MRI after lumpectomy

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Hi everyone.  I had a lumpectomy performed last week, and my surgeon told me at the time that the sentinel lymph node was clean, which was a relief.  Today, however in my my post-op visit, I learned that in the surrounding tissue of the the lump they removed (1.5cm/2.5 cm), they discovered a node and tested it.  The location of the node wasn't common.  Well, the node tested positive for suspicious cell activity, and now I am scheduled to have an MRI done.  So, now I'm freaking out because it seems like most people have the MRI before their surgeries, and I'm having it afterwards.  Has this happened to anyone here...and if so, what rollercoaster ride can I look forward to?  Before the discovery of the uncommon node, my treatment looked like radiation only, but now it is pretty much decided that I will have to undergo chemo as well.   I can't help thinking that an MRI at this stage means that the cancer, which was once thought to have been removed from the lumpectomy, is now going to be something far worse.

Comments

  • blackjack
    blackjack Member Posts: 1,010
    edited November 2008

    HI Easdla,

     I didn't have a MRI before by surgry. I only had a biopsy followed by a lumpectomy and rads txs. I had my first MRI this past Oct to check to see if there was anything abnormal. It turned out fine.

    I think your md is being very through as MRI can be very sensitive in that they pick up alot of false positives. Talk with your md about your concerns and take one day at a time.

    Wishing you the best

    Blackjack 

  • wishiwere
    wishiwere Member Posts: 3,793
    edited November 2008

    {{Easdla}} So sorry you've gotten this conflicting information.  It's so great the SLN was clear, but certainly it's a concern having that lymph node found among the breast tissue.  I've heard this can happen as lymph nodes like other body parts don't always take anatomy class and mind their manners and get in their assigned spots.  Little humor to lighten your load, sorry if you don't find the humor in it. :(  Just try to lighten you day.

    Have they said they would do further testing on that lymph node that was found to have suspicious cell activity? Was the entire node removed, or a section of it?  Perhaps the MRI is to figure out if there are more lymph nodes in that area, or something similar?  Did you or can you ask before teh MRI what they are looking for exactly?  What their expectations are at this point?  If this has ever been seen by them before?  I'm sure there are many thoughts going through your mind in this regards.  Have you considered perhaps a mastecomy to insure there aren't more nodes contained in the breast tissue? Just some thoughts I had.

    Will keep you in good thoughts and prayers that this all turns out to be nothing, but I'm sure you are sitting on pins and needles worried, we all would be.  Please try to eat and stay hydrated and remember to get your rest so you can move forward with treatment regardless of where that lies.  Hang in there!  When is you MRI sceduled?

  • eadsla
    eadsla Member Posts: 217
    edited November 2008

    (wishiwere)  First off, humor is always appreciated.  Perhaps it will be a lesson to all the other nodes that if they just stay with the group, then they might not get the cancer! 

    The questions you raised are ones I will definitely raise with my doctors before the MRI.  True to form, I was a bit dazed when my post-op brought forth this new development, and I didn't really have the preparation to ask as many questions as I should have.

    I hadn't given thought to a mastectomy simply because it didn't seem that it was necessary at the time of the original diagnosis.  But with this "rogue" node development and the resulting MRI...well, I don't want to get too ahead of myself on any of this.  I don't know the extent of the node removal that was done since the node was discovered in the surrounding tissue that was removed to clear the tumor (I can't remember the technical term for it at the moment.)

    Since this all happened today, my surgeon's office will be scheduling the MRI for me, so I don't know when that will be, but soon.  Also, I have to schedule my first appts. with my oncologist and the radiation oncologist.

    It's hard to get a grasp of all of this happening.  I discovered the lump in early October and since then have had so much happen...which is a good thing to get it taken care of as quickly as possible, but it makes it all a bit difficult to process...which has it's benefits in that it leaves me a bit numb emotionally...but it also leaves me a bit numb intellectually becasue there's so much to comprehend.  But this website has proven to be a great resource.

  • wishiwere
    wishiwere Member Posts: 3,793
    edited November 2008

    I remember that hurry up and wait time.  Mine all started sept 21 of last year with a mammo, and oct 25 was my mast.  Chemo started dec 5th.  That was the day I signed on here finally to become a part of the best group of women I've known in my lifetime.  They are here, supportive and helpful, cry and laugh and just lift each other up at any of the day or night.  It's the best support any woman can find and I surely wish there were more opportunities for more women to know about them all.  I hope you find a year from that you feel the same way :)

    As for that numb feeling....I'm a year out as they say and have an appt with new onco in 2 days. I'm nervous as heck b/c the first and last one (same guy) was not good at understanding my questions and thus those I did remember, or find the wherewithall to ask, went unanswered.  Now, I'm seeing his superior and while I'm very much looking forward to meeting him and getting answers, I'm afraid too, that I'll forget half of the questions on my list. 

    If you don't have someone to go with you, I and others will suggest you do.  Write down you questions and if possible, have the person with you write the answers as they are given, so you can concentrate on your list of said ?'s.  I'll be interested to hear what they say for you in regards to this all.  Very interesting.  Stay strong...we're here and will extend that hand/arm to support you through it!

  • PuddinTame
    PuddinTame Member Posts: 128
    edited November 2008

    I had an MRI after lumpectomy.  Since there weren't clear margins, the surgeon wanted to try to see the extent of the DCIS to see if it was worth another try.  Apparently, they found something else that has to be checked out, so he'll be doing a wire guided surgical biopsy when he does the reexcision.  Sounds like we are sort of in the same boat because now I'm concerned that this other spot may be something besides DCIS.  I'm wishing even more now that he'd done the MRI when I asked for it before the lumpectomy.  From now on, no cutting without looking first.

    I hope and pray for both of us that our worries will be for nought.

  • eadsla
    eadsla Member Posts: 217
    edited November 2008

    Kateful...wow, it didn't occur to me that an MRI would lead to a reexcision.  So, does that mean that you'll be basically having the same surgery as the original lumpectomy?  Also, a question on the MRI...how long does that procedure take?  Mine is scheduled for Tuesday, and I have no idea what to expect.

  • wishiwere
    wishiwere Member Posts: 3,793
    edited November 2008

    Seemed to me, that the entire appt, getting there to leaving was 2 hours, but I might be mistaken.  Mine was late at night (scheduled at 10 to be there for a 10:45pm MRI).  The MRI bx the next week though was longer, I think entire thing was like 4 hours, but 45 of that was stopping the bleeding or trying to.

    It's loud and you're in a weird position, face down with hard foam pieces where the tenders joints are, like you head, and hips and such.  But the breast will hang down into an open area below you.  The mammo type paddles under the table are used for the bx, but I don't think I remember them for the MRI itself.  GOsh, never thought I'd forget details, but danged if I can't remember that first one now!  Hmmmmm...weird!

  • PuddinTame
    PuddinTame Member Posts: 128
    edited November 2008

    eadsla,  The MRI didn't lead to reexcision. I knew I'd have to do that because there weren't clear margins.  We did the MRI to try to get an idea of how extensive it is and whether it was even worth a try to reexcise. But it also showed another area that didn't show on the mammogram which also has to be biopsied. Praying now for either for something that doesn't have to be removed or more DCIS rather than numerous other alternatives.

  • eadsla
    eadsla Member Posts: 217
    edited December 2008

    wishiwere, am I mistaken in reading had you had two MRIs done?  I'm sorry to read that there was bleeding involved in the second one.  Yipes, what was that about?  Okay, so face down, loud and uncomfortable...and you stay like that, say, an hour?  Charming, to say the least...but then I'm sure this is just the tip of the "charming" iceberg as far as this journey will prove to be.

    kateful...I hear ya on praying for the best results from the MRI.  And I can't help but question mammogram results when things don't show up, but then appear on other tests.  It sort of disputes the preventative nature of the mammogram to some extent, doesn't it?   I'm just waxing rhetorical on that last bit...I'm sure MRIs are way too costy in comparison to the mammogram to have them done with regularity.

  • wishiwere
    wishiwere Member Posts: 3,793
    edited December 2008

    Eadsla, Mammo, Ultrasounds and MRi's are all good in their perspective at finding different things at different times.  For instance MRI's can sometimes find a mass that is only 5 mm (1/2 cm) whereas a mammo might find one at 1cm or 10mm.  Also, the type of mass and/or calcification's, and other things can be seen differently on each.  Ultrasounds are also good at deciding when something is actually a cyst as opposed to a cancerous mass.  The bx regardless is the ONLY to know for certain.  ILC is sometimes not seen as early on mammo or U/s because it forms sheets almost, rather than a lump/mass oftentimes.

    And yes, I had a mammo which saw the primary tumor (IDC w/DCIS), then and U/S confirmed and he did a bx at that time. We scheduled a lump for the following week with a pre-op MRI to make sure nothing else was present.  IN that MRI, the 2nd primary(ILC w/ LCIS) was seen so the surgery was canceled and an MRI Bx was done instead that next week.  That confirmed the 2nd cancer so a mast was needed as they were in separate quadrants. 

    If you feel your uncomfortable with confined spaces, you can ask for something to take before hand.  My BS gave me a script for xanax, others have had other scripts which worked for them.  It just calms you enough to stay put in that thing and not want to run for you life! :D  J/K, it's emotional, very loud and is quite a while, but the more still you lay, the quicker it goes. :)

    Good Luck, have you gotten your date yet as to when they will be doing it?

  • eadsla
    eadsla Member Posts: 217
    edited December 2008

    wishiwere, thanks for your information.  One thing that amazes me here on this site is how well informed everyone is.  My MRI is sceduled for tomorrow(Tuesday).  The hardest part is trying to process what I do/don't/should know and balancing that with trying to take it one step at a time.  I'm meeting with my first consultaion with the radiation oncologist this morning, so hopefully I can get some answers as to what they will be looking for, etc.

    I'm only now beginning to appreciate the allure of meds like xanax and valium.  Up to this point I was one of those people who avoided prescription drugs at all costs...didn't like the idea of putting chemicals into my system...but lately I wish there was some super pill that could just knock me out for the next six months or so.  Oh, wait...that's going to be chemo to some extent, isn't it? :0

  • wishiwere
    wishiwere Member Posts: 3,793
    edited December 2008

    Well, not really.  Chemo doesn't knock you out, just wishes you were again:)  The only that really knocks you out, would be the anesthesia in surgery :)  Seriously though, you'll be amazed at how quickly the time goes. I can NOT believe it's been a year dec 5th, that I started chemo!  amazing really.  I'm so very thankful it's all over, but...would NOT wish the last year/15 months on any soul, for any reason!  It's so emotioally draining, even today can be with follow ups, but, that's over sooner too :)

    Day by day, and you'll do great, I'm sure.  And this time next year, you'll be here, helping someone else through the maze and wondering the same things we are! :)  Hang in there Eadsla :)

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