ongoing screening: concerns about gadolinium contrast in B-MRI?

peggy_j

It seems like there is increasing evidence that the gadolinium in the B-MRI contrast can cause long-term side effects. Has this caused anyone to change their ongoing screening? Since I'm now getting a tomo (3D mammogram), my MO said, in her opinion, the B-MRI is no longer needed. I'm waiting to hear the opinion of my surgical oncologist (since she reads the images all day long).

When I got the B-MRIs in the past, I used to drink tons of water before and after the test, to help flush the contrast. I'm not sure how effective that is. Better than nothing, I guess.

What you doing? What do you docs say?

Tresjoli2

My MO did two MRIs 6 months apart for a good baseline...and now no more unless absolutely necessary because of this issue...

momoschki

While I am not exactly in your situation, I’ve been identified as high risk after a dx of ADH in 2011. My BS has ordered an MRI every 2 years. My next one would have been this coming spring, but it just so happens I saw her today for a 6 month check and had a discussion about this very subject. Like you, I had some serious concerns about the impact of the gadolinium. We agreed on a new protocol of 3D mammos and ultrasounds at 6 month intervals. BS said she felt comfortable with this. While I’m relieved not to have to worry about potential gadolinium dangers, it’s also of concern that I’m passing up the most sensitive imaging.

Here’s a very comprehensive article on the subject:

https://www.itnonline.com/article/debate-over-gadolinium-mri-contrast-toxicity

peggy_j

Tresjoli2, thanks for your info. Did you MO say which scenarios would still warrant a B-MRI? It sounds like she's definitely against doing them for annual screening, which is helpful to know.

momoschki, thanks for your info too (and that link). Again, it sounds like they are not recommending routing screenings w/ B-MRI. Are you getting 1 3D mammo a year and 1 ultrasound a year, on 6 month intervals? (or both, every 6 months?)

momoschki

Peggy, the new routine will be a 3D mammo in the fall and an US in the spring- so 6 month intervals

peggy_j

momoschki, ok, that makes sense. (so the US will basically replace the BMRI).

momoschki

Peggy, to clarify: previously, I had the mammo and the fall, US in the spring. The next year would be mammo in the fall again and MRI in the spring. Rinse and repeat, ad infinitum. Now we are eliminating the MRI and just alternating between mammo and US

peggy_j

Thanks for this post and sorry for my long delay. I haven't logged in here in ages. I met w/ my MO last week and she agreed that I can drop the MRI. Her opinion is that the Tomo (3d mammogram) is pretty good.

jessie123

I am newly diagnosed and scheduled for a BMRI in a week. I had read about the problem with the contrast, but was reassured when many people said not to worry. However, the article just posted by Momoschki pretty much verifies concern from the "big guys". My first biopsy was messed up so I have to have a second one. I think I should have my biopsy first to see what I'm dealing with before consenting to the MRI. Also if I chose a mastectomy won't that negate the need to know how much cancer I have in my breast?

WC3

jessie123:

I said some things about gadolinium on the thread linked to below.

Gadolinium

I had neoadjuvant chemotherapy so the gadolinium breast MRIs were used to monitor any progress. I'm not sure how necessary it was to use the gadolinium for the breast MRIs but I also had a brain MRI and gadolinium is necessary to spot brain metastasis because some small tumors will only show on brain MRIs with gadolinium.

Tresjoli2

my MO said only if we have an issue. No routine MRIs anymore

momoschki

I guess that ultimately it’s a question if weighing the risk against the benefit. When I was dx’ed with the ADH in 2011, it was pretty standard to have an MRI after a positive needle biopsy and before the excisional surgery. I’d be more concerned about the routine screenings, as it seems the potentially harmful effects of the gadolinium are cumulative.

It’s so frustrating though that our best, most sensitive tool comes with its own set of risks. If I eliminate the regular MRI screening,I worry that something may be missed that it would’ve detected- but if I continue with the regular MRIs, I worry about the long term effects of the gadolinium.

peggy_j

Jessie, I see your point, that if you have an MX, you wouldn't benefit from an MRI. My MRIs have always been done for both breasts, so your surgeon may still recommend one to take a lot at your other breast. FWIW, I think the effects of the contrast accumulate. Getting one to help with a Dx, is different than getting one annually to screen. Of course, talk to your docs. They know your case the best.

snorkeler

Just made an appointment for my yearly MRI. Since my breast tissue is dense (extremely or heterogenously, depending on who's reading the mammogram), my oncologist still recommends the MRI. She also takes labs to check my kidney functioning, so at least I know it's normal. The MRI techs usually suggest drinking lots of water afterwards to help flush the contrast agent out. I make sure to drink plenty of water before the MRI to plump up my veins and make inserting the IV easier.

So I'm going to get the MRI this year but continue to monitor the research on this issue and keep open the possibility of making changes in the future. Thanks to everyone for the helpful discussion.