Suspicious mass and nodes on MRI

Tmh0921

Guess I'll hang out here for a while. I had a mammogram and ultrasound on 4/29 that showed a new spiculated mass and 2 abnormal nodes in my left breast. I had a follow up MRI this week to rule out scar tissue. MRI results also indicate suspicious mass and nodes. It's been 19 1/2 years from original Dx for me, with a few scares over the years.

Im scheduling an ultrasound guided biopsy of the mass and nodes, then meeting with my surgeon to discuss Mastectomy and DIEP.I'm strangely calm about this.

Meow13

I went through an MRI scare in 2016, it was fat necrosis my oncologist said after 5 years it was very very strange to see changes in the tissue I had an MRI guided biopsy it was fat afterwards I had my yearly mammogram and the radiologist confirmed it was scar tissue contracting.

Tmh0921

Meow

Do you remember if the scar tissue showed heterogeneous enhancement on your MRI?

I have had several biopsies in the immediate area in the last few years, the last in September of last year with a Dx of ADH, ALH, and DCIS. I wasn't too surprised by the abnormal finding, and was pretty sure it was scar tissue. The cortical thickening of the suspicious nodes and the heterogeneous enhancement of the mass are worrisome.

The MRI report has my BiRads at a 4, but they logged my visit diagnosis as “Malignant Neoplasm of the Breast". I can handle a new malignancy, but am worried about the suspicious nodes.

Meow13

I didn't see the MRI report I only spoke to the oncologist and radiologist. I asked the radiologist what she thought. She was convinced it looked like fat necrosis it was the oncologist that found that very strange. But it was a newer MRI machine at a brand new facility than my previous MRIs I thought it could be a false positive.

Well during my next regular mammogram the radiologist (a different radiologist) showed me the previous year's image next to the new one. It showed clearly contraction around the scar tissue. So my oncologist was not correct in telling me after 5 years no changes as far as scar tissue changes could happen.

Tmh0921

Thanks Meow

I know MRIs have a pretty good false positive rate so I still have some hope thatthis is scar tissue. It definitely was not there in September of last year when my last mammogram and biopsy were done.

Tmh0921

I love my surgeon, I'm scheduled for US guided core biopsies of the mass and both nodes tomorrow.

Once pathology is back we'll meet to plan next steps. Benign or Malignant I'm headed for BMX and DIEP reconstruction. I want off the yearly abnormality/biopsy roller coaster and my surgeon agrees

wallycat

Biopsy and pathology are really the only way to know for sure. My cancer was NOT spiculated. I was told it was not cancer and I was nuts to want it biopsied. They were wrong. Technology only tells you so much. I hope yours turns out to be fat!

KBeee

Hoping it turns out benign. Sorry you're dealing with this worry.

Tmh0921

Had US guided core biopsies of the breast mass and abnormal nodes today, now we’re waiting on pathology.

I asked the radiologist why he has my BiRads at a 4 instead of 5 given the suspicious mass and nodes. He said 4 was still applicable given that the nodes are only slightly abnormal, and given the fact that I had 14 nodes removed years ago these nodes are doing double duty. It’s not uncommon to see these changes in circumstances like this.

So, I’m anxiously awaiting pathology, but feeling a bit more hopeful today

KBeee

I'm glad you asked for clarification. I do think that helps so much! Hoping you get good news!!!!!

Tmh0921

I had my US guided core biopsies on Wednesday and the preliminary pathology came in today....

Lymph Nodes are clear (Thank God)

Mass in left breast is, unfortunately, IDC.

Hormone status, etc. pending.

Salamandra

Hey Tmh,

I'm sorry you're dealing with another recurrence. So glad it hasn't spread to the nodes though. Thinking of you1

wallycat

So sorry to hear. You know we are here for you.

Tmh0921

Thank you for the replies.

I’m waiting on the rest of the pathology (Hormone status and grade), then I’ll meet with MO and surgeon for next steps. Definitely going for a BMX this time, with immediate DIEP reconstruction if possible

KBeee

Uuugh. I am sorry the breast mass has come back for IDC, but thankful the nodes were benign. Frustrating nonetheless to be dealing with this beast again.

Tmh0921

I see my MO this afternoon to review the full pathology and next steps. Preliminary pathology did show LVI, I’ll know grade and hormone status today. Then I can get a plan in place

Tmh0921

Met with MO today and my pathology is actually pretty good:

ER Positive 95%

PR Positive 69%

HER2/neu negative

KI-67 is 14%

There was a foci of LVI on the core sample

Lymph node pathology was benign

They're scheduling me for BMX w/immediate reconstruction ASAP. Barring any surprises in the surgical pathology they aren't recommending chemo. That would change if the LVI is found to be extensive or if it is found in any of the nodes they'll remove.

Because I developed a strongly hormone positive IDC while on Tamoxifen, they will be taking me off of Tamoxifen and switching me to ovarian suppression + AI. The oncologist is also classifying this as a new cancer and not a recurrence. This has no bearing on treatment, but it sounds better

Feeling much better about this DX tonight

Salamandra

I'm sorry you're dealing with this. I hope the treatment goes smooth and well!

KBeee

Hoping you can get the surgery done nad over soon and that the pathology yields no surprises.....so you can put this rotten detour behind you.