MRI results

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Trhoosier
Trhoosier Member Posts: 5
edited June 2019 in Diagnosed and Waiting for Test Results

I have been diagnosed with Paget’s of the nipple via biopsy. With this type it normally comes with an underlying cancer as well. I got the results of my MRI Friday and it showed a .7mm round smooth mass surrounded my a 2.6cm nonmass enhancement. The surgeon is assuming the non mass is DCIS and says there is a 50/50 chance that the smaller mass is IDC. The results said they recommend an ultrasound second look with biopsy. Surgeon never mentioned biopsy as an option. Should I get a second opinion? Can DCIS have an actual mass? I didn’t think a lot of breast cancers were round and smooth. Any advice

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

    MRIs are very sensitive and have more false positives than other imaging. That may be why an ultrasound is recommended.

    Were you expecting to go straight to surgical removal without any more testing? I can see how this would be a frustrating delay if that's the case.

    I wonder if this would be a good time to get a second opinion?

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  • Ingerp
    Ingerp Member Posts: 2,624
    edited June 2019

    Just chiming in to say that one reason so many lumpectomies require re-excision is that DCIS is, as my BS described it, "squirrelly." You can't see it, you can't feel it, . . . . I was a little confused by your post. Are you going to have a biopsy or not?

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  • Trhoosier
    Trhoosier Member Posts: 5
    edited June 2019

    Honestly, I didn’t know what to expect when I went to talk to the surgeon. I had gotten my nipple biopsy done by a dermatologist, so this was my first oncology appointment. I asked him about my MRI results and he told me I had DCIS and a small mass that may be DCIS or may be IDC. He never mentioned that a biopsy was requested. I just happened to go get the MRI results to have for myself right after my appointment and that is what radiology recommended with a Birad-4. He told me that if he did a lumpectomy he would have to remove 1/3 of mybreast in a way that it would look strange and that at my age reoccurrence in my healthy breast would be 30% since I am 40 and already diagnosed with breast cancer.

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  • Trhoosier
    Trhoosier Member Posts: 5
    edited June 2019

    So, I was just curious on how things normally happen. I guess I found it strange that he didn’t mention the biopsy and it made me question things. He made it seem like a lumpectomy wouldn’t be favorable, but if it was a false positive, he wouldn’t have to remove as much as he was telling me. I am unsure of this entire process and a nervous wreck. I just want to make smart choices

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  • Ingerp
    Ingerp Member Posts: 2,624
    edited June 2019

    Are you working with a breast surgeon? They typically order the biopsies and perform the surgeries. If you're not your oncologist should be able to recommend one.

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  • Trhoosier
    Trhoosier Member Posts: 5
    edited June 2019

    I have only met the breast surgeon so far. I haven’t met my oncologist yet. I will call up there today and see if I can talk to one of the nurses about the fact that no one even gave me the option of a biopsy. If I didn’t go get a copy of the the results, I would have never known

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  • MBPooch
    MBPooch Member Posts: 229
    edited June 2019

    Trhoosier -

    I was diagnosed at 45 about a year and a half ago with pagets after a core biopsy with my dermatologist. After the positive biopsy I had an MRI which picked up on a mass just under the pagets as well as one more spot in each breast. I already knew I was opting for BMX but wanted to know what I was getting myself in for so I could prepare myself best I could. I did 3 core biopsies and as we assumed there was DCIS under the pagets but the other two masses were B9. Of course there could have been a surprise when the pathology came back but thankfully it was only the DCIS. I opted for BMX not only for peace of mind and being able to avoid radiation but also because I cosmetically wanted a good outcome. I was able to go direct to implant so avoiding a second surgery was also appealing to me. They may suggest genetic testing based on your age. I was told it was covered because I was under the age of 45. I have two girls so wanted to know not only for myself but for them as well. Best of luck with all the decisions you make. You will feel much better once you have a plan!

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  • Trhoosier
    Trhoosier Member Posts: 5
    edited June 2019

    Thank you MBPooch! I have over a 2 week wait till my mastectomy so I may opt for the biopsy just for some peace of mind, to know what is actually there! Did your other spots look solid? How long did you have Paget's before you got it biopsied?

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