Ultrasound and MRI results WAY different

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Flnana2
Flnana2 Member Posts: 118
edited July 2019 in Diagnosed and Waiting for Test Results

Hi,

I'm new here. Dx June 19th. On June 11th my ultrasound report said my tumor was 1.5 x 1.7x1.2. Yesterday I had an MRI and the results said, “at least a 3.7 x 2.4 mass".

I have seen my BS, MO, AND RO this past week and they all referred to the mass as being slow growing. So, either the tumor more than doubled in size in 3 weeks or one of these tests is way off.

Has anyone else seen such drastic changes in 3 weeks or their ultrasound to have such a big difference compared to their ultrasound? Either scenario has me a bit worried.

I've been lurking for a while around these forums and appreciate all the support from fellow warriors

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited July 2019

    Finana, what was your diagnosis? IDC? ILC? DCIS?

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited July 2019

    Finana,

    Mellissa Dallas asks a good question. ILC is more difficult to "see" than IDC, which makes determining the size to be more difficult.

    Regardless of cancer type, it is also the case that different scans "see" things differently. It is not unusual for different scans to size your lump differently. The ultrasound showed that my lump was 3.9 cm. The MRI showed it to be 5 cm, with a little satellite friend. If you don't do chemo first, the surgical pathology will tell you the "real" size. By the way, it is unusual for someone who is ER+/PR+/HER2+ to be Grade 1. Most of us triple positives are Grade 2 or 3.

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  • Flnana2
    Flnana2 Member Posts: 118
    edited July 2019

    Hi,

    Thank you for your responses.

    I was a grade 1 when my tumor our was 1.7cm. Now that it is 3.7 I'm sure I've moved up.

    Melissadallas, I have ILC, triple positive

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited July 2019

    Also, if Finana’s diagnosis had been IDC her MRI could have seen DCIS along with the IDC not easily identifiable on other imaging. At this point, until final pathology, her ILC is somewhat “up in the air” as to the diffetences between the imaging modalities.

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  • letsgogolf
    letsgogolf Member Posts: 263
    edited July 2019

    Fiana2, I have never heard of the grade of the tumor changing as the tumor grows between the scans and surgery. Have you had a biopsy and pathelogy report yet? Just curious about your DX info. on your profile because you list a 1cm tumor as stage 2A, grade 1. Grading can be done from the biopsy and/or surgery but staging is normally only done after surgery. As far as I know, neither staging or grading is done from ultrasounds or MRI. Best wishes!

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  • Flnana2
    Flnana2 Member Posts: 118
    edited July 2019

    I’m really new to all this so please forgive me. My grade was determined after my biopsy. The report says, “with a Nottingham combined histology grade of 1 (tubular grade 3, nuclear grade 1, mitotic, grade 1, for an overall histologic grade of 1, score of 5). So, let’sgogolf, you are absolutely right, my grade shouldn’t change because the size of the tumor changes.

    My MO said at this point he would grade me at stage 2...obviously that can change after the CT scans that I had yesterday are revealed and/or surgery are done. I am scheduled to start chemo on July 23rd.

    Thanks for your input

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  • Flo80
    Flo80 Member Posts: 349
    edited July 2019

    Hi there I have a similar problem. My ultrasound showed a size of 0.9-2.8 cm and then MRI showed 5.2. I have an appointment with my surgeon tomorrow and I will ask about this. Also I had my ct scans of chest, abdomen and pelvis which came clear. They did my bone scan yesterday and at the end of it they did spect ct and the radiologist has not read my report yet. I am freaking out as they ordered additional spec ct why do they not read it faster. But about the size many people have told me that MRI includes DCIS and the mass that’s why mot

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  • Beesie
    Beesie Member Posts: 12,240
    edited July 2019

    Flnana2,

    "when my tumor our was 1.7cm. Now that it is 3.7"

    Until you have surgery, you don't know the size of your tumor. You also don't know that it's been growing during this time.

    The ultrasound might have under-estimated the size of the tumor. The MRI might have over-estimated the size of the tumor. That happens a lot. So your tumor might turn out to be 1.7cm, or it might turn out to be 3.7cm, or it might turn out to be something in between. It might even turn out to be smaller than 1.7cm or larger than 3.7cm, although that's less likely. Odds are that whatever size it turns out to be is the same size that it was on June 11th when you had your ultrasound - the inconsistency and change is probably an imaging issue, not a tumor issue.

    As for tumor grade, no it won't change - grade 1 cells will remain grade 1 cells - but many breast tumors are not homogeneous, so it's possible that the final pathology could find some grade 2 cells mixed in with the grade 1 cells. If that happens, it won't indicate a change from when you had the biopsy, but will just reflect the area that was sampled during the biopsy vs. the totality of the tumor.

    Good luck with your surgery. Hopefully your ultrasound proves to be more accurate on the sizing of the invasive component of your tumor.

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

    My MRI showed much larger than my biopsy. My surgeon wasn't concerned. She thought that it was likely due to swelling from the biopsy. My final tumor size came out larger than the biopsy estimate but a lot smaller than the MRI estimate.

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  • Flnana2
    Flnana2 Member Posts: 118
    edited July 2019

    Flo80,

    I’ll be very interested in hearing what your surgeon says tomorrow. Please keep us posted.

    Bessie, thank you for your feedback. I also hope that the ultrasound is the correct size. We shall see. Thanks for the positive thoughts on surgery but that won’t be til the end of the year...9 rounds of chemo first

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited July 2019

    I’m in a similar situation, though the variance isn’t quite as drastic. Mammogram/US measured the tumor at 1 x 1.1 x 0.9, but MRI has it measuring 1.2 x 1.9 x 1.9. My tumor is IDC, strongly ER+/PR+ and HER2Neu -, grade 2, KI-67 14%.

    My MO says it’s not uncommon for measurements to vary from scan to scan, and we’ll get the actual size from pathology when I have my surgery. My MRI also showed 2 suspicious nodes, core biopsy on those were benign.

    I just got my Oncotype score back, and it came in at 26, so now I’m also getting chemo after surgery. This is a first for me, chemo wasn’t recommended at my first Dx in 1999, but these tests weren’t available then either

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