report ,once again, said to continue with alternating MRI and mammogram every 6 months.

I guess the worry continues.

Thank you for your input this week, I really needed it.

Lola