How reliable are MRIs?

EllieMac08

Hey guys! I’m 41, married with two young children.Six weeks ago, during monthly breast exam, I found a tiny lump. I watched it for a few days, as sometimes I could feel it, other times I could not. Ended up seeing obgyn the next week who said it felt like a fibroadenoma, but just to be safe, moved my annual mammogram up a few months. Mammo and u/s were “worrisome” and labeled a BIRADS 4. The mass is 1.2cm x 1.0 cm x 1.0 cm. The concerning issues were a dilated duct, a 6 cm area of lateral calcifications nearby, and evidence of blood flow to the solid mass. Sent to a surgeon, who said the report was “weird and wordy.” He also said felt like fibroadenoma. Said 90% chance it was gonna be benign. Wanted MRI before biopsy. Had to wait a bit for MRI and while waiting, decided for a 2nd opinion with oncologic breast surgeon. Had mri and saw specialist that same day. They repeated the US and tech said looked like fibroadenoma to her and that I had dilated ducts in both breasts so it was probably normal for me. Doc said it was smooth and mobile to touch, which was a good sign. Said the appearance on US was promising, as it appeared smooth and oval, no architectural distortion, and parallel. The concern was mainly the calcifications. Did core biopsy and I go Monday for results. She also said decent chance this is nothing, but if it is, probably stage 1. I was optimistic until MRI report posted. Said mass is round with microlobulated margins, has heterogenous enhancement, more prominent along the margins. Said suspicious for malignancy. Also reported mild suspicion for DCIS in the OTHER breast, but that’s another story. I’m not sure what to think. I’m trying to tell myself the opinions of 3 physicians who said it felt benign and a tech that said it looked benign has to count for something. I know only biopsy will tell for sure, but I’m trying to find some hope. Are false positive MRIs really a thing? Thanks.

NorCalS

EllieMac08,

I’m hoping that the doctors are right. Also, hopefully others that have more experience with accuracy of MRI’s can chime in

NicInTexas

I'm no expert, but I just had a false positive on a recent MRI - confirmed via biopsy (got results today), so it certainly happens. Mine was also listed as BIRADS 4.

Hope this helps!

Salamandra

False positives are a huge issue with MRIs and one of the reasons they are not used for regular preventative screening even though they are so good at picking up issues.

They are powerful and sensitive, and known to find "problems" that turn out to be just part of a person's physiology, or completely not in need of attention or treatment. But once something is found on an MRI, one must go through the process of further investigation with biopsy etc. This has tremendous costs in both money and stress.

Agreeing to/asking for MRI screening is basically asking for (almost certain) risk/stress of false positives in exchange for the (possible) benefit of earlier/accurate detection than one might have with other methods. I know because that's what I did - I asked for annual MRI screenings after my first diagnosis. Due to my age and family history, my doctor and my insurance agreed to it. I have already had one biopsy false positive that I would not have had were it not for the sensitivity of the MRI. It was incredibly unnerving, but in the end, it's still a risk/benefit that I want to take on.

"Suspicious for malignancy" is what doctors have to write to get a biopsy done/covered by insurance. It doesn't mean they think it's cancer, it means they think it could be cancer. Did you get a birads score for the MRI?

To me, it sounds like you're in nearly the exact same situation after the MRI as before - you have a lump that is probably benign but can't be ruled out for cancer without a biopsy, and could in fact be cancer. You also have a new finding that could be absolutely nothing, but since it was picked up by the incredible power of the MRI, your doctors now have to deal with as a possible finding.

It sounds like you pushed for an MRI without fully understanding what it meant, and your doctors didn't really educate you, and now it's increased your stress and anxiety. But I don't think you have any more reason to be concerned about cancer than you had before the MRI. Like you said, you still have to wait on the biopsy.

gamzu710

I had a breast MRI following my cancer diagnosis this summer that identified 3 other areas of concern, Bi-RADS 4. All three came back benign. MRIs are very sensitive at catching problems but do have more false positives than other imaging. Wait to see what the biopsy says before you panic! Best of luck to you.

LivinLife

After my initial DCIS diagnosis I had an MRI to cover diagnostic bases before making a definite surgery decision, etc. The MRI showed another 3 cm area - mine was deemed "non mass enhancement" of that size in the report. All of that turned out to be lots of benign and precancerous stuff - was amazing how many different kinds of things were in that area though none of it was cancer. Had I not been undergoing BMX another biopsy of that area was recommended.... Please keep us updated as there are new developments. Wishing the best for you!

EllieMac08

Thanks guys. It does seem like there are a fair number of false positives. I wish I would’ve been warned about, but the surgeon wanted it done before biopsy bc he said it could prevent unnecessary biopsies. Sounds like it may be just the opposite.I’m ignorant to all things breast cancer, but I feel like I am learning quickly. Here’s to good new tomorrow.

aseal321

sorry you’re going through that! MRI also has a false positive and the images overlapped and they told me a had twice as many masses than I actually had. Second MRI and they figured it out. Scared me to death.

I hope this turns out ok for you! Praying for benign results!