Entire Right Breast Contrast Enhancement fro MRI

ckhoward
ckhoward Member Posts: 4
edited April 2019 in Not Diagnosed But Worried

I had a Bilateral Breast MRI with Contrast last week. My entire right breast lit up like a Christmas Tree with no focal definitive lesions. The radiologist said that it almost looked like mastitis, but he knew it was not as my children are 10 & 12. He categorized me as an ACR Category 4 and I have to wait until Wednesday to meet with my breast surgeon. Four months ago I had chronic itching at the top of that breast's areola where a fibroadenoma was eventually identified and removed. I can't help but worry that this is IBC, but I don't have any issues with skin dimpling and inversion of my nipple. Is it possible that this is IBC?

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  • djmammo
    djmammo Member Posts: 2,939
    edited April 2019

    ckhoward

    IBC involves the filling of the lymphatic channels of the skin, with tumor cells. So to be IBC after 4 months there would have to be skin changes. Also when the FA was removed if there was IBC in the surrounding tissue they would have seen it then. Are your breasts the same size? They both develope normally, at the same time, at the appropriate age? Any surgery in your chest proper? Every have a venous port for any reason? Did the other breast enhance normally or did they mentnion that?

    Can you post the report of your last bilateral mammogram and the MRI report?

    EDIT: Did the mammo report mention calcifications in either breast?

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  • KBeee
    KBeee Member Posts: 5,109
    edited April 2019

    Can they do a punch biopsy of the reddened skin?

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  • djmammo
    djmammo Member Posts: 2,939
    edited April 2019

    KBeee

    There is a special gadget to do punch biopsies, its a small metal cylinder with a sharp edge on one end. Not sure how many non-dermatologists have those handy in their offices. The surgeon could always take a little ellipse of skin with a scalpel.

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  • ckhoward
    ckhoward Member Posts: 4
    edited April 2019

    Thank you for your thoughtful response. I failed to mention a few other issues:

    • I went to an endocrinologist at Hopkins last week and they identified notable anterior cervical, superclavicular and axillary lymphadenopathy. I am going back up on Thursday to an US Soft Tissue Head/Neck due to the enlarged lymph nodes in my neck.
    • In the past I have had lymph nodes in my neck that measured 3.9*0.6*1.4 cm, 2.4*1.0*.3 cm, 2.*.09 *.05 cm, 2.0*0.8*.3 cm, etc.
    • My family history includes: Father - lymphoma (died 48), Paternal Grandmother - Non-Hodkins lymphoma (died 28), Paternal Grandfather - pancreatic cancer (died 47), Paternal Great-Grandfather - bone cancer, Maternal Grandmother - ovarian cancer, Maternal Great-Grandmother - ovarian cancer
    • I have had severe exhaustion and achy joints
    • I have silicone implants and worry about Breast Implant Associated Anaplastic Large-Cell Lymphoma
    • (I can't seem to post the report, but can type the verbiage if you would like...)
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  • KBeee
    KBeee Member Posts: 5,109
    edited April 2019

    DJMammo...make sense. I have had them done at the dermatologist and gyn, but not by surgeon, so that makes sense. And so does taking a sample with a scalpel.

    Hoping you get answers, ckhoward. Hoping it is infection related, and not cancer related. Do keep us posted.

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  • djmammo
    djmammo Member Posts: 2,939
    edited April 2019

    ckhoward

    As the journalists say, you've buried the lede. When was your last blood work done?

    Let me know what the biopsies of the nodes and the breast show unless you have already had them biopsied.

    I would be interested Hopkin's opinion of the MRI results.


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  • B-A-P
    B-A-P Member Posts: 525
    edited April 2019

    For me personally, my mri lit up like a Christmas tree and couldn’t detect my two masses. What was mainly lighting up was DCIS everywhere. They called it “non mass like enhancement” It covered my whole breast. I want to say it was 7.5 cm. I may be mistaken. My Pet scan is was differentiated between the dcis and my tumours.

    Based on the mri they said “you might have cancer” and then the testing began.


    Hopefully for you it’s nothing. I just wanted to add my two cents

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  • ckhoward
    ckhoward Member Posts: 4
    edited April 2019

    My apologies for 'burying the lead'. I had seven vials of blood drawn this morning and have not had my biopsies done yet.

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  • djmammo
    djmammo Member Posts: 2,939
    edited April 2019

    B-A-P

    I have seen that only once. It was an unusual variant of DCIS. There were too-numerous-to-count calcifications throughout the breast. Were there such calcs on your mammo?

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  • ckhoward
    ckhoward Member Posts: 4
    edited April 2019

    MRI Report:

    Technique: Breast MRI was performed using dynamic intravenous gadolinium infusion, thin sections, and a dedicated breast coil. Contrast enhancement analysis by computer-aided detection.

    Findings: The implants are intact and unremarkable. There is generalized contrast enhancement involving the tissues immediately adjacent to the right-sided implant. In fact, the entire right breast shows generally more contract enhancement. There are no focal definitive lesions. The previously described nodular areas turn out to be fibroadenomas after excision biopsy. There is no rapid enhancement on CAD. The skin and axilla are unremarkable. Limited images of the thorax and abdomen show no abnormalities.

    Impression: ACR Category 4. I would recommend generalized soft tissue sampling of the right breast during the removal of the implants.

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  • Sunshine_On_Water
    Sunshine_On_Water Member Posts: 4
    edited April 2019

    Hi CKhoward --

    I also had extensive dcis that wasn't found until I had an MRI with dye. It also was described as 'lighting up like a Christmas tree" with no masses.

    I had bloody nipple discharge which kept them looking when nothing was detected by 3D mammogram or ultrasound. When they did the 3D and ultrasound with dye, they could see some sort of blockage as the dye didn't travel far up the milk ducts. Had a lumpectomy and within the large DCIS area they removed, a 4mm tiny dot of invasive mucinous was found.

    Hope you receive good news in all this!

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  • B-A-P
    B-A-P Member Posts: 525
    edited April 2019

    DJmammo

    I want to say yes.As far as I know there was DCIS that took up my entire breast. Even when I had my mastectomy , they said it was all over. My mammogram after my mri showed calcs all over as well. So much to the point where they thought all I had was dcis and I needed a mastectomy. The node biopsy came back positive a few days after which prompted the pet scan. The rest as they say, is history.

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  • djmammo
    djmammo Member Posts: 2,939
    edited April 2019

    ckhoward

    Though I have never personally seen a case of BIA-ALCL, I do know that there it usually presents with a fluid collection around the implant on imaging, and so far is only associated with implants that have a textured surface.

    The blood work should provide much more information. Hopkins is nothing if not thorough.


    (Interesting trivia: https://www.merriam-webster.com/words-at-play/bury-the-lede-versus-lead)

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