dr. says MRI is too expensive

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newtobc13
newtobc13 Member Posts: 12

My 34 year old sister was diagnosed with metastisized IBC and IDC a couple months ago. It spread from the time of the biopsy to the PETscan/CSCAN/MRI etc. It was misdiagnosed by our local doctors.  We thought her only risk factor was weight..apparently we have an Aunt who has had 3 tumors removed, and another that is positive for the breast cancer gene.

 My risk factors are now family history and weight (I have jumped 20 lbs in the last few months). I am in my low 30's and have seen an OBGYN for consult. She wants a mammogram, which I said I'd rather not have given the amount of radiation in them.  She suggested an MRI, which I'd prefer, but said it was an expensive test and insurance might not cover it.  I insisted on no mammogram.  Then I got a call scheduling one!  My thoughts are...what tests should I really be having?  I thought mammagrams could not detect IBC..wouldn't an MRI be better then having mutiple tests like mam and ultrasound..all in one kind of thing. 

Secondly, how long should a breast exam take and what should it consist of?  The one I got seemed very quick..? Like 2 minutes?

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  • newtobc13
    newtobc13 Member Posts: 12
    edited May 2011

    Also..sis is HER2 negative and it appears to be hormonal (although I have read these tests have a 1 in 5 wrong answer rate).  Should I ask for hormonal testing to see where I am at?

  • mawhinney
    mawhinney Member Posts: 1,377
    edited May 2011

    The amount of radiation exposure with a mammogram is very small.  The benefits of a mammogram far outweigh the risk.  All test procedures have their benefits and drawbacks.  No test is perfect. Generally, a mammogram is done first. If follow-up is needed, an ultrasound and/or an mri may follow.

    I suggest you find a doctor that specializes in breast health and is associated with an NCI. Take your records and if your sister is agreeable, a copy of your sister's   test results with you so your doctor will have a clear picture of your situation.

    You want to have your mammogram at a place that uses the newer, digital mammogram equipment which produces clear images.  You also want to make certain that the radiologist reviewing your mammogram is experienced at reading mammograms. 

    Take care!

  • Fearless_One
    Fearless_One Member Posts: 3,300
    edited May 2011

    MRI's are always better than mammos.   The only thing a mammo is better for is detecting microcalicifications.  

  • MRDRN
    MRDRN Member Posts: 537
    edited July 2011

    MRI saved my life and was encouraged by my insurance for preventive care.

  • newtobc13
    newtobc13 Member Posts: 12
    edited December 2011

    Thanks for the replies..I think I will talk with my dr. again.  Turns out my sister is BRCA1 positive, mine came back negative but they only tested for her specific mutation.  After reading the articles on BRAT/BRCA2 etc. I am not pinning my future or my childrens on Myriad's testing. The genetics counselers say I can go back to regular screening at age 40 now. I disagree and will continue to screen every 6 months.. 

  • MRDRN
    MRDRN Member Posts: 537
    edited December 2011

    Good for you! Being proactive is def the way to go . Glad to hee it was negative though :). I was told I had a 50/50 chance since my sister was positive.

  • crystalphm
    crystalphm Member Posts: 1,138
    edited December 2011

    MRI's seem to find almost everything, and considering your sister's situation, it would seem the right way to go. As far as safety goes, my MRI's had to have a dye contrast, which is a load for your liver and kidneys to process, so no test is without it's concerns.

    I would probably at least have the mammogram becauase it would be your baseline to watch for things that are changing...I never avoided a mammogram because of radiation. Just my 2 cents...

  • AnneW
    AnneW Member Posts: 4,050
    edited December 2011

    One reason MRIs are not used for screenings is that they lead to "false positive" findings, which result in unnecessary biopsies and anxiety. They are a very expensive screening tool, but some insurances will probably cover that with proper authorization. Check your benefits. I wouldn't expect your health care provider to know what your policy covers. It's just way easier to say, "It's too expensive" and hope you'll cave and do the mammogram.

  • beepbeep
    beepbeep Member Posts: 84
    edited January 2012

    I know how you are feeling about radiation. I'm under 30 and my doctor seems to be avoiding mammogram with me. She is urging an MRI and genetic testing though, even though I'm not sure if my insurance will cover either. You could always have an ultrasound although that really is not going to be the most effective screening tool for the longterm. It's certainly better than nothing if you feel very strongly about radiation. My aunt is in her 50's and only gets ultrasounds even though her sister died of BC. I think she's taking a risk at her age doing that but I think a younger person might be okay getting just ultrasounds for now. I think my aunt should at least be getting a mammogram every few years. My doctor doesn't even bring up mammogram to me and I have a rather large lump.

    I think insurance is more likely to cover an MRI when you have a family history. I'd look into that before making a decision. My doctor wants me to consider that test. It frustrates me though because if my current lump shows up on MRI, she will likely do nothing further because it was already biopsied. Not sure how good of a tool it is for a pre-existing lump. We shall see. Breast exams should be pretty thorough. My doc did a thorough one the first time around but not subsequently. It's a bit nerve-racking because it seems easy to miss a spot. That's why it's important to check yourself too.

    Best of luck to you!

  • beepbeep
    beepbeep Member Posts: 84
    edited January 2012

    Just for informational purposes, what are the risks of MRI? It was my understanding that there is no radiation exposure, correct? I know false-positives are common. Does that mean any finding they see needs to be biopsied? What if they find more than one abnormality? Will they put a patient through multiple biopsies in that case? Thanks.

  • flash
    flash Member Posts: 1,685
    edited January 2012

    You need to understand that statistically, if you are PRE- menopause, then the weight is not an added risk factor.  It is a statistical factor for anyone that is POST menopausal.  

    There is no perfect test.  Your doctor is really following a pretty standard course suggesting a mammogram first since they are a small amount of radiation.  It really is a combination of the different tests that gives the total picture.  Yes, each type of test, including the MRI, gives a different piece of info.  Part of the problem of starting with an MRI is the false positive.  Every time you biopsy somewhere in question, you leave more scar tissue that may obscure something important down the road. the MRI however is one of the best tests we have but it is not the definitive test.  Unfortunately, we don't have any one test that is 100% accurate and 100% effective. this journey is never easy, and it does require patience. 

  • bak94
    bak94 Member Posts: 1,846
    edited January 2012

    I would do both, alternate them, so you have a test every 6 months.

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