Suspicious mass and nodes on MRI

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Tmh0921
Tmh0921 Member Posts: 714
edited June 2019 in Not Diagnosed With a Recurrence or Metastases but Concerned

Guess I'll hang out here for a while. I had a mammogram and ultrasound on 4/29 that showed a new spiculated mass and 2 abnormal nodes in my left breast. I had a follow up MRI this week to rule out scar tissue. MRI results also indicate suspicious mass and nodes. It's been 19 1/2 years from original Dx for me, with a few scares over the years.

Im scheduling an ultrasound guided biopsy of the mass and nodes, then meeting with my surgeon to discuss Mastectomy and DIEP.I'm strangely calm about this.

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  • Meow13
    Meow13 Member Posts: 4,859
    edited May 2019

    I went through an MRI scare in 2016, it was fat necrosis my oncologist said after 5 years it was very very strange to see changes in the tissue I had an MRI guided biopsy it was fat afterwards I had my yearly mammogram and the radiologist confirmed it was scar tissue contracting.

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited May 2019

    Meow

    Do you remember if the scar tissue showed heterogeneous enhancement on your MRI?

    I have had several biopsies in the immediate area in the last few years, the last in September of last year with a Dx of ADH, ALH, and DCIS. I wasn't too surprised by the abnormal finding, and was pretty sure it was scar tissue. The cortical thickening of the suspicious nodes and the heterogeneous enhancement of the mass are worrisome.

    The MRI report has my BiRads at a 4, but they logged my visit diagnosis as “Malignant Neoplasm of the Breast". I can handle a new malignancy, but am worried about the suspicious nodes.

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  • Meow13
    Meow13 Member Posts: 4,859
    edited May 2019

    I didn't see the MRI report I only spoke to the oncologist and radiologist. I asked the radiologist what she thought. She was convinced it looked like fat necrosis it was the oncologist that found that very strange. But it was a newer MRI machine at a brand new facility than my previous MRIs I thought it could be a false positive.

    Well during my next regular mammogram the radiologist (a different radiologist) showed me the previous year's image next to the new one. It showed clearly contraction around the scar tissue. So my oncologist was not correct in telling me after 5 years no changes as far as scar tissue changes could happen.

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited May 2019

    Thanks Meow

    I know MRIs have a pretty good false positive rate so I still have some hope thatthis is scar tissue. It definitely was not there in September of last year when my last mammogram and biopsy were done.

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited May 2019

    I love my surgeon, I'm scheduled for US guided core biopsies of the mass and both nodes tomorrow.

    Once pathology is back we'll meet to plan next steps. Benign or Malignant I'm headed for BMX and DIEP reconstruction. I want off the yearly abnormality/biopsy roller coaster and my surgeon agrees

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  • wallycat
    wallycat Member Posts: 3,227
    edited May 2019

    Biopsy and pathology are really the only way to know for sure. My cancer was NOT spiculated. I was told it was not cancer and I was nuts to want it biopsied. They were wrong. Technology only tells you so much. I hope yours turns out to be fat!

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

    Hoping it turns out benign. Sorry you're dealing with this worry.

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited May 2019

    Had US guided core biopsies of the breast mass and abnormal nodes today, now we’re waiting on pathology.

    I asked the radiologist why he has my BiRads at a 4 instead of 5 given the suspicious mass and nodes. He said 4 was still applicable given that the nodes are only slightly abnormal, and given the fact that I had 14 nodes removed years ago these nodes are doing double duty. It’s not uncommon to see these changes in circumstances like this.

    So, I’m anxiously awaiting pathology, but feeling a bit more hopeful today

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

    I'm glad you asked for clarification. I do think that helps so much! Hoping you get good news!!!!!

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited June 2019

    I had my US guided core biopsies on Wednesday and the preliminary pathology came in today....

    Lymph Nodes are clear (Thank God)

    Mass in left breast is, unfortunately, IDC.

    Hormone status, etc. pending.

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  • Salamandra
    Salamandra Member Posts: 1,444
    edited June 2019

    Hey Tmh,

    I'm sorry you're dealing with another recurrence. So glad it hasn't spread to the nodes though. Thinking of you1

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  • wallycat
    wallycat Member Posts: 3,227
    edited June 2019

    So sorry to hear. You know we are here for you.

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited June 2019

    Thank you for the replies.

    I’m waiting on the rest of the pathology (Hormone status and grade), then I’ll meet with MO and surgeon for next steps. Definitely going for a BMX this time, with immediate DIEP reconstruction if possible

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

    Uuugh. I am sorry the breast mass has come back for IDC, but thankful the nodes were benign. Frustrating nonetheless to be dealing with this beast again.

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited June 2019

    I see my MO this afternoon to review the full pathology and next steps. Preliminary pathology did show LVI, I’ll know grade and hormone status today. Then I can get a plan in place

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited June 2019

    Met with MO today and my pathology is actually pretty good:

    ER Positive 95%

    PR Positive 69%

    HER2/neu negative

    KI-67 is 14%

    There was a foci of LVI on the core sample

    Lymph node pathology was benign

    They're scheduling me for BMX w/immediate reconstruction ASAP. Barring any surprises in the surgical pathology they aren't recommending chemo. That would change if the LVI is found to be extensive or if it is found in any of the nodes they'll remove.

    Because I developed a strongly hormone positive IDC while on Tamoxifen, they will be taking me off of Tamoxifen and switching me to ovarian suppression + AI. The oncologist is also classifying this as a new cancer and not a recurrence. This has no bearing on treatment, but it sounds better

    Feeling much better about this DX tonight


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  • Salamandra
    Salamandra Member Posts: 1,444
    edited June 2019

    I'm sorry you're dealing with this. I hope the treatment goes smooth and well!

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

    Hoping you can get the surgery done nad over soon and that the pathology yields no surprises.....so you can put this rotten detour behind you.

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