Probable local recurrence after 8 years

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nash
nash Member Posts: 2,600
edited March 2015 in Not Diagnosed With a Recurrence or Metastases but Concerned

Hi, everyone. I've been off these boards for years, happily chugging along on my Tamoxifen (10 year plan), post-surgery/chemo/rads for Stage 2 pleomorphic ILC. I'd opted for a lumpectomy at the time for a variety of reasons, even though I had a lot of pleomorphic LCIS left over in the boob, with the understanding that I'd be monitored with annual breast MRIs.

After six years of clean MRIs, my onc decided that I didn't need them anymore. I argued that I did indeed need them due to the PLCIS, so we compromised on MRI every two years. So I went two days ago for one, after having the last one in 2013. Well...you know things are not good when your onc calls at 5pm the same day as the MRI. Or when they want to schedule the biopsy before getting insurance approval.

Anyhow, there is a new 1cm mass where the original tumor had been, plus what appear to be new satellite tumors plus an area of suspicion in a different part of the boob. BIRADS 4C. How this all popped up in two years while on Tamoxifen, I don't know. I'd like to think it's a weird MRI blip, but I kind of don't think so. The MRI report states that it's most likely a recurrence of the first tumor along with new ones. Terrific.

So....the only thing to do until my biopsy on 4/6 is to turn for support here, b/c one thing I learned last time is that although my friends all mean well, it is best not to discuss cancer issues with them, as I can only handle so much "think positive", "my friend cured herself with meditation", "why didn't you have a mastectomy the first time" etc.

The one question I have is--they have scheduled me for an u/s to try and target the areas for biopsy, but said if they can't, I'll have an MRI guided biopsy. I don't know if that means the same day or their next available appt or what. I can't imagine why we're not going straight to MRI guided biopsy, unless the u/s guided biopsy is just that much cheaper/easier? I've had biopsies done both ways before, but I didn't know what the decision driver was.

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  • coraleliz
    coraleliz Member Posts: 1,523
    edited March 2015

    Sorry to hear of your reoccurrence. When my original tumor was found on MRI, the images were displayed on a screen. This help the tech & MD locate it by US. Not sure how a MRI guided biopsy is done. In a MRI scanner? Hopefully someone who's been thru it will come along .

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  • nash
    nash Member Posts: 2,600
    edited March 2015

    I had to have an MRI guided biopsy in 2009 on the "good" boob, and yeah, it was done in an MRI machine. I'm just curious why, if these masses were found on MRI, we're going with u/s. Now I'm wondering if it's b/c there is more than one area in question, and it's just easier to biopsy multiple areas while on the table with an u/s tech.

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  • Ridley
    Ridley Member Posts: 634
    edited March 2015

    Nash -- sorry to hear about your situation -- I have had biopsies done both ways too, and I can only guess that its cheaper to do an ultrasound guided biopsy.  I also wonder if they can be more precise as they can see the image while they are doing the biopsy.  As you know with the MRI guided one, they mark the spot, but do the biopsy out of the machine.  I had a bilat biopsy done that way because they couldn't be seen on mammos/ultrasounds.  One spot moved during the MRI and we knew then that we might not have got the spot.  A number of radiologists looks at the MRI and thought they did and the biopsy was negative. Turned out to be a false negative for DCIS -- luckily it was caught within a few months -- and biopsied with an ultrasound guided biopsy.

    Good for you for fighting for an MRI.  All the best for B9 results.

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  • Moderators
    Moderators Member Posts: 25,912
    edited March 2015

    nash, thiking of you. Best of luck with biopsy results!

    The Mods

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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited March 2015

    Nash, yes, an ultrasound-guided biopsy is far easier (for both patient and staff), far quicker, and far, far cheaper. If your lesion is visible on ultrasound, the radiologist can watch his work (and so can you!). For obvious reasons, it can only be done if the lesion is visible by ultrasound. I had three lumps, two (these two turned out to be benign) visible only through MRI, so I had both kinds of biopsy.

    An MRI-guided biopsy requires a specially trained radiologist who maps the site/s on his screen, matches the locations/s to a grid placed against your breast, and does the biopsy blind. The procedure involves multiple scans, and multiple trips by the doc, back and forth to the viewing room (or whatever they call it), to be certain the correct areas are targeted. Each scan takes several minutes. For the reasons above, as well as patient comfort, they do this only when the lesion is not visible by ultrasound.

    The marking of the MRI site is done by placing the actual biopsy needles, then running another scan with the needles in place to check that they are correct. I realize this sounds a bit harrowing, but once the needles are placed, you really do not feel them. Oh, and they do use lidocaine. Lots of lidocaine. Because you'll be sliding in and out of the machine for what seems like ages, all the while remaining perfectly still so as to not disturb the accuracy of the grid, it gets a bit tedious.


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  • nash
    nash Member Posts: 2,600
    edited March 2015

    Thanks for the feedback, ladies. Will keep you posted.

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