2nd MRI at odds with 1st in diagnosis.

Evilmidget · December 2014

I was diagnosed with a very small 1cm IDC at the beginning of the month. Because my breast tissue is so dense, my surgeon sent me for an MRI. The initial findings were, in addition to the known cancerous nodule, two other areas of suspicion. Then, on the same pathology report was an addendum that said both suspicious areas were Bi-RADS 0 (non-cancerous). My surgeon sent me for a second MRI at a different facility and that report said that the two areas are actually part of the original biopsied tumor and are BI-RADS 6 (malignant). The combined size of these 3 areas now take the tumor to a stage II.

I can't believe the extreme variance between the findings but haven't had my appointment with my doctor yet to see what she has to say about it. It will mean a mastectomy instead of a lumpectomy but my other tests still indicate I won't have to have chemo, just radiation and hormone therapy.

Has anyone else experienced such a variance between 1st and 2nd opinions?

yikes1 · December 2014

are you being given your radiology reports directly from the radiologist?

If so, please be very, very careful trying to interpret them yourself.

a pathology report may note what was seen on the MRI but a pathology report is not evaluating the MRI scan, is it? You refer to an addendum on the pathology report. Do you mean the MRI report?

You had two MRIs, both with contrast?

Or a second radiologist rendered an opinion about the first MRI?

Evilmidget · December 2014

I had two separate MRIs, both with contrast. I was given a copy of the 1st MRI report by my doctor and the second MRI was done at a hospital facility and they posted the results to a portal I'm given access to.

(I misspoke when I wrote pathology report. I should of said MRI report).

yikes1 · December 2014

wow, interesting that they post the report before the referring physician reviews it.

makes more sense now about the pathology report.

as far as i know from my own experience, the mri could show something, but I was told that it could not be known what it meant without a biopsy - in my case an mri guided biopsy.

I think they grade what they see so others reading report know what they think.

mri's can vary due to so many factors.

and as far as I know, the "result" is an interpretation.

but, to address your question, I have found that there can be a difference between opinions, guess that is why they are called opinions. I think your doctor may be able to put it all together.

I do not think you have radiation with the mastectomy, only with the lumpectomy.

yikes1 · December 2014

one more thought -

if the 2nd mri states the areas are bi rad6, then because they are being read as part of the original site, wouldn't they have to be the same diagnosis, which is cancer?

maybe the 1st mri study was referring to other areas they see, but not suspicious looking, so category 0, and not part of the original biopsy site?

bevin · December 2014

HI there, I'd check with your doctor on size. According to my oncologist, they do not add together separate tumor sites to get a total tumor and stage you. They stage by the size of the largest independent tumor. Not added up together. I hope that helps and is in concordance with what your surgeon or oncologist will advise you.

wrenn · December 2014

Were the two suspicious areas part of the original tumour? A tumour can have cancerous and non cancerous parts to it so I wonder if the original MRI noted that there was an area that didn't show cancer and an area that did and interpreted it as 3 separate areas when it was all one tumour?

Mollymae · December 2014

I had an MRI after being diagnosed with <1cm IDC in right breast. In the meantime,I chose to get a bilateral mastectomy instead of a lumpectomy after reading about so many people needing further treatment after a lumpectomy. In addition, I have very dense breasts and didn't want the continual worry that something might get missed. The MRI showed suspicious areas on both breasts but I'm told that this is not unusual. I skipped the biopsies because my bilateral decision had already been made. I had surgery on 12/19/2014 and there was Cancer in both breasts. The decision turned out to be right for me. Lymph nodes were checked on both sides and no Cancer was found. MRI's do show many false positives. Good luck

2nd MRI at odds with 1st in diagnosis.

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