Not sure what to make of this.

HerpaDerpina · January 2018

Hello, all.

My name is Morgan. I'm a 29 year old stay at home mom of two young boys (ages 4, and 1). Thank you all for being so willing to share your experiences and support. This is a sort of long story, so hopefully it doesn't turn into a book.

Over the summer, I met with a surgeon to pursue vertical sleeve gastrectomy (weight loss surgery). One of the first papers they handed me in the office was a breast cancer screening to see if i was a candidate for genetic testing. Long story short, I found out that I don't carry any of the genetic mutations that Myriad tests for, but because of family history it was determined that I have increased risk of breast cancer. It was recommended that I have yearly MRIs starting this year. My dad's mother was diagnosed with breast cancer twice. My dad's sister was diagnosed with breast cancer at about age 45-ish and with either ovarian or cervical cancer about a year ago (I'm not very close with that side of the family, so I don't really know).

I had my MRI on the 10th of this month. The MRI showed what the radiologist called a "band of tissue" in my left breast that extends from my nipple to the back of my breast. It basically looks like a nodule near the "back" of my breast started sprouting stuff, too a sharp right, and headed straight for my nipple. I am having pain in one spot on my left breast, but there are no discernible lumps. Today I had an ultrasound and a mammogram. I'm unclear about whether or not anything was shown on the mammogram, but he said that nothing showed up on the ultrasound. I plan to pick up the reports and images on Thursday. I have no idea what my BIRADs score is. Honestly, I was just kind of overwhelmed and my brain completely failed me in the moment.

I'm to have an MRI guided biopsy after I start my next cycle, which I'm not expecting until sometime around the first of February. The MRI likely won't be until late the following week sometime, and they said that the pathology reports typically take up to three business days.

I was ok with all of this until the ride home from the hospital. I was in the car alone with my thoughts, and even though I was trying not to freak out...I was freaking out. I'll post more information here when I get it on Thursday...or I might just get impatient and make the trek tomorrow. I haven't decided yet.

Does anyone have any idea what to make of this? Similar stories? Advice?

Again, thank you all so much for your time.

Georgia1 · January 2018

Oh goodness, that is a lot to take in. Honestly, if I were you I would get copies of the mammogram, ultrasound and MRI reports tomorrow if they are ready. Can you maybe call and ask them to email them to you? It seems odd that they have scheduled a biopsy without explaining what, exactly, they are testing. Or do you think they're planning multiple biopsies of that "band of tissue" the radiologist described? I'm not an expert, but I do think the mammogram and/or MRI report would at least give you the size of the spot the radiologist is worried about, tho weird that there was nothing on the ultrasound.

I know this isn't very satisfying, but do know I am sending warm wishes your way. Odds of BC at your age are very low.

SavedbyGrace1972 · January 2018

Hugs to you. Try not to panic though easier said than done. Do you at least have the results of the first MRI? Well I asked to see the mammogram films and I also asked to see what they were looking at on the ultrasound. Play with those babies and before you know it, your results will be available. Good luck. We are here for you.

HerpaDerpina · January 2018

@Saved

The MRI, which is what I did before the mammogram and U/S is what showed the band of tissue. The results of the MRI are why I had the mammogram and U/S. I did ask to see the MRI, and she enough there's one very bright line of tissue with a sort of nodule at the end.

@Georgia1

I don't think they can email them to me without me physically going in and signing releases. I'll just go up there tomorrow morning and see if they're ready. If not, I'll give it a couple of days. The radiologist I saw today won't be the one doing my biopsy, but he said that he's willing to bet that they'd go after the nodule thing. They are going to biopsy the band of tissue and the nodule for sure...he just wasn't quite sure what to make of it. He seemed to be perplexed.

I'll go first thing in the a.m. tomorrow and share the report here and the MRI image (if that's allowed?) so y'all can see what I'm talking about. It's difficult to explain

Veeder14 · January 2018

I get my test results by email through the hospital system, some test results are automatically released that way, and others are sent to me by primary care. You shouldn't have to wait to get copies of test results. Does the hospital your going to have some sort of system to send patients information through computer? I can't get the actual images/film unless I make a release of information request only because the hospital system doesn't have a way to send images/videos. Will you be going to your primary care office or radiology to get the results?

HerpaDerpina · January 2018

I just called to see if they can email me the records, and they can't. It's their hospital's policy that I have to physically go to medical records and pick everything up in person

HerpaDerpina · January 2018

All righty. Here are all three reports, copied and pasted. It wouldn't let me post the MRI image which is a bummer because it's pretty interesting. My gut tells me that if this was actually a "fibrocystic change" that they'd be able to see it on either the ultrasound, mammo, or both. But I'm not doctor so this is way over my head.

MRI report:

MRI BREAST BILATERAL WWO
SCREENING BREAST MRI OF BOTH BREASTS - WITH CAD: 1/10/2018
CLINICAL: No comparison-12cc of gadavist-family h/o br cancer; genetic
testing recommends MRI.

No prior exams were available for comparison.
Interpretation of this MRI was correlated with available mammograms,
ultrasounds and clinical information. Informed consent was obtained
from the patient. 20 cc of gadolinium contrast was injected. Axial T1
and T2 images were obtained at 1 mm intervals with a dedicated breast
coil. Pre and post contrast images were obtained at 1 minute intervals.
Post processing was performed including color parametric mapping,
computer aided calculations of any tumor volumes and dimensions and 3D
multiplanar reconstruction.
Bilateral background breast enhancement is mild.
Current study was also evaluated with a Computer Aided Detection (CAD)
system.
There is a 3 cm x 7.3 cm ductal area in the left breast at 1 o'clock
posterior depth. This shows homogeneous enhancement.
No other findings are seen in either breast. There are no abnormalities
seen in the axillary nodes region or internal mammary nodes.

IMPRESSION: INCOMPLETE: NEEDS ADDITIONAL IMAGING EVALUATION
The 3 cm x 7.3 cm ductal area in the left breast at 1 o'clock posterior
depth has a differential diagnosis of DCIS or fibrocystic change and is
indeterminate. A mammogram or an ultrasound are recommended.

Abnormal ductal enhancement extending from the nipple into the left
upper outer quadrant. A left mammogram and left breast ultrasound are
recommended. If these are unrevealing this area may ultimately require
MRI guided biopsy.

MRI BI-RADS Category 0: Incomplete - Need Additional Imaging Evaluation

Mammogram report (I'm just going to copy and paste the summaries for the mammo and U/S because there was nothing found on either):

There is no abnormality seen in the left breast to correspond with the
breast MRI finding in the anterior, middle and posterior depth in the
outer aspect, however ultrasound is recommended.

BI-RADS Category 0: Incomplete - Need Additional Imaging Evaluation

Ultrasound:

IMPRESSION: INCOMPLETE: NEEDS ADDITIONAL IMAGING EVALUATION - FOLLOW-UP
RECOMMENDED
There is no abnormality seen in the left breast to correspond with the
breast MRI finding in the anterior, middle and posterior depth in the
outer aspect, however biopsy is recommended. MRI guided biopsy is
recommended for the area of concern most evident on MRI.

Ultrasound BI-RADS Category 0: Incomplete - Need Additional Imaging

Georgia1 · January 2018

Huh. I'm a layman of course but I don't see anything there to worry about. It sounds like a recommendation to biopsy the 3 cm x 7.3 cm area which "may" be DCIS but also may be a benign fibroid, just as a precautionary measure. So for sure go ahead and do that, but please try to be optimistic in the meantime.

And perhaps someone more knowledgeable than I will come along and offer something more helpful.

HerpaDerpina · January 2018

Wouldn't a fibroid show up on either the mammo or u/s? It seems very strange to me that something of that size wouldn't allow up on either if it was a fibroid.

I really wish I could post the MRI.

moth · January 2018

HerpaDerpina, I think the thing with MRI is that it's known to be way too sensitive. It shows a lot of things that mammo & u/s don't see well. Sometimes that's good because those things are actually 'something' that need to be dealt with, but it also shows a lot of things that turn out to be 'nothing'.

This page explains it well I think (ignore the cartoony feel. It really is a reputable site run by a breast radiologist in Canada but he's trying it to be a big light-hearted and less clinical. The info is solid evidence based science.)

"Common benign MRI false positive findings include duct hyperplasia, papilloma, sclerosing adenosis, fibrocystic breast changes, adenofibroma, lobular carcinoma in situ, ductal atypica, and simply normal breast tissue at different times in the menstrual cycle."

http://breast-cancer.ca/mrifacts/

Not sure what to make of this.

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