MRI questions

Giselle20

in January I finally paid attention to a small dimple on my outer left breast and a slight flat spot on my lower right breast. Both become more pronounced when I flex, they have been around for more than a year just not sure how much.

After the initial visit with my primary she ordered an ultrasound which came back clear. She said that nothing really stood out as concerning to her that everything looked fine. I was still concerned because she mentioned feeling a slight lump on the left but nothing was seen on the ultrasound. In her clinical notes she wrote as follows (asymmetric firmness without discrete mass from 10:00 to 3:00 on the left breast. The right breast appears heterogeneous to palpation with indiscrete firm tissue, less organized than that of the left breast.). After extensive research I decided to ask for a MRI which was granted both by my doctor and insurance (Kaiser Permanente). However the order was only for a Unilateral Left Breast MRI?

I assumed the order would have been for both breasts to look for symmetry and what is "normal" compare to the other. And I mean you are already there hooked up to everything, like how much more work is it. And since this will be my first, to have a record for possible future evaluations.

All the information I've seen online regarding breast MRIs always shows both breasts, which is why I was confused when I saw the order. Never have I seen a single/unilateral breast MRI image, only when they zoom in on the final image to screen individualy and in more pronounced detail. Even when you Google them nothing really shows up besides general MRI info.

So I guess what I'm asking is if the MRI is only going to be of the left breast? Or is it going to be of both breasts with an emphasis on doctor interpretation on the left one?

If it was only on the left one and they found a anomaly what would happen next? Whould they do a biopsy first to look for malignancy, followed by MRI of the other breasts. Would the tech immediately scan the other one, or would you have to schedule another appointment to screen the other breasts and then have a biopsy? Also would it have to be an MRI biopsy?

Should I ask for a bilateral MRI, and would I have to be re-approved by my insurance because it is technically a different "procedures"? This is so confusing.😑😑😑😑

Another smaller probably insignificant question. I know MRI is magnetic so no metal is allowed but what about metal dental fillings mercury I think, are they a problem or no?

Lula73

Fillings are no problem. And there really isn’t a way to do a breast mri just on 1 breast that I know of. They’re not looking for symmetry really between the 2 breasts as 1 can be very different than the other but rather they’re looking for tissue anomalies. Your doc’s designation may have been just a way to let the radiologist know which breast was the primary concern. I went in for mri for left breast calcifications and ended up diagnosed with a 9mm IDC and DCIS in the right breast so obviously both were evaluated. To put your mind at ease you may just want to inquire with your doc and at the mri center if the radiologist will be evaluating both breasts on the imaging.

djmammo

Giselle20

IMO anyone ordering a unilateral breast MRI either has never ordered a breast MRI before and/or is completely unfamiliar with the concept breast imaging.

They are always bilateral and they are always with and without contrast.

Fillings are no problem. Let the tech know if you have any other implanted metal (it will be on the intake form) aneurysm clip, pacemaker, joint replacements etc.

gb2115

Do scars on the skin of the breast show up on MRI? I had a lesion removed (deep shave) from my treated breast after my last mammogram. It turned out to be ok, but I have this MRI coming up and wonder if they will think it's something because it wasn't there before, when they look at the mammogram and MRI together, or compare to my last MRI.

Giselle20

gb2115

I don't know, but I would assume it has been written down on your file so they would know what it is. If not you can ask/mention it to the tech so they can let the radiologist know and write it in your file if it's not already there.

Giselle20

I don't know, but I would assume it has been written down on your file so they would know what it is if it did show up. If not you can ask/mention it to the tech so they can let the radiologist know and write it in your file if it's not already there.

Recap

For many years my mammogram place would hand us a paper with two breasts outlined on it and ask us to mark any specific features of our breasts like moles scars etc-I always assumed that was to compare those locations to the mammogram images.

MRI is so highly detailed I assume it will show scar tissue (but may not show minor surface-only skin scars like faded burns.)

I had a shoulder MRI that showed a collection of fluid. I asked if the MRI showed what kind of fluid (I wanted to know if it was blood, or a thin watery fluid) and they said no. I also had a brain MRI and though I only saw my images briefly, it was astounding. Go to Google then click on Images first, then type in the search box "breast MRI images" +scar and see if it finds anything.

djmammo

Giselle20

You can point it out to the tech and ask if they can place a marker on it for the exam, they use Vit E capsules as markers. If the biopsy was confined to the skin it will not show up as a distortion in the underlying breast tissue on the mri, and may be too subtle to see without the marker.

gb2115

Thank you all for answering! I think the dermatologist went fairly deep into the skin, but I am not sure exactly how deep. I will make sure they know at the MRI today. My surgeon doesn't even know I had that done. Derm did it in January and it was between all my cancer follow ups.

djmammo

gb2115

Dont' be worried if they don't wind up marking it. When I read an MRI i am more concerned with a history of surgical procedures that involved the breast tissue itself which may affect my reading. Things confined to the skin are not critical in reporting and cant be confused with an intraparenchymal abnormality.

gb2115

Thank you for your reassurance! I am headed off to my MRI in an hour or so.

greetings1

First I had a 3D mammogram that showed a couple of masses in my left breast, one was over 1.5 inches, the report also stated I have very dense breast. Then I had a ultrasound that didn't show anything, next was an mri and the report states right DCIS +/- invasive adenocarcinoma, an enlarged lymph node (I forgot the size) and a few more things. My main question is this is DCIS detectable on an MRI or is a biopsy needed? I really don't want a biopsy, if the cancer can be seen on a MRI I would rather just have a mastectomy. I have many family members with breast cancer and I am worried about a biopsy spreading the cancer.

Georgia1

Hi Greetings1 and sorry about the diagnosis. Absolutely you need the biopsy; it will give you and your doctors the genetic info you need to make treatment decisions about chemo, radiation, hormone therapy etc. It truly is a painless and risk free procedure. Best of luck.

greetings1

Georgia1 thank you for your reply. The reasons for a biopsy that you state are good. I will have to think about this more.