Very dense breasts, mammo and ultrasound uncertainty

Slavica · August 2018

I should be used to this by now. I am 43, have very large, very dense fibrocystic breasts. My mom had DCIS at 34, her cousin died of the BC she developed before menopause.

I get screened every year. Every other year, it's an MRI, and in the intervening years, it's a mammo and U/S. Today was the mammo and U/S day. The doctor said my breasts are very dense and mammography is not very informative, but that they saw "many calcifications". On U/S, the right side was not worrisome, but the left side, where I already had a core biopsy for a large lump while breastfeeding 9 years ago (fibrocystic changes), had many more calcifications than the right and also a large non-homogenous area on U/S. The doctor said he'd compare it with my MRI from last year and said it's very hard for them to evaluate my breasts by any modality. Then asked me how I deal with MRIs and whether I already have a followup appointment with my gynecologist.

From his comments, I'm wondering whether I'll have another MRI pronto and/or a biopsy. The thing is, I am in perimenopause and my left breast has started hurting in the last two months of so, sharp, stabbing pain unrelated to my period. I did not mention it because I know it's neither here nor there and many doctors still say that if it hurts, it's not breast cancer. No new lumps that I can feel, but that breast is so full of lumps and "rafts", for lack of a better word, that it's hard to know whether any new ones are there. No nipple changes, no discharge.

I am a bit freaked out, but I have to wait for the report, of course. Thank you for reading, if you got this far.

Peregrinelady · August 2018

Just wanted to let you know that breast cancer can hurt. I had sharp stabbing pains after being misdiagnosed for 20 months. It may be rare, but it does happen.

Denise-G · August 2018

You need to do what gives you peace of mind. And you know in your gut what that is so you can quit losing sleep over it.

Not to add fuel to the fire, but I had severe pain 1.5 years before diagnosis of a huge tumor. I ignored it because everyone always told me breast cancer does not hurt and I skipped my mammogram. All kinds of women on these boards had pain with breast cancer. My sister had very dense breast tissue. Her tumor was not seen by ultrasound or mammogram. The radiologist only biopsied because of myself and my mom's diagnoses, and thank goodness he did.

There is another technology called MBI or Molecular Breast Imaging. I would urge you to research it. It is a new technology not available in all cities. A friend had it and it saved her from another MRI and biopsies. She had really good experience with it and has had it every year since.

Sending you all my best wishes.

Slavica · August 2018

Thank you both! I will look into molecular breast imaging, Denise-G. I know breast cancer can hurt, I have read many stories on these boards... my mother got diagnosed because her lesion started hurting and she insisted on a biopsy. The fact that it hurts cannot exclude a malignancy.

Of course, what bugs me is the uncertainty and waiting. Luckily I have a very interested gynecologist, I'm in a country with good health care and insurance (Switzerland), and I am a geneticist, so at least I know how to read the literature if I need to.

sweetp6217 · October 2018

I went for my first mammo (post chemo, surgery, radiation) in July. When I went for my follow up appointment with my surgeon, she mentioned MBI. The hospital I go to is going to have it in a few months and I went to a seminar about it about a week ago. I managed to get a number out of them as for my density; I'm a 3 out of 4. I'm hoping that I'll be able to get this test done since I'm likely to have recurrence. According to my BS and my diagnostic radiologist, it doesn't take the place of the mammo, but it can be helpful if the images are poor due to breast density. They inject you with a tracer and you sit in a chair and get lined up into something similar to mammo plates. Big difference: it shouldn't hurt much since they're not supposed to press as hard as a mammo. The images produced using MBI appear so clear as compared to the mammogram (with patients with high density).

I await a letter come January that should state my density rating and whether or not I may be one of the first to try it in the next wave, if there is one.

Slavica · October 2018

Thank you very much for your informative reply, sweetp6217! If you do end up being one of the first to have it in your hospital, I'd be curious to hear your experiences with it. The blazing white mammo pictures look scary and are not very informative for those of us with dense breasts, I'm glad to hear newer additional methods are being developed.

sweetp6217 · October 2018

YW Slavica. I noticed when I searched for this testing that BC.org has a little information about it dating back to 2016. I wish that this type of thing would take off quicker, but the main focus still seems to be on mammograms, usually sufficient for most. The success rate quoted for the the test doesn't seem to be as great as one would hope, but perhaps with experience may come improvements. I've mentioned MBI to several HCPs, most of which have not heard of it (or perhaps they read about it and forgot about it). At least I have 2 doctors that will recommend it and work out the P/A (prior authorization) should my insurance deny it...something that they are very good at.

Very dense breasts, mammo and ultrasound uncertainty

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