....And it keeps getting more complicated....

Be aware that, as my BS told me, "*everything* lights up on an MRI." They have something like a 30% false positive rate. The biopsy will give you peace of mind either way. Try to stay calm. Somehow it's always better to have the complete dx and a treatment plan in place.

How often does it happen? A lot.

Once diagnosed, many surgeons want the patient to have an MRI just to ensure that nothing else is going on. No point in having surgery only to find out after surgery that the area of concern was larger than expected (and therefore the surgical margins aren't clear) or to find out a short time later that there is another area of cancer in the same breast or the contralateral breast. I applaud surgeons who take this step. The downside however is that MRIs tend to see everything and have a high false positive rate. I too required an additional biopsy between the discovery of the cancer and the surgery, although in my case it was for the contralateral breast. Fortunately mine turned out to be benign.

Will this change you surgery plans from lumpectomy to MX? It depends first if the upcoming biopsy uncovers cancer, and if it does, it depends on the location of the cancer. A lumpectomy might still be feasible, if that's your choice. You have to wait for the biopsy results and then a discussion with your surgeon to get that answer.

As for genetic testing, sometimes this is done prior to surgery and sometimes it's done later. In my case, it was done later. In your case, since the testing is already scheduled for next week, this new discovery doesn't change anything and the timing was always such that it could delay your surgery, if you decided to wait for the results before having surgery. However you can always opt to proceed with surgery sooner, either a lumpectomy if medically feasible or a MX, and then if it's found that you do carry a genetic mutation, you can have a second surgery later if you decide that you want a BMX (which is usually on the table, but not always chosen, when a genetic mutation is found).

At this point, until you have the biopsy result, there are no answers to your questions. And ultimately, whatever happens with the biopsy and genetic testing, the choice is yours.

I had the same thing happen, said DCIS and after the lumpectomy they called and said they were very surprised there is also IDC. I thought the biopsy told the whole story so the call was shocking as I had no idea the diagnosis could change. Thinking they should say final diagnosis will occur after the lumpectomy pathology so we are prepared for a change in the diagnosis. I had to have a reincision to get a clear margin and to check the lymph nodes which they had not done the first round as they did not anticipate the IDC, thankfully lymph nodes were clear and they got a clear margin. 30 rounds of radiation including 5 boosts, I am on # 20 today and is has not been too terrible. A little red and very sleepy some days.

rabby55 - After being diagnosed with Pagets of the nipple I had an MRI that noted two other highly suspicious areas of concern. Keep in mind I had a mammogram and ultra sound that did not pick up the Pagets or the DCIS or other areas of concern. Pagets was diagnosed by a punch biopsy with my dermatologist who then ordered the MRI. The MRI spotted the DCIS underneath the nipple as well as the other two areas. I had already planned on BMX only because I know my personality and knew I would question every little thing and the anxiety of every follow up would be too much for me. Even knowing I was going that route I did biopsies of all areas because I wanted to know what I was dealing with. I already had a feeling that the mass under the nipple was DCIS but was happy to find out the other two areas were B9. I did wait for my genetic testing which was also negative but came back within 2 weeks of testing. Always an option to wait if you think that would alter your decision. Keep us posted on everything!

Yup

my initial biopsy said 1.2 cm- and I completely flipped when it came back after pathology as 2.5cm--but ultimately it did not change anything--- and I learned from my one that pathology is everything-- and you are right-they should tell you that first-- it is a moving target- the MRI is a good idea-my surgeon insisted upon it-- and you will be grateful for that--they should know all of what they are dealing with--but does not make it any easier for you. Each step gets you closer to a treatment plan- and the uncertainty will disappear-this is the hardest part--nailing down the details.