Please help me understand this MRI report
Hello everybody. I am new to this forum and so glad I found it. I am actually here because of my mom. She was diagnosed with left breast DCIS last year and went through lumpectomy and 30 sessions of radiation. Also she was found to be BRCA1 positive as well. We have a huge family history of breast and ovarian cancer in her family. I am on a 6 month mammogram/ MRI/ vaginal ultrasound/ CA125 test as well, although hasn't been tested for BRCA yet and hasn't been diagnosed with cancer (NOT YET). Anyways, after my mom completed her radiation in October 2010, her oncologist put her on a 6 month mammo/MRI schedule. She had one mammogram in Feb 2011 which was clean and clear but she had one MRI last week which why I am here today. 2 days after her MRI, we got the call from the nurse saying that she needs to come in for biopsy on her left breast (the same radiated breast) because of a nodule that was seen on MRI. She continued that the radiologist recommendation is to have just an U/S and another 6 month follow up MRI but the oncologist doesn't want to wait 6 months due to her family history and her BRCA situation and she wants her to do the biopsy. So next week she is going for biopsy. I got a copy of the MRI report and here what it says:
Right Breast:
No abnormal contrast enhancement or suspicious mass lesion. 6 mm lobulated nodule at right mid eight o'clock, seen on 7/47. Nodule shows no contrast enhancement and appears bright on gradient echo images and dark on fast spin echo images, consistent with a fibroadenoma. There is a limited fat suppression of the medial and lateral inferior breast. BI-RAD: 2
Left Breast:
4 mm well defined well marginated contrast enhancing nodule at the left mid 3 o'clock, seen on 7/33. On fast spin echo images, the nodule appears signal void and on precontrast it appears isodense. Finding is consistent with a fibroadenoma. Second look ultrasound and six months follow up breast MRI are recommended. BI-RAD 3
Here are my questions:
1-The radiologist's comment for both breasts suggests that finding is "consistent with fibroadenoma". How come he is not concerned about the right breast but he is concerned about the left one? What made the left breast more suspicious than the right one? Why right breast has BIRAD 2 but left one has BI-RAD 3 and biopsy was ordered only on the left one?
2- Can somebody shed some light and tell me how the left breast nodule looks like? benign/malignant? Do these terms (well defined, well marginated, signal void, isodense) show anything?
3- Is it possible for a breast that was radiated 30 times, to develop another cancer after only 8 months from completion of radiation, given the fact that the first cancer wasn't even invasive (DCIS)? I was told by her oncologist that a radiated breast most likely won't have any recurrence for 5 years.
I appreciate any information. It is so difficult to wait one week to get the biopsy done and few more days to get the result. Thank you all and God bless all of you.
Comments
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Sahar, I can't answer your questions. Maybe your mom could send these questions to her doctor and ask him/her to respond before the biopsy.
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Sahar,
Welcome. I can only give you my layman's understanding having had an MRI and did layman's research.
Malignancy has a certain way of acting during an MRI. From the way the report reads, it doesnt sound concerning. If I got a report like that I wouldnt be frigtened.
That being said I also dont have the BC history in my family, haven't been thru what you mom has and am not BRCA+.
They really may just want to be excersizing an over abundance very caution due to all the above. I think that is reasonable considering all the history taken into account.
Dont freak though. I found nothing that would scare me in that report based on what I learned during my layman's research.
God Bless and best of luck to you and your mother!
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Sahar,
I am totally a layman, not a medical professional but in reading the report there are a few differences in the two possible fibro's. The right has no contrast enhancement; the left does. The left is isodense on precontrast. So the fibroedenomas are different from each other.
I think the doctors are being super vigilant with your mom. If it was more serious then it would have had a higher BIRADS rating.
Take care, Dagny
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Thank you ladies for responding to my post. Your words were very encouraging. I hope everything goes well on her Wednesday biopsy. I am also thinking may be I should ask for an U/S of her right breast, although the BI-RAD was 2 on this breast but she is very high risk, so since she is already going for an U/S and biopsy of the left one, I want to give it a try and ask the doctor tomorrow to see if she orders U/S on the right one as well. She may say she doesn't need it since radiologist rating is 2 but I want to ask. I heard if somebody is high risk with BRCA+, ANY finding, even BI-RAD 2 findings should be evaluated. So we'll see.....
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Hello ladies,
We are getting close to my mom's biopsy on Wednesday. I am really freaking out of what the outcome might be. I understand that there aren't that many scary information on her MRI report but she is very high risk and that's my concern. I always think any single minor BREAST thing could turn in to a cancer. I only pray that the radiologist's comment is true and these nodules are really Fibroadenomas. I have a question from you ladies about Fibroadenoma. Does any of you know if fibroadenomas can develope in older women? My mom is 57 and monapause. I heard that fibroadenoma mostly developes in younger women due to hormonal thing. If that is true, then it is possible that these nodules aren't fibroadenoma. Oh gush, so what are they? Could they be cysts? Can MRI distinguish between a cyst and a solid nodule? Her MRI does't say anythign about cyst, it just says "nodule". My mind doesn't work anymore. I've read so many things on internet, some encourage and some scary. This waiting is killing me. I wish we could have at least got some news on Wednesday but most likely we won't find out anything on that day until few days later when the result comes out. But first they do an ultrasound, I hope they could give us at least some encouraging news when looking at these nodules on the U/S screen. I am still hopeful that some of these characteristics (well defined, well marginated, small size, bi-rad 3, fibroadenoma) do their magic and give us a B9 result but when I think about her risk (previous DCIS in the same breast, BRCA+) I freak out. If this is a recurrence, her choice is limited to Mastectomy and a very hard reconstruction due to radiation on her left breast. SO I just pray for a B9 result.
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Sahar!
Keeping you and your mother in my prayers today. The waiting and fear really is the worse part. It gives time for all those questions to just swirl and fuel our fear...
Do you best to stop researching right now. Researching wont matter at this point until you have results. It's counter-productive at this point.
Keep as busy as you can
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We are at the clinic right now. Waiting to be called for U/S and biopsy if needed. Very scared.....
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Hi Sahar...
Sending hugs and warm thoughts....
It's ok to be scared.
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Also sending warm thoughts....
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WHAT A RELIEF!!!!
We just came back from the clinic. IT WAS A LYMPH NODE! I can't believe I drove myself crazy for just a lymph node. They didn't even do the biopsy. They said it is not necessary. First, they did an U/S and they said that they were pretty sure it was a lymph node but to be 100% sure, they needed to do a second U/S with a different technique. Well, they did the second U/S ( and of course I was going crazy during that time), and then they said it is 100% a lymph node and no biopsy is needed, go enjoy your day!!
I am extremely thrilled and relieived. I can't still understand how MRI can't distinguish between a lymph node and other nodules. Isn't MRI the best tool available? So why couldn't it show the nodule as a lymph node in the first place and avoid all the stress? Aren't we better off doing U/S than MRI?
The nurse told me that they don't like MRI AT ALL, because it is so dramatic but for somebody like my mom (even myself, I still don't know if I carry BRCA, haven't been tested yet), it is worth it to go through stress but end up with nothing than let it go and end up with something.
Thank you everybody for all warm wishes and prayers. I enjoyed talking with all of you. I will still be in touch.
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Sahar!!
CONGRATS to you and your mother. It's great that you are so vigilant. And it's also great to know that it was B9 even with her history.
ENJOY YOUR FALL!!! hugs to you and your mother.
(I have to admit I was glad to get my MRI. For me it gave me hope. Just a different side to that same coin)
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marie5890,
Thank you. Yes I agree that when you are done with your MRI and get your good result, you feel relieved. It is just handling the stress of the false positives. I am due for my MRI end of this year so until then, I try to relax. It is funny that I go through this stress 4 times a year. 2 times for myself and 2 times for my mom as both of us are on 6 months MRI/mammogram schedule. I still have the BRCA testing on my to-do list but not sure when I am going to be ready for the stress of it but eventually it HAS to be done one of these days..... lots of hugs to you..
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What I ment for me with my MRI, after mine was done and I got the report, even prior to biopsy, I knew that the "alarm" had been lessened. I could tell by the report that it was a new finding, but it didnt appear to be acting like cancer.
So for me, after the MRI, some of my anxiety was diminished even though I hadnt had the biopsy.
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waiting for my MRI interpretation. Can someone tell me what these words mean. I do have stage 1 common breast cancer in right one. Checking on both with MRI preop. Birad 6....type 111 kinetics....6mm mss w type 111 kinetics...seroma.
What do these mean?
Thanks. Seeing oncologist on Monday but can't wait for explanation. Trying to figure it out myself.
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