Here we go again?

etnasgrl

I was first diagnosed in 2015, at age 41, with IDC, Stage 1, ER+/PR+/Her2-, no lymph node involvement. Had lumpectomy, followed by radiation and now Tamoxifen. I have been on Tamoxifen for almost 3 years.
My mother was diagnosed with breast cancer at 42. It began as Stage 1, then several years later, metastasized to Stage 4. She passed away from metastatic breast cancer at 56.
The first two years after treatment, I had mammograms and ultrasounds every six months. They all came back clear. My oncologist wanted me to have breast MRI's as well, as part of my follow up, (mammogram, then 6 months later, an MRI, then six months later, a mammogram, etc.), due to my personal breast cancer history and also my mother's, however my insurance denied it. I did test negative for BRCA. I was tested when first diagnosed. 

Once I completed 2 years of every six months mammograms/ultrasounds, which was last October, I "graduated" to yearly mammograms, followed by ultrasound, if needed. Yesterday, was my first mammogram since last October. It was a diagnostic 3D. After finishing, I was sent to the waiting room to wait for my results. (At my breast center, if you are a breast cancer survivor, you will receive your results on the same day, which I love!), After several minutes, I was called back for more imaging. Finally, I was brought to a consult room and met with the radiologist. She explained that some calcifications were seen on my non cancer breast. She stated that she believed them to be "probable benign" due to their shape and their locations within the breast. She said that she was not too concerned about them, but wanted to make me aware of them, given my history of breast cancer. She did not recommend a biopsy, but instead suggested going back to every six month mammograms, to monitor the calcifications. She gave me a BIRADS of 3 for this mammogram.

I meet with my oncologist on November 7th for my routine follow-up visit. I will be discussing this with her. I absolutely LOVE my oncologist and trust her 100%. I personally, want a biopsy and I want it now! I will let her know my feelings, but I'm also curious to see if she agrees with the radiologist. If she does, I'll have to take that into account and make a decision.
What do y'all think? Should I request a biopsy or should I do the watch game of mammograms every 6 months? I know that my desire to biopsy is out of fear and I honestly don't want to do anything out of fear. I want to make my decisions with a level and calm head. Advice would be great! 

Georgia1

Good morning. It's great that you trust your MO! If I were you I would ask her to recommend an MRI based on the new findings, and press hard on your insurance company to approve it. They're not fun but MRIs are good for providing additional information, and now seems like the right time to appeal their decision.

I would also ask her to look at your genetic test results to be sure your body can metabolize Tamoxifen. Some women can't, so asking for the CYP2DX results would be a helpful step here. If for some reason you are not a "normal metabolizer" then I would ask for the biopsy and also switch to an AI.

Hope that helps, and best wishes.

etnasgrl

Hi Georgia1.....thanks for responding! 

An MRI would not be necessary at this point. The reason being is calcifications do not show up on breast MRI's or of they do, they are not easily read or visible. Mammogram is the way to go when looking for calcifications. (I have done SO much research over the years, given my mom's "journey" with breast cancer, and now my own.) I had a breast MRI when first diagnosed, prior to my lumpectomy. Like you said, not a fun experience, but was necessary at the time. Given that calcifications do not show up well on an MRI, I already know that my insurance will not even entertain it.  
As for the CYP2DX results, they showed that I can metabolize Tamoxifen perfectly fine, no issues there.