MRI next step!!

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artesia10
artesia10 Member Posts: 9
edited June 2014 in High Risk for Breast Cancer

Has any with breast cancer start out with a mammogram like this? I have had 2 mammograms this year I just had my 6 month follow up July 25th now I'm going for an MRI the radiologist said he might be looking at early stages of breast cancer.. The dr called this morning and said it would be a fight with insurance that she recommends me to wait another 6 months for mammogram.. I told her no when the radiologist suggest cancer ill take the mri..well guess what about an hour or so later insurance approved the mri and there scheduling my mri. I'm waiting on the call back for a date I have had no issues what so ever with insurance yet so I had a feeling that would be no problem. Anyways my question is why would the dr want to wait if the radiologist thinks it might be early stages of breast cancer.. I also asked him if there was any changes this time and he said yes but it went down instead of out I'm not sure what that means? The radiologist also stated that I have calcifications but there not noted on here?



Here is my mammogram report



Technique: Craniocaudal and mediolateral oblique views of both breasts

have been obtained. Spot compression views of areas of interest as well

as ultrasound evaluation of the upper inner left breast were also

performed.



Findings:



Breasts are heterogeneously dense, which limits the sensitivity of

mammography. A 1.1 cm asymmetry is identified in the upper inner right

breast corresponding to palpable lump on physical exam. This asymmetry

improves, but does not completely resolve on compression views. A 1.2

cm asymmetry just superior to the nipple on right MLO view only does not

persist on compression views. A 1.5 cm asymmetry in the upper inner left

breast does not persist on compression views. No microcalcification or

architectural distortion is seen in either breast.







Dedicated real time ultrasound evaluation of the 1.1 cm upper inner

right breast asymmetry showed no corresponding sonographic abnormality.

Incidental note made of prominent terminal ductal lobular units, within

expectation in this young patient.



IMPRESSION: 1.1 CM UPPER INNER RIGHT BREAST ASYMMETRY WITHOUT

CORRESPONDING ULTRASOUND ABNORMALITY. THIS ASYMMETRY IS CURRENTLY

VIEWED WITH LOW SUSPICION AND REPEAT BILATERAL MAMMOGRAM IN 6 MONTHS IS

RECOMMENDED. THE PATIENT IS DUE FOR BILATERAL SCREENING MAMMOGRAM IN 6 MONTHS.

GIVEN HETEROGENEOUS BREAST DENSITY AND FAMILY HISTORY OF BREAST CANCER,

SCREENING MRI SHOULD BE CONSIDERED FOR FURTHER EVALUATION.







BIRAD: 3 - Probably Benign Findings - Initial Short - Internal Follow

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  • Beesie
    Beesie Member Posts: 12,240
    edited July 2013

    "my question is why would the dr want to wait if the radiologist thinks it might be early stages of breast cancer"

    The reason the doctor suggested that you wait is because the BIRADs rating that the radiologist gave to the imaging was a BIRADs 3.  A BIRADs 3 is given when the radiologist assesses that there is a less than 2% likeiihood that whatever is seen on the imaging is cancer.  The normal follow-up with a BIRADs 3 image is a 6 month follow-up. So your doctor's recommendation makes sense given what the report says.

    The inconsistency is not with the doctor's recommendation, but with how the radiologist described and rated your imaging (a BIRADs 3) vs. what the radiologist said to you (that it might be early stage breast cancer, which normally would warrant a BIRADs 4 rating and from there, a biopsy).  It's also odd that the radiologist mentioned calcifications to you, but then specifically said in the report that "No microcalcification or architectural distortion is seen in either breast."  So the report actually says that there were no calcifications.

    As I interpret your report, it seems to me that the radiologist does not believe that there is anything showing up on either the mammogram or ultrasound that is particularly concerning, and based on your imaging, the recommendation is a 6 month follow-up.  However because you have heterogeneously dense breasts (as do the majority of women your age) and because of your family history, the radiologist suggests that future screening with an MRI might be advisable. It doesn't sound to me from reading the report that the radiologist felt that there was an urgent or immediate need for the MRI, just that it's something to consider for the future. 

    What is confusing is what the radiologist seems to have told you, vs. what he wrote on the report.

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  • artesia10
    artesia10 Member Posts: 9
    edited July 2013

    Beesie

    Thank you for responding! That is to what is confusing to me and makes no since. When he talked to me for the first mammo and the second both times he talked about the calcifications and that's what he was talking about going down instead of out on the second mammo. He said the MRI would be able to look further into the asymmetries that he thought might be early stages of breast cancer.. And dumb me thought asymmetry meant that my breast were not the same size and I was assuming he was talking about the calcifications being early stages of breast cancer.. But then when I read my report and it talked of no calcifications and the asymmetries were the lumps I was really confused.. One others note he had told me that the lump I was feeling was not on the mammo it clearly states that it was..

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