Trying to decipher my Breast MRI results.

Paisley2916

Hello Everyone! I'm am new to this online community and I am so grateful that it is here. I've been reading a lot since being diagnosed with Grade 3, Bilateral IDC on December 13th. So far, I've had 3 breast biopsies - of course came back positive, had an MRI, met with a Breast surgeon, and tomorrow I'm going in for Ultrasound Guided Biopsies of Supsicious Lymph Nodes on both sides. I just had my MRI report emailed to me this morning and these things are always a scary read. I don't understand all of it, but it looks like both of my breasts are full of IDC - right breast shows nodules in all quadrants plus a nodular non-masslike enhancement involving a large portion of the breast, left breast shows two separate areas of IDC (largest one is 4 cm) plus a non-masslike enhancement involving a large portion of the left breast measuring 7.4cm x 10cm. The MRI also shows that I have at least 3 intensely enhancing lymph nodes with abnormal morphology on the left - 2 probable lower left axillary lymph nodes appear round with at least partial effacement of the fatty hilum and measure up to 5mm in size. On the right side, at least 4 intensely enhancing lymph nodes with abnormal morphology and focal cortical thickening of up to 5mm. Anyone have any idea what this means? I know I'll find out soon enough - and am almost expecting to have cancer in the lymph nodes - but I am hoping for the best. If it is cancer in my lymph nodes - does that mean it has automatically spread throughout my body? Is there a chance that it's just hanging out in the lymph nodes and hasn't spread? Can anyone explain to me what a "non-masslike enhancement" is? I will meet with my oncologist for the first time Jan. 5th. Do you think he will send me for a PET scan? I'm freaking out a little bit.....By the time I see my oncologist, it will be a full month of tests and worrying before even receiving any treatment.....

OCDAmy

paisley, I don't know much about the report, there are other women in this community who are very knowledgeable and I'm sure will respond. I wanted to tell you that I had an enlarged lymph node on ultrasound and it was positive for cancer from biopsy. I had a CT scan and no other cancer was found. So yes it's possible to have cancer in your lymph nodes but not spread any further. Best of luck to you, this is the hardest part. Once you have a plan you will feel better, at least I did.

Georgia1

Hi Paisley. First, I agree with Amy that you can definitely have lymph node involvement without further spread. That would change your treatment plan a bit but it's definitely treatable.

It seems a bit early to think a PET scan is required but that's a good question to ask at your next appointment.

An area of enhancement means an area that kinda "lit up" on the MRI. The fact that it's described as "non-mass like" seems like a good finding, since cancer cells form a solid mass. So perhaps it is a non-solid cyst or something similar.

Sorry this is all so scary and nerve-wracking. Sounds like you trust your surgeon, but remember you can always take the time to get a second opinion at any point. Best wishes to you.

HollyDollyD

Hey Paisley,

You wrote: "If it is cancer in my lymph nodes - does that mean it has automatically spread throughout my body? Is there a chance that it's just hanging out in the lymph nodes and hasn't spread?"

That's a great question for a Dr. However, if you want my take after reading the literature, it is possible that it has spread and yes there IS a chance that it is hanging out and hasn't spread.

As for non-masslike enhancement 60% are benign.

(Wilhelm, Annamaria & Mcdonough, Michelle & R Deperi, Elizabeth. (2012). Malignancy Rates of Non-masslike Enhancement on Breast Magnetic Resonance Imaging Using American College of Radiology Breast Imaging Reporting and Data System Descriptors. The breast journal. 18. . 10.1111/tbj.12008. )

It means they have found something that is not a 3D mass, which needs further investigation. From: http://www.radiologyassistant.nl/en/p47a585a7401a9...

• Non-masslike enhancement
are areas of enhancement without a detectable three-dimensional mass. Features of non-mass enhancement include its distribution, its internal enhancement pattern, and whether the enhancement is symmetric or asymmetric.

Hope that helps.

Holly