Not even a year after lumpectomy/rads, enhancement seen on MRI

SiameseX2

Hi all,

I was wondering if anyone else has experienced something suspicious on MRI that did not show up on mammogram and can't be palpated on the cancer breast? My MRI report says there is a "6mm enhancing nodule" on my right breast, with "moderate contrast uptake and predominantly progressive kinetics." It has been labeled "category 4 - suspicious."

Last year, I was diagnosed with DCIS of the right breast when microcalcifications on a mammogram led to the need for biopsy. MRI and genetic testing were done while planning treatment. MRI didn't reveal anything new/concerning at that time, pretty much matched the mammogram, genetic test was normal.

I proceed to have lumpectomy on 5/5/17. Margins were clear, however on the underside they didn't have enough breast tissue to remove before chest muscle began. So they ended up removing the fascia off the muscle and called it an "anatomical margin." No nodes taken, nothing invasive was found.

Radiation to breast and chest wall was a little over 7 weeks long in June and July, and I have been on Tamoxifen.

At my one year recheck, mammogram was clear! However on physical exam, they palpated a lump on the LEFT side. The lump doesn't show on mammogram or ultrasound, I refused to have it removed, because it is likely not cancer. They decided that we could do MRI early and if nothing showed up we could watch and wait - that is when they noted the area of enhancement on the RIGHT side. Slightly near the lumpectomy site; it is at 6:00 where the lumpectomy was around 7:00 position.

It just seems like the more they look, the more they find and it is never ending. Now I have to wait until 5/5 for ultrasound on righty, which likely won't reveal anything, and I'll have another breast biopsy to look forward to.

After checking some of the posts here, it seems that false positives on MRI are common. It could be something else, like hyperplasia, papilloma or a collection of blood vessels from radiation?

Thanks for listening, and any thoughts.

Caber224

I had a similar experience last year when an MRI indicated 3 enhanced areas 15 months after my lumpectomy, radiation and letrozolfor DCIS. I had MRI guided biopsies after a clear ultrasound, and all three were benign findings. Two of the sites were in the breast with DCIS and one in the clear breast. The report indicated:

A. Breast, left, MRI core biopsy: Clustered apocrine cysts and duct ectasia with periductal fibrosis.

B. Breast, right, site 1, MRI core biopsy: Fat necrosis and surgical site changes. Breast ducts and lobules with radiation-induced changes. Negative for tumor. Calcifications are present in benign ducts.

C. Breast, right, site 2, MRI core biopsy: Fibrocystic changes including dense stromal fibrosis, duct ectasia with periductal fibrosis, and breast lobules with radiation-induced change.

It was a difficult wait for results, and I am not looking forward to my next MRI in June. Good luck with your procedure - and I hope your results are also benign.

Caber

RoseGinger

I had the same thing happen to me. I was diagnosed with DCIS, left breast, in April of 2017. had a lumpectomy and 7 weeks of radiation in June and July. When I went in for my follow up mammogram last month they found a suspicious area ( Birads 4) on the right breast. They also did not like the look of a 3 mm area on the left breast either. Two weeks ago I had a stereotactic biopsy on the right breast. Results were benign. Last week, I had an MRI with biopsy planned on the left breast. Thankfully, the results came back benign there too.

Going through the testing, waiting, etc. so soon after being treated last year was very difficult. I had thought this was all behind me. Is this going to be the new normal? Hopefully not.

Siamese, I hope you get good results. They are being extra careful, which is a good thing. I know it’s impossible not to worry, but keep in mind that many times these things turn out OK. Take care

SiameseX2

Caber and Rose,

Many thanks for the responses. I felt a little bit better as I went in for my ultrasound Saturday. And, this time, they truly only did ultrasound - unlike the last time I was told US and then they wanted more mammograms too.

The nodule turns out to be visible on ultrasound, and the radiologist thinks it is most likely a fibroadenoma. It is round/oval and doesn't have a blood supply. Since no nurse was present on a Saturday, I have an ultrasound guided core biopsy scheduled for 5/15.

I'm still debating whether or not to push the biopsy back a month or so. I am in the process of moving, and I am going to be cleaning my new place and taking boxes over later this week. Not to mention, I'm going to be hauling lots of things over the next month. The timing really sucks, and I know if my results indicated the need for more surgery I'd have to delay it several months.

Siamese