Biopsy-proven DCIS not visible on MRI

I am about to get a biopsy and have a similar story. MRI showed nothing. I don't think they can see most microcalcs on the MRI and not all DCIS presents with tumors- which is what would show on the MRI.

I've seen research that MRI is better at detecting high-grade DCIS than low- or medium-grade DCIS. Here is one example (see the table on the 2nd page):

http://www.cancernetwork.com/breast-cancer/mri-acc...

Interesting study but I had high grade DCIS (grade 3) and 1.4 cm tumor and NOTHING showed on MRI. Mammogram caught it and I could feel it with self-exam.

I had grade 3 DCIS er-/pr- Concerned after self exam, seen on Mammogram, diagnosed with core biopsy. NOTHING showed on MRI with CAD assist.

Chose BMX instead of lumpectomy plus radiation because last year the stats showed 2% better cure rate. Am currently awaiting US for possible recurrence due to 2 pea sized bumps on my chest wall (on the DCIS side) with swollen lymph node.

If mammogram has lead to increase in DCIS dx, I think that's good because if they hadn't caught mine as DCIS it would have turned to stage 4 before I knew it. It seems that is has anyway because my tx was limited to bmx even though it was a high grade. I wish the stats separated out high grade vs. low grade and the incidence of recurrence instead of lumping low grade-high grade to determine tx protocol for the insurance companies. ugh. that's my rant.

Hi

I have the situation that my 22mm high grade DCIS did NOT show on mammogram or ulstrasound, but was found when they had to remove Nipple and tissue below for Paget's. It was found in the tissue they removed with the Paget's but hadn't shown on the MMG and US. the week prior when they were looking for any associated tumours etc. with the Pagets.

I have been given 2 x options - mastectomy or just annual screening......haha - as if I would rely on screening. No offer of radiation as the risks would outweigh the benefits apparently due to the smaller size of the DCIS which had healthy margins.

My main concern is what else is lurking in the breast unseen waiting to turn invasive before it ever shows up on a MMG? That is presumably why they have offered a MMX - so for me it really has to be a no brainer and have the mastectomy in case there is some more there, unless I am missing something. Surgeon says it is my decision, likely anything that did appear etc. would be treatable - but why take that risk, by treatable he could mean a mastectomy years down the road but risk of lymph involvement by then.

Wish we didn't have to make these huge decisions!

All the best to all, any wise info and words apprecidated!

Thanks

Eliza

Hi all, I had a lumpectomy for DCIS almost 3 weeks ago, also microcalcifications found on mammo, 95% ER/PR +. My BS ordered an ultrasound to rule out an actual mass & eval lymph nodes. She said with dense breasts U/S is more diagnostic than breast MRI. The biopsy was the definitive word, she just wanted to check there was nothing else to be aware of. Hope that info is helpful.

BTW My surgical path report came back w/ clear margins. Still waiting for Oncotype DCIS DX findings.

ALL imaging tests have a percentage of inaccuracy - be it false negative or false positive. Tissue pathology following excision is the only accurate ones. I read the cases described above and mine was just the opposite. Mammo saw area of about 5 cm, US saw nothing, MRI saw area of 10 cm in right breast 7 cm in left breast, stereotactic biopsy showed DCIS, final pathology results after BMX, well, read my signature

Oh my goodness you poor thing. Hearing that re-inforces my decision to have the mastectomy to avoid the worry of anymore unseen DCIS. Just wish the surgeon would allow the double, they are not comfortable with it. Recovery needs to be quick as possible so I will settle for the single and then later in year plead my case for the other one if the lack of symmetry (don't wear a bra ever and not about to start) and the worry of more unseen gets the better of me.

Hi MBPooch

Yes pretty much identical! MRI would not alleviate any worries as that often misses DCIS as well according to various sources. My NHS team here in UK would find it hard to get the OK for a double. I then had a 2nd opinion privately - he initially was against it, but when he got to know me over the hour and my reasons for it, ie no bra / symmetry, breasts have served their purpose blah blah, he said he would be happy to proceed that way subject to a few other psychological checks, but the insurance here in the UK doesn't cover a prophylactic mmx, although the private doctor may be able to word the reason for it accordingly, not sure.

But think I will just have a single and see how that goes and how I feel in 9 months time when I have my next screening.

Your recovery certainly sounds pretty amazing considering! Well done.

Hi Cimo37

Looking at your profile for diagnosis treatment, I see no treatments listed, I just wondered what were their recommendations for the DCIS they found in November?

Thanks

Eliza