Birads ratings post-radiation

Good to know JB.  I just had my first mammo since diagnosis.  It was clear.  I did not see anything about birads.  I need to get a copy of the full report.

I had already talked to my onco about annual MRIs due to reading about a lot of missed tumors with mammos.  In my case, the mammo missed a small area of DCIS that was adjacent to my larger tumor (which clearly showed up on mammo).  That is the reason I wanted MRIs, but this only reinforces it.  I don't think my onco was going to suggest MRIs on her own but she readily agreed when I suggested it.  

JBinOK, sorry you went through that but thank you for sharing your story. Good for us to know. FWIW, I finished rads 2 weeks ago and when I met with my MO earlier this week, she said she doesn't like doing mammos more than 1 a year, due the radiation exposure, but would likely recommend the MRI for the next few years since my breast tissue is dense. Thanks for arming me with more info (on mammos not seeing through scar tissue), so I can insist on it.

Hmmm.  I finished radiation  in Nov 2009 and had follow up diagnostic mammos on the treatment side (lumpectomy) March 2010, Sept 2010 and March 2011.  All three were benign - Birads 2.

Diagnostic mammos post - lumpectomy  for the first three years are one of the diagnotic codes on the radiation center's order form.  The radiologist who read mine said I go back to yearly screenings after  2 years (she's the head of women's screenings for the center.)

There doesn't seem to be much problem with scaring.  My RO is haed of rhe hospital's breast cancer program and my MO is an appointed member  National Mammography Board of Quality Assurance -- so I have  a fair amount of faith that things are being done by the book.

I have been getting digital mammograms with CAD software assistance for a while.  They started following the area three years before I got the biopsy on density and birads 3 readings - diagnostic mammos at six month intervals.

Check and see if your facility is doing digital mammography, it can make a difference.

(Edited for spelling error)

MarieKelly, yeah I hate the insurance companies too (and my MO is no fan). Part of her logic in the risk/reward calculation is the effectiveness of mammos vs. MRIs. My understanding is that MRIs can see tumors that are 0.2cm to 0.3 cm. My 0.5 cm tumor was hard to catch on the annual digital mammogram. (and I've known women who, unfortunately, found lumps themselves that the older style mammos didn't catch). I had an MRI prior to surgery and it was clean except the known tumor, so even if it missed something, I'm not sure a quarterly mammogram would catch it before an annual MRI, would it? (hmmm...this is starting to sound like a math problem, where we're trying to calculate the growth rate of cells. Sorry if this is a bummer) If it makes you feel better, the MRIs cost hella more than the mammos.

JBinOK, thanks for the add'l info on the scarring. Always more to learn ...

Valgirl, yeah, I prefer the digital mammo and *experienced* radiologist to the old ones. After DX, my BS said that my tumor was a hard to catch from the mammo, only visible on the top view, not the side. My diagnosing radiologist has 20+ yrs experience--yeah!-- I believe the digital mammo allowed him to zoom in and have much better resolution than the old kind.

JBinOK thanks for your information on scarring from radiation - I'll talk to  my MO and RO.

I'm  in my sixties, so dense breasts is probably less of an issue for me.   Given your situation, it was good that you took the inititiative.

Like   Valgirl   I had a MRI post biopsy/pre surgery; I also had a pre-op PET/CT scan -- both were right in line with my mammogram -- the micro invasion in the lymph node was too small to pick up in MRI or CT/PE.

I  have 20+ years worth of mammograms/ultrasounds with the radiology practice -- they're a very experienced group and started following the area as probably benign but to be checked every six months three years before it showed up as suspicious.

My breast cancer survivor ship plan has a schedule for mammograms and lists MRIs  exams "as needed".   My MO limits her practice breast cancer and is quite straight forward about following up on anything that seems the least bit irregular.

Everybody's situation is different and we all have to go forward with what makes the most sense for them.

Back to Karen's original question -- Yes it is possible to have benign birads after breast cancer treatment.

 spendygirl  -- PET scans can light  for any number of reasons including inflammation/infection.   I have some activity in my thyroid that reflected the inflammation for Hashimoto's thyroiditis an autoimmune disease (there was a clean FNA)   Things have to be checked out, and may very well be a false positives.   Hope you have a reassuring appointment with your onc.

I had several MRIs/MRI-guided biopsies pre-treatment, but no MRIs after treatment. I feel two ways about this -- I think I should be screened more, but MRIs have a tendency to show up false positives, which lead to more biopsies, more worry. Don't know if I could go through that every year.