MRIs, Mammograms after taking Tamoxifen?
I'm getting to ready to take my first of 20 days of tamoxifen, and will have a mammogram/mri/ultra in a month for my checkup. My question is, how does the tamoxifen affect the scans and pictures? Does it make it cleaner? Does it immediately shut down the estrogen to the breast so you get a better (meaning less cystic) image? Maybe I'm not saying it right, but does the drug help stop cancer from developing in the breast in a short time frame? I would love to go into a mammogram and not worry as much!
I have mild dysplasia and the doctor is checking me more frequently and wants an MRI this go round with a short run of tamoxifen for better pictures
Comments
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IMO 20 days on Tamoxifen would not affect scans, mammos, etc. Good luck...
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AWB took tamoxifen preventively but over a period of years. These are all great questions. Since your doctor prescribed it there must be something to that. How exciting to be a part of such a groundbreaking process. Please do let us know how it goes. I'll ask my radiologist these questions but my appt is next year. I personally don't have much breast tissue but would love to know about this for my DD's sake. I think you are getting cutting edge advice. Take care.
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I just thought of something. You could ask these question on the "Ask an Expert" site on the Johns Hopkins website. The nurse who manages the site is amazing.
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There is some research that has been done to try to determine whether the imaging of the patients for whom tamoxifen is more effective might show changes that could be used to help to decide whether the patient is having a response to the drug or not. (Google Karolinska Insitutut and tamoxifen.) IF that research proves reliable, then patients who are not responding to the drug could at least be taken off it and possibly switched to alternative treatment.
That research was not being done yet at the time I was treated. However, I pointed out at the time to the radiologist that my mammos had been very dense prior to starting tamoxifen and after completing chemotherapy, and that within 3 months of starting the tamoxifen my mammos showed they were very clear of density.
I am 13 years out from a stage 1 diagnosis as a HER2 grade 3 DCIS/IDC node-negative cancer patient, have never received Herceptin, and remain without evidence of disease. I hope the research continues and provides more information about who should be on tamoxifen and who is wasting their time on it.
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AA - That is really excellent point. Thank you.
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Thanks, farmerlucy!
I should mention also that it may provide help in determining how long a given person would take the tamoxifen.
I probably could have quit taking it when my breasts became clear at 3 months, if their research turns out to be solid. As it was, I only took the tamoxifen for a year at full-dose and then 3/4 of a year at half-dose, which was just a personal decision, not a medically recommended one.
13 years out,
A.A.
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FYI, I asked the MO I met with how long one has to be on Tamoxifen before one may see changes on imaging. He consulted the peer reviewed studies and said the average time to effect is 18 months on Tamoxifen. Tamoxifen "may" have an effect on reducing breast density, but it's not a given. Women who have little breast tissue and/or are very lean and dense may not experience a reduction in density at all. Even if you don't experience a reduction in breast density over time that in and of itself would not necessarily mean that Tamoxifen is not doing the job of reducing your risk. The role that breast density may (or may not) play in all this is one of the many points of contention in the medical field. There are a few studies that have postulated that breast density may be a risk factor, but that is unproven. If you ask me, at this point, what we do know is that our current medical technology is insufficient to be able to do a really thorough job of screening people who are extremely dense. The docs acknowledge density can be a limitation to discovery, but there is no proof that density alone represents a non-obligate precursor to invasive disease. This has been a topic of interest to me because this business of extreme density (+ diagnosed LCIS on repeated biopsies) is what I had dealt with for the last almost 8 years. I was always looking for new studies.
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Thanks for the average, MsVDB.
One drawback is that loss of breast density is due to the loss of the internal breast tissue support "framework", so the breasts sag. (The "framework" is what makes it hard to see cancer in dense breasts because the cancer and the "framework" are both white on mammos, which lets cancers hide even when they are "in plain sight".)
As I said, I hope the research continues and provides more information about who should be on tamoxifen and who is wasting their time on it. If on average it takes 18 months for density changes, I wonder how that relates to the basis for the recommendation for the average patient to be taking it for 10 years.
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