Did everybody have an MRI?

I've had a breast MRI as part of the initial diagnosis and also pet/ct scans at the same time. I can't even remember how many scans I had then--breast, brain, maybe some others, pet/ct for sure. Since then, I've had pet/ct scans galore. If I didn't have a tissue expander with metal in it, I would have had another breast MRI about 2 years post diagnosis.

Nancy,

I had an MRI after initial diagnosis, but it was the one thing my insurance really didn't want to pay for! It did show that my lump was bigger than had been revealed by the diagnostic mammo and ultrasound, so I guess that was informative. I also got a PET scan, which insurance paid for without much fuss. I'm wondering what scans I'll get done before we decide on my surgery (lumpectomy? mastectomy?), and how willing insurance will be to pay for them.

I was told by my surgeon that all patients diagnosed with invasive breast cancer were given either a breast MRI or something called a breast gamma imaging before surgery to help show any other problems and give a better idea about size of the tumor and if anything was going on with the lymph nodes. There really seems to be a lot of differences between doctors.

Nancy,

Yes, I'm getting to the end of the Taxol and really really really want to plan my surgery so I can figure out the holidays. I think one reason that the insurance company balked at paying for the MRI had to do with the fact that the two authorizing figures (my GP and my BS) weren't in town, and we were relying on the other people in their offices who aren't my doctors to sign the paper work. (My radiologist said that she couldn't authorize it because it would be like her drumming up business for myself.) It was a crazy time; I had just been diagnosed and was trying to get everything going quickly because of my tumor size and grade (grade 3).

Diagnosis was done with mammogram, ultrasound guided biopsy, and clinical exam--clear results, no MRI. Now almost two years out and have had only two yearly follow-up mammos (both clean). Surgeon will order an MRi to see behind remaining scar tissue from lumpectomy, but that will be in 6 months, to give scar tissue still more time to disintegrate. I am fine with this, since they are seeing everything they need to see and not seeing anything problematic. The CAT scan before rads was purely for planning the rads, not for diagnosis of any kind. Every patient is different, and so is every physician.

ruthbru, thats what my doctor told me. She said she wasn't going to ask for scans at this time because you had to have a certain amount of cells beginning to form something before it would show up.

If you have enough cells to be diagnosed with a mammogram or an ultrasound, and a biopsy, you have enough cells to be seen with an MRI. MRI is far more sensitive than either mammogram or ultrasound. That is one of the reasons that MRI cannot be used for screening--it picks up everything, even benign conditions, so you would be doing too many biopsies, potentially MRI guided biopsies, because it would pick up things that cannot be seen on mammo or ultrasound. Which means that MRI should only be performed at a center equipt to perform MRI guided biopsies. And that's the other reason that MRI is not used as a screening tool: it is too expensive and the cost/beneift ratio doesn't work at a population level.

That being said, MRI is an excellent tool in the circumstance of a known breast cancer to determine the size, particularly with lobular carcinoma, look for satellite foci that would preclude lumpectomy, look for disease in the contralateral breast, look for positive lymph nodes that might not have been seen. It can be very helpful for pre surgical planning.

@WinningSoFar

My mother was diagnosed with Triple Negative Breast Cancer in 2008, she had lumpectomy, six chemos and radiation. Since then she was doing well until this January when she was diagnosed with lung mets. She had 8 rounds of taxol and carboplatin chemotherapy. The chemos got over in June end and the scan showed improvement. Suddenly on 1st November she had a seizure which made me took her to the neuro and he asked for immediate MRI, which showed brain mets. The doctors had started decmax (steroid) and whole brain radiation(WBRT), with 37.5 cGY in 15 fractions.Currently she has undergone 13 fractions with manageable side effects.

I saw your were also diagnosed ER-/PR-, Her2- , same as my mother. As per study and doctors no oral chemos work when hormones are negative. Can you tell me what course did you follow ?

Also currently what line of treatment are you following. My mother does not have much time left as per doctors since it has mets to the brain.

Please help.

Thanks

Saile

I can tell you that at MSKCC, early stage breast cancers get an MRI prior to surgery, I had one when I had DCIS in 2008 and again with this diagnosis. This time the MRI picked up two adjacent tumors that were 1mm and 2mm big.

People got turned off to breast MRI because of how sensitive it is which is why it is not useful for general screening, but when the diagnosis is not in doubt and you want to know what else could be there before you make a surgical plan it is a great tool. But it takes a while to convince people who have been working without it. Also reading it is a skill set that people have to learn, and it is only as good as the radiologist reading it.

I'm beginning to think that I must have had every test devised and then some. That may have to do with my insurance being easy to get along with. When I was first diagnosed, I had ultrasounds at least monthly, head to toe pet/ct scans every 2 months, breast MRI once, brain MRI, chest xrays and that's just what I remember. I don't know if all of those were necessary but when you have IBC, and it's stage IV, you're not exactly in a position to claim you want to know less.

I just got diagnosed Nov. 19. I found my lump during a self-exam. My last mammogram was in March and was CLEAR. (or at least as far as they could tell.)

So mammograms did not catch my 3cm lump!

After DX, MO got me a hip/abdomen CT, and that is all because it's the company's standard procedure. I got a second opinion for outside oncologist saying I should get everything: PET, CT-full body, MRI-bilateral breast, MRI-Brain, bone scan...

My oncologist refused to do anything without getting that 2nd Opinion letter. I think he needed it to justify the extra tests.

But he was still saying I shouldn't get a PET because of high radiation. I partially feel that it's because it's the company line not to give PETs, but on the chance that it really IS bad for me, I told him I'll skip it (but I still think of doing it anyway, for peace of mind!)

I'm also getting many of those tests (MRIs, bone) AFTER my first course of Chemo because I had to wait weeks to line up all the appts and 2nd Opinion and then fight for stuff recommended by the 2nd Opinion. It might not be as good, but I'll be happier to have the tests.

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Should I insist on the PET since I'm not getting a SNB before chemo??? Anyone know?

Thanks for the info, funthing42. That was helpful. And I hope you are doing well!