Does Breast MRI show lymph nodes?
Hi there. I have been scheduled for an MRI on both breasts on May 24th. I was just wondering if this scan shows whether the cancer has spread to the nodes, or does it just show the size of the individual tumor / see if there are any other tumors in the breasts only?
I'm also wondering if I should insist on more scans prior to my scheduled double mastectomy (June 15th)? Everyone has been asking me if I got a PET scan, brain scan, bone scan, etc yet. Is it normal to get all this done prior to surgery or wait until after? I can't seem to get a good answer from my docs, other than "everyone does it differently" ...
Comments
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I did have an MRI prior to my BMX as this is standard practice for my surgeon. My 2cm mass had not shown on mammography, but did show clearly on ultrasound. The MRI did not show anything in addition to the already imaged mass in the right breast. I was a lumpectomy candidate but chose BMX for my peace of mind, as I had always had very fibrocystic and dense breasts. In the OR my SNB on the right side was declared clear. Post-op pathology showed a micromet in that right SNB, which would not have been seen on the MRI because it was too small. What the MRI failed to show was the additonal 6mm node further up in the axilla, and in addition, it failed to show the atypical ductal hyperplasia and atypical lobular hyperplasia that was present in the left, or "prophylactic" breast. It is important to understand that a pre-surgical MRI is just another tool in the diagnostic process. Different patients have differing levels of success with different types of imaging. I think as far as other scans go, it is best to wait until after your surgery. I think this is pretty standard, and this is usually the point where the surgeon takes a step back, and the oncologist takes a step up. Because there can be surprises on post-op path such as I had, the approach your oncologist takes is best formulated when the answers come back from pathology after your surgery. I did have a PET scan between BMX and chemo and another PET at the conclusion of chemo, but even with nodal involvement I did not have a brain scan, or a bone scan. My oncologist felt that the PET was encompassing enough to show any issues, and that any further scans at that time were not necessary. I wish you the best on your upcoming surgery!
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Dusterella, my BS told me that no imaging is considered reliable for nodes. MRI for me showed nothing in my nodes and then, Surprise! 6 nodes involved.
Each doc has his protocol for what he considers the best tools before surgery. Some do other scans (my BS did CT and bone scan in addition to MRI) and some leave it to the MO to decide after surgery.
Best of luck.
Leah
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I didn't have an MRI before surgery, but I did have a biopsy and ultrasound. I didn't understand what was being said at the time, but during the ultraound (there were two people there), there was a question asked about can you find a node? The answer was, yes, a couple. It turned out there were four bad ones. I didn't learn that until the pathology came back after surgery, but someone had a good idea it had spread to the nodes from the ultrasound.
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My mammogram, ultrasound and MRI did not turn up my positive lymph node (4.5 mm macromet). None of them showed any of the extensive DCIS throughout my breast that turned up in the final pathology of my UMX.
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My Oncologist does an ultrasound to check axilla nodes even post lumpectomy and rads - just another way to ensure there was not further disease.
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Thank you so much for the replies! Did any of you who had node involvement have any pain or sensitivity in your armpit(s)? My underarms have been bugging me for a couple weeks, but I've also had a slight cold, so maybe that's why.
BMX scheduled for 6/15/2012
Anyway, it's so freakin' hard to wait to find out all this stuff! My friend had a PET scan prior to surgery and that's how they found her node involvement, so I was hoping to get one of those, but I'm not sure who to ask, as I haven't been seen by an oncologist yet. This is all so confusing! -
Hi Dusterella - my BS ordered my PET Scan and MRI. By the time I saw the MO, I'd had a lumpectomy, blood work including BRCA testing and both scans. Any of those physicians can write the Rx for the scans, so if you want one, you should ask.
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dusterella - no symptoms at all for the positive nodes - I was physically examined, mammoed, ultrasounded and MRI'ed prior. By the time I had a PET nodes were already out.
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Yes. I had broken a foot and was in a nonweightbearing cast for about 7 weeks, so I was on crutches. One underarm could not endure that. I was told I just didn't have the upper body strength for crutches, but that underarm showed 4 bad lymph nodes a short while later. The underarm complained before I or anyone else could have found the breast tumor. I wondered if using the crutches moved the cancer into the nodes. No one could answer that.
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Unless the cancer in the lymph nodes is VERY large, it will not show up on an MRI. There are currently no tests that accurately indicate cancer in the lymph nodes except for dissection.
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