MRI good but still concerned

Janeway69 · April 2015

Hi,

I had a breast MRI ordered after a diagnostic mammo ( spot compression) revealed an area of concern. The radiologist said he did not think it was serious but could not explain it. Sonogram found cysts but there was an underlying area in the mammogram that he felt could not be explained by the cysts in the sonogram.

I got my results. "No evidence of malignancy. Fibrocystic tissue corresponding to findings on mammogram."
Bi-RADS rating of 3.
The tech on the phone said "It's a GOOD report" with that "Trust me" tone. She was very nice.

However they want me to do a follow up mammogram in six months to check stability.
Before I got these results, my GYN said if things do not change for two years it's considered benign. That was when she hadn't even received results so I am guessing her statement applies to many things.

I've heard cysts can make you more prone to cancer, but it doesn't mean you get it for sure. I know that fibrocystic tissue is not unusual in women. I'm having them mail me all copies of my reports though.
By some amazing coincidence I'm having some pains in my left breast. They are very similar to pains I had in my right one back in 2002, which my GYN checked and said was likely due to a progesterone surge.

Part of me wonders if a biopsy still should not be done, but I've been told that they generally are not done unless truly warranted. Before the MRI the radiologist said if it comes back good, odds are 99% that I don't have cancer. I realize in medicine they never say 100%, just in case. But I wonder just HOW much an MRI can really tell the doctors?

MelissaDallas · April 2015

Biopsy is not recommended for a Birads 3 test. The odds are less than 3% that a Birads three rated are is cancer. You run more risk having unnecessary biopsies, plus it would create scar tissue in your breast that would make future mammograms, etc. harder to read.

Janeway69 · April 2015

Okay but less than 3% is not that great as far as I'm concerned. Even biopsies create scar tissue?

Does scar tissue increase risk of cancer, or just of more hard-to-read mammograms and more biopsies? All those things stink but compared to cancer....

MelissaDallas · April 2015

No, scar tissue doesn't raise the risk of cancer, but it could hide a cancer on a future mammogram.

I would imagine the majority of women have some Birads three areas on testing after a certain age, because 60% of women have fibrocystic breasts and most of us develop calcifications as we age.

The fact that it is so low risk confirmed by an MRI is good. I would just do the follow ups.

Janeway69 · April 2015

Okay great. And I saw on at least one site - though I don't know how good it is - that with experience and improvements in technology, the odds of cancer with a Bi Rads 3 is closer to 1% than less than 3%.

So, I can see how risk of more biopsies can add to perhaps unnecessary anxiety. I was weighing that vs being one of the rare birds that still has a cancer which was just missed. But that may be just anxiety fueled concerns and not rationale-fueled.

Appreciated!

Janeway69 · April 2015

BTW, if most women develop calcifications as they age, how do "they" know when to biopsy and when not to?

april485 · April 2015

Hi Janeway,

If they see calcifications and rate you a Birads 3, they generally have you come back for follow up diagnostic mammogram in 6 months. If the calcifications have multiplied or in any way changed, then they might rate you a Birads 4 and order a biopsy. Hope that helps since that is exactly what happened to me. In my case, at the 6 month mark, mine had tripled from 3 to 9 clustered together.

Edited to add that if they are spread out all over the breast, they are usually benign and do not warrant a biopsy. It is when they cluster or form a linear pattern that they watch it closely.

ballet12 · April 2015

Hi Janeway, there are different kinds of calcifications. There is a certain kind which would raise the risk of cancer in the area. It is a microcalcification. If THOSE calcifications group together or form a linear pattern, there is an increased risk that it is associated with cancer (mainly, although not only DCIS) or it could be associated with atypical cells. MANY, MANY women have this pattern of calcifications and don't have a cancer or atypia diagnosis after biopsy. It's just that this kind of calcification (not the larger more gross calcifications) that is considered more at risk.

Did they find calcifications on your mammo that they are following?

Janeway69 · April 2015

Ballet12 no, no one mentioned calcifications and from what I saw on the mammo myself vs what samples I've seen, I didn't see any either.

I want to thank everyone here and if you think of a good BC research program, center or project that is worth donating a few bucks to, please PM me. I am relaxing now for the time being and want to give some money to BC research. Someplace where there is not a lot of waste in admin costs, etc.

Thank you everyone!

bellajenn · April 2015

Janeway - It's so good to hear that you're feeling the support and are relaxing a bit. It's definitely a journey you're finding yourself on. Those of us on the same journey are definitely here for you!!

ballet12 · April 2015

Hi Janeway,

You can actually also contribute to this website (bc.org), which allows us to be here and share.

april485 · April 2015

Hi Janeway,

Good organizations to contribute to are Stand up to Cancer.org or MBCA (Metastatic Breast Cancer Alliance) American Cancer Society and of course, as Ballet mentioned, our own BCO!

Janeway69 · May 2015

I shouldn't keep torturing myself but does anyone know stats on how often women get atypia? Does it differ for women who have fibrocystic tissue vs those who do not?

I read the response about 60% of women getting fibrocystic tissue. I guess it's a cost of dealing with estrogen. I feel an urgent need to lose weight now.

dolfin · May 2015

Hi Janeway 69

I have a lot of fibrocystic changes and had a negative stereotactic biopsy last week for microcals and they were trying to rule out DCIS based on their pattern. I have many estrogen dominant issues and am now working with a naturopath to deal with this as I think it can only help. It starts as it was explained to me with no phytoestrogens; no hormonal supplements, approaching this with liver detox methods which includes probiotics.

I have lots of cysts, 2 complex cysts, ductal ectasia, fibroadenomas, some adenosis (as per biopsy path report) but so far no atypia. I had mastitis (non-lactating) in Feb. which started me down this investigative path and who knew I would need a biopsy as I have no masses. and now I need closer monitoring with 6 mos interval mammos on top of the 6 mos ultras sounds I was already getting for my cysts and ductal issues.

I am also attempting to lose some wt. too since estrogen likes to hang out in fat cells and the less of it I have the better.

Best wishes to you

alicki · May 2015

Hi dolfin,

Same problem here. Estro dominance. Can u tell me how to get rid of it?

Thanks,

Alicki

dolfin · May 2015

Hi Alicki,

My naturopath has suggested to me (and I went to see her for help with peri-menopausal questions I think I'm experiencing and I expect my transition through this will be rocky since my understanding is estrogen dominance causes the ratio of estrogen to progesterone to be really high and imbalanced which means progesterone isn't high enough to help balance things) that the place to start is with detoxifying the liver and helping it get rid of the bad estrogen. there are herbs like milk thistle that can help, a probiotic which helps this too i.e. Align; she wants me to try Iodine supplements for breast health (a bit leery of that one since it can affect thyroid); evening primrose oil; also Maca root (which apparently is a hormone modulator/balancer) and for those people with estrogen dominance, the last thing you need is more estrogen so she said no phytoestrogens and definitely no soy or tofu products. I am also trying to be more mindful of the products I am using with parabens in them and trying alternatives. I may see a menopause specialist about the merit of progesterone supplementation but figure I have enough to work with here to get started. I am also on Vitamin D 200IU's a day.

I hope this helps.

Janeway69 · May 2015

When I was 32 I had a stabbing pain in my right breast. My GYN checked me and she said "one gland is a little thicker here, the one you felt pain in, but it's not unusual or concerning. You probably had a progesterone surge."

By some wild coincidence, for the first time ever, now my left breast, which was the subject of concern recently, has had similar achy pains that I always associated with the right breast. Not stabbing out of the blue as happened with the right one, but definitely the same overall feeling. It even started in the same location, on the outer side of the breast, which seems to be opposite of the location of the fibrocystic tissue found.

So, I'm wondering if more progesterone to balance out would really be advisable either. I'm going to ask my GYN about what good hormone checks do. I read that they fluctuate so much that testing at any one time may do little good. I also am not sure about how to dose evening primrose oil.

MRI good but still concerned

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