Size of tumor - accuracy of ultrasound

Cliffyw

Hi

My wife was diagnosed with ILC a few days ago. The initial ultrasound put the tumor at 2.5cm. However when we met with a surgeon today and discussed an MRI, she mentioned that the MRI quite likely could show the tumor is larger than that. Has that been others experience? Given the difficulty in finding ILC in traditional screenings does the more accurate MRI typically show a much larger tumor ?

MsMisha

Hi Cliffyw -

Unfortunately that was true for me. My ultrasound measured 1.8cm, the MRI measured 2.4cm and the final size after surgery was 3cm. The funny thing is that my surgeon said the exact opposite of yours. She believed that MRIs exaggerate the size and wasn't worried about that part of the MRI result. However, even with the increased size, I was able to have a very successful lumpectomy. And my surgeon doesn't believe I'll need chemo. Apparently my tumor isn't very aggressive, and she doesn't believe chemo will have much of an impact. Now I'm waiting to see if the MO agrees with her assessment. I think the bigger concern with the MRI is whether or not any other areas of concern show up.

Outfield

Yes. They really create their pictures in different ways, and MRI has the ability to pickup more minor differences between normal and abnormal tissue than US.

I would advise not getting cognitively attached to something like a measurement. There is nothing that will be remembered as a number set in stone over the longterm until you've had surgery and the tumor is measured directly.

Cliffyw

thank you all. That is good advice. I suppose we are just in a phase where we don't know much so I am trying to grapple with the little information we do have and hoping it is not worse.

LeesaD

My ultrasound / biopsy measured my IDC tumor at 6-8 mm's. Pathology after my mastectomy measured it at 3 cm's so more than three times the size. I wish there was never a measurement to begin with as I feel some of my doctor's decisions were based on the biopsy measurement. That was my first surprise and not my last one either. Unfortunately you won't know for sure until surgery. Best of luck.

EastcoastTS

Mine was .8mm with US, 1.2 with MRI, 1.8 upon final surgical.

The time until you find out everything is the worst -- the waiting and uncertainty. I'm thinking of you and your family.

jojo9999

my MRI was very close to what was seen on mammo and ultrasound. Also close to the actual size, measured after surgery.

Cliffyw

We just got my wife's MRI results back, and the size was greatly different from what the ultrasound showed. The MRI reported the tumor in her left breast as 5.9 cm compared to 2.5 cm when reading the ultrasound. It may be possible that the MRI is overestimating the tumor size (though they are accurate, studies do show it tends to be more likely for MRI to overestimate somewhat). Nonetheless, that is concerning, especially since my wife does not have especially large breasts (34B bra), and the MRI indicated it is close to the nipple area. Also, they saw something on the other breast which appeared concerning. Since my wife has already decided she wants a BMX, that might not make a difference for her treatment but they still want to perform another ultrasound and possibly biopsy that breast.

On the bright side, the MRI did not show anything on the lymph nodes. That is not conclusive of course, but at least some good news.

MsMisha

I'm sorry the size is larger. In a fairer world, it would work the opposite. Each test/pathology would show it smaller than the last one. But I suppose if we're talking about fairness, we wouldn't be dealing with cancer at all. Hopefully, you can get the next tests and surgery done soon. Although the larger size of my tumor shocked me, it still easier being on the back end of surgery and knowing exactly what I'm dealing with. Did the doctor give you an idea of what her treatment will look like?

Optimist52

On biopsy my tumour was estimated as 8mm. I had an MRI which then said 6 x 6.5cm. I was so shocked I couldn't speak when the doctor told me. It was very scary. However after surgery it was found to be 4cm, still not great I know, but somewhat better than the MRI assessment.

With ILC, tumours are not solid masses, they form in a spiderweb type pattern or thickening of breast tissue. Therefore they are often measured as larger than IDC, though the actual amount of tumour cells may be less. Best of luck to you and your wife. She's lucky that you're so supportive.

wallycat

My ultrasound showed zero tumor; MRI showed 7mm. Actual was 1.8cm.

jj50

my tumour was 4 cm on ultrasound 6 on mri and 11 finally, so its not uncommon. the first few weeks are the worst, t will become easier to deal with it when you have all the facts.