Question about MRI

Zeek28

Hello,

First off, I apologize if these are frequently asked questions - I did a few searches and haven't found what I'm looking for. So, I figured I should just ask directly.

My mom just told me she was diagnosed last week with breast cancer. Unfortunately, I don't have much more info because my mom is pretty stoic and does not like to dwell on things. Additionally, I didn't know what to say or ask her at the time...so, as a result, I'm mostly in the dark on her current situation. The things I do know though -

1) She said it was IDC but that she didn't know anything else at this point

2) She received 2 mammograms and a biopsy last week (which all led to the diagnosis)

Tomorrow, she's going to be at an all day appointment having an MRI (and I assume other tests) done. I want to be there to make sure that we can get as much info as possible. So, with that and with what limited info I have, what questions can or should I ask to the doctor following the MRI tests?

I took a look at the main questions article (Title: Your Diagnosis: Questions to Ask Your Doctor) and they seem to be mostly focused on questions pertaining to the pathologist report. If I am wrong though and these questions are all appropriate for the doctor tomorrow, please correct me and I will ask all of them.

My plan of attack at this point:

1) Review the NCCN PDFs once I know exactly what stage/type of cancer she has (Will an MRI provide this information?)

2) Help my mom get organized with her records (she's not the most organized)

Like I said, my mom is stoic. She has a fairly laissez-faire approach to life and it's one of the reasons why I love her. However, I want to make sure that we are getting all the information we need and that we are approaching this with everything in order. This is a scary situation and information makes it easier to approach.

Thank you for the help.

gb2115

Hi! An MRI is used to get a better picture of the cancer and to check the rest of the breast(s) more closely to make sure nothing was missed in the other imaging. Staging isn't usually done until after surgery because it includes whether or not there is lymph node spread (determined by surgery).

The type of cancer should be listed on the pathology report. Has your mom shared that with you?

MTwoman

Zeek, it sounds like you are in the scariest time (you have all heard the word cancer, but don't know a lot more of the details critical in understanding what types of interventions might be recommended). I am so sorry that you're lovely Mom has been diagnosed with IDC. What may (or may not) be hard for you is that she will get to determine what information you will be privy to and whether you are able to speak directly to her providers or not. To be honest, I had my Mother drive me to appointments where I didn't allow her to come back in the room. She is the "worrying" kind, and I felt that the attention would shift to answering her questions and alleviating her fears - instead of focusing on me and mine. I'm sure it is a difficult time for you as well (my Dad had ca, so I'm aware of what it's like to have a family member going through diagnosis and treatment). Each of us needs a certain amount of information to make our decisions. The tricky part is that each of us needs a different amount. What might feel like the right amount to you might be the wrong amount for her. Please try your best to take your lead from her as to what's helpful for her. There is a forum for family, friends and caregivers that may be helpful for you to get support, if her wishes differ from her own. I do hope tomorrow's appointment goes well. ((hugs))

(edited for spelling and grammar)

Luckynumber47

Hi Zeek28,

I'm so sorry your family is going through this. Your mom is so lucky to have your support. In my experience the MRI is just a test with no chance to ask questions. I'm guessing it probably went that way for your mom today too.

Right now your mom and her doctors are in the information gathering stage - exactly what is this cancer and how are we going to treat it. IDC is the most common, usually slow growing, easiest to treat cancer. All positive things. Doctors don't usually stage until after surgery but you can guess from the tests your mom has already received. What is the size of the tumor? My tumor was 1.5 cm so that made me a stage 1. (The ultrasound had the tumor at 1.2cm but it was found to be slightly bigger after surgery - very common). Before surgery I was told that my lymph nodes looked clear and that proved true after surgery. So I was stage 1a before surgery and luckily that didn't change after surgery.

Your mom will face decisions regarding surgery - can she have a lumpectomy, followed by radiation or is mastectomy (usually without radiation) recommended. Which does she prefer? Will she want reconstruction? It's a good idea to read up on the risks associated with each of these choices.

Next up is the tumor make up. Is it ER/PR positives? If so, the doctors will recommend she take an aromatase inhibitor for 5 to 10 years.

Is the tumor Her2 positive? Then herceptin is recommended.

This information is usually available after the biopsy. Grade is also determined at biopsy - is it slow growing (grade1) intermediate (grade2) or aggressive (grade3)

After surgery they will probably do an Oncotype test to see if the benefits of chemo outweigh the risks.

When I was diagnosed I spent a lot of time reading the articles that applied to me on the main board. I also read the IDC forum and read everyone's signature line - if their diagnosis was similar to mine then what treatments did they have.

Even if your mom is very stoic this thing will rock her to her core. I used to say that I looked 100% on the outside but the inner me was over in the corner whimpering. It takes a long time to get over the constant fear. Just being there for her will be a huge help.

Zeek28

Thank you all, I appreciate the advice.

We've had some good news and bad news since the MRI. Bad news is that it has spread to her lymph nodes and it's HER2-positive. However, as you've mentioned, HER2-postive is highly treatable with the advent of new therapies. Her oncologist is optimistic about treatment.

We're still in an exploratory stage at this point. PET scan next week to see if the cancer has spread out of the breast region. Her bone scan yesterday was negative for any spreading...so, our last hurdle before the start of chemo will be the PET scan.

As you all mentioned...the initial diagnosis is the most scary part. As we get more information though and as we meet with her doctors, it has has helped make the process more clear and less scary. Just having a plan in place for diagnosis and treatment is nice. I will keep your advice in mind, especially about overstepping my boundaries and not being attuned to my mom's fears. I'll really just try to be there for her when she needs me.

MTwoman

So glad you (both) have gotten more information and started to put together your Mother's team. I am also glad she only has one more set of imaging to do before she can get started on treatment. Thanks so much for letting us know how she's doing!