MRI and LCIS.

yes

In my case, LCIS was seen as 2 suspicious areas on my MRI but it was not noticed until I went to a PS for a reconstruction consultation. In late 2012 I was diagnosed with IDC and an MRI was done prior to my UMX. My oncologist said the MRI looked normal. In Feb. 2013, made an appointment with a PS, but before I could see him, I was required to send my records and MRI to their breast clinic so they could review my case. Their team of doctors, including a radiologist, looked over my records, reports, slides and the MRI. To my surprise they noted 2 suspious areas in the MRI and said they need to be biopsied. I decided that I didn't want to go through repeated testing so I had a second MX in May. The pathology report indicated the areas were LCIS. I realize that I might never have gotten cancer in that breast, but since I already had a diagnosis of IDC in my other breast, I'm glad I made the decision to have it removed. Of course I wish I would have made that decision in Dec. but I'm not going to beat myself up about it. I did what I thought was best for me at the time!



Ann

I had a mammo that found "suspicious" microcalicifications. Followed that with a vacuum-assisted stereotactic biopsy and then lumpectomy to remove LCIS. Never once had an MRI or ultrasound. 

MRI did not show my LCIS which was extensive.

I didn't think LCIS showed up on an MRI.  My mammo showed microcalcs which led to the biopsy, which came back with LCIS. 

Hi jeninfla, 

MRI is a precise imaging tool, so perhaps trying to confirm his diagnosis. 

You may find these links helpful:

http://www.breastcancer.org/symptoms/testing/types...

http://www.breastcancer.org/symptoms/types/lcis/tr...

Thinking of you! 
The Mods

jeninfla--reportedly, mammos are better at finding non-invasive bc (LCIS and DCIS), while MRIs are better at finding invasive bc (such as ILC and IDC). that's why I'm glad I'm on an alternating schedule, so that what one test might miss, hopefully the other will pick up.  Since LCIS is thought to be a bilateral condition, I know I probably have it in more than one area. When I have my MRIs, I'm not really worried about them finding more LCIS; (as the LCIS itself does not need to be completely removed as it is non-invasive); it's any invasive bc that might be there. If you are going to have an MRI, I would suggest waiting at least a few months, as it will show a lot of "post-op changes" from your excisional biopsy and that can confuse the findings.

(Leaf---from her post, she's already had her excisional biopsy.)

Anne

My LCIS showed up on MRI as vascular changes, I pushed for biopsy of it. It did have necrosis so I do not know if that makes it  more visible or not.

When I got the original needle biopsy, he said it showed Atypical Ductile Hyperplasia and Atypical Lobular Hyperplasia. that is why he did the excisional biopsy. When the result of the Excisional came back as LCIS, he said he wanted the MRI to make sure that he didn't miss anything. If the MRI comes back OK, my chances of getting cancer bilaterally is 40% due to 3 Maternal aunts and my Mom having BC. I thought about the tamoxifen but I really don't see a benefit in it. I am 45 yrs old, Mom to a 4 yr old and am NOT in menopause yet. The Tamoxifen lowers my percentage to 28%. Still way to high for me. did anyone on here have a similar situation? If so, did you decide to have a dbl mastectomy and total reconstruction or take the pill? I had my test today but now my Doc is on Vacation all next week so I wait.......which I am not very good at.

You get percentages of breast cancer risk from the docs. 

 Know that the docs do NOT know these numbers with any kind of certainty for you, an individual patient. The science of breast cancer prediction is in its infancy (perhaps except if you have a very high risk situation such as a deleterious BRCA mutation).  Almost everything concerned with LCIS (with nothing worse such as DCIS or invasive breast cancer) is controversial; it is an unusual condition. (Incidence is the number of new cases diagnosed per year.)  This paper estimated the incidence of LCIS (in SEER data) was about 2.5 in 100,000. http://www.ncbi.nlm.nih.gov/pubmed/23846782

This paper  http://jnci.oxfordjournals.org/content/98/23/1673...commented on the accuracy of the modified Gail model, which is the 'standard' model of breast cancer prediction for women who have not had breast cancer.  (The Gail (modified or not) model automatically excludes LCIS and DCIS women.) http://www.cancer.gov/bcrisktool/. The Gail model (or modified Gail model) has been peer-reviewed, and has been validated for large groups of women in the United States.  There are other statistical tests that can be run for how well a model works for individuals. The compared the accuracy of the Gail model to (the Gail model plus adding other risk factors such as breast density).

In other words, for 59% of the
randomly selected pairs of women, the risk estimated
for the woman who was diagnosed with breast cancer was higher than the
risk estimated for the woman who was not.
Unfortunately, for 41% of the pairs of women, the woman with breast
cancer received
a lower risk estimate than her cancer-free
counterpart. Thus, for any given woman, the two models were better at
prediction
than a coin toss—but not by much.  <The models may work better if you have a BRCA mutation which puts you at much higher risk than LCIS.>

If they have this much trouble predicting the breast cancer risk of 'average' individuals in the United States, just think how much data they have on the risk of women with LCIS - even in a group of LCIS women.  

So, while they can give you 'your percentage risk', sometimes down to 3 significant figures, they don't know this number well at all.  They know these percentages at best 'better at
prediction
than a coin toss—but not by much'.  This does NOT mean your chances of breast cancer are about 60%.  This means that the modified Gail model predicts accurately about 60% of the time in individuals. That means the modified Gail model predicts wrong about 40% of the time in individuals.

So AWB, are you saying that you have just waited to see what will happen? I am not sure I can do that. I have a 4 yr old son, I really am not that patient and I hate to sit and wait for the other shoe to drop.....I am going to see the plastic surgeon and the Oncologist and then weigh my options. On a side note, I have never had any surgery other than a C section when I had my son. I had the excisional biopsy on my left breast, about 2 inches up from my nipple and closer to my arm pit. I am a rather large breast size. The skin around my nipple, about 2 inches around is red, almost like a sunburn. It doesn't hurt at all. Still very tender around my scar. Is this normal to be red like thatl, or something I should call my doctor about? I was told by my surgeon that he went deep into my breast for the biopsy so is this just part of the healing?

I am sorry, I think I worded that incorrectly. I didn't mean to sound like you weren't doing what you needed to do. I apologize for my wording and what sounded very cold and insensitive. I am so confused as to what to do. I dont want to get cancer. My Mother, and 3 aunts have all had breast cancer. My Mother had a mastectomy and is taking a chemo drug but she has already been through menopause. I guess I don't know that I want to go through early menopause (I am 45) and then find out I STILL got cancer. Once I see the oncologist, I think it will give me a better handle on what to do. Did you have any redness like a sunburn around your breast after the surgery? Its been about a month since my lumpectomy. Its strange but it might be perfectly normal. 

Once again, please accept my sincere apology. I appreciate you talking to me.

Finally replying to Rosieride:

.the thing that keeps nagging at me is my surgeon saying bmx is what she
would do because of LCIS and that I have a 30% in my lifetime of
another bc... 2nd opinion doc said that % is for women who haven't had
bc....since I had bc the % is 1/2 percent a year ...so in 20 years that
would be a 10 % chance???I would be 74 and I figure THEN I would get
bmx...I am confused about percentages...but I so like the 10% number!!
So confused!! Rosie

The numbers you have been given are for groups of LCIS patients, not for individual LCIS patients.  They have much less information about whether these studies apply to you as an individual. (Being understandably self centered, our first impulse is to ask, "What are my chances of getting breast cancer?", not "What are the chances of someone in the group of LCIS women get breast cancer?")

The studies they have cited are from relatively small groups of patients.  Usually they have not stated whether or not the patients took antihormonals or not.  The long-term (decades long) data is really sparse.  Probably the best long term study is the Chuba paper

http://jco.ascopubs.org/content/23/24/5534.long, but, again, at 25 years post diagnosis, they're looking at a few dozen people at most.

http://jco.ascopubs.org/content/23/24/5534/T2.expa...

So there's a lot we don't know about predicting who will get breast cancer.  We do not know hardly at all whether your risk (or my risk) will be 10% or 60%, but its probably not 10% because the 'average' woman in the US has a risk of about 13%.

I understand you are scared, but do note that my oncologist does not want to follow me 10 years after my LCIS diagnosis.  I am not sure she knows all the LCIS literature, but that is her judgement.