Kel, positive nodes may have a little as 2mm of cancer (or less if it's micromets or ITC). Something this small will never be visible on an ultrasound or MRI. If screening was reliable, sentinel node biopsies wouldn't be necessary. I was warned by my surgeon that screening will find nodes with a lot of cancer involvement but having clear nodes on screening does not mean that the SNB may not find nodes with a small amount of cancer.

Once a sentinel node is found to be positive, if the surgeon proceeds to an axillary node dissection, because the cancer in the nodes is invisible to the naked eye, normally the surgeon will remove all level I and level II nodes. The number of nodes differs by individual, so this can as few as 10 nodes or as many as 40.

Axillary lymph node dissection (ALND) https://www.cancer.ca/en/cancer-information/diagno...

I don't know much about CT scans, but my understanding is that no screening can reliably/consistently find cancer that is less than 5mm in size.

As for how long your cancer was present before being detected, it is generally believed that most breast cancers have been present for 3-5 years, or possibly longer, before they become large enough to be detected by imaging. This chart, which I posted recently in another thread, shows how the size of a cancer changes over time, based on a 100 day doubling rate. The doubling rate for some breast cancers might be slower than that. That said, if you've had a mass in your other breast for ten years and it has remained stable in size and has not grown, it's extremely unlikely to be cancer.

Jons_girl, its JCP. I was reading where you get an ultrasound every six months but may be moving to a MRI and ultrasound alternating. Well, after 10.5 years of anti estrogen drugs I came off due to dr worried about further bone issues. Anyway, since I came off the med, i wanted more surveillance but my dr said she cant get approved by any insurance for a screening MRI unless there is a noted problem. I have moderately dense breasts, in the middle. I asked her about the density and she said that's why I order 3d mammograms for you. So, basically no need for anything else. How in the world did your onc insurance approval for MRI's? Bc yours are VERY dense? I almost switched drs bc I wanted a mammogram every six months bc couldn't get anything else ordered. She wouldn't do the mammogram more than once yearly. She says she wouldn't know what to put on form when ordering another mammogram or a MRI. I even said I'd pay for the mammogram. Ended up getting screened w ultrasound company that's been around for years that goes to different parts of a few states. No order needed. Scared tonight. I googled my issues for CT again. I don't know. Take care Susan

Jons_girl, It does sound like you have a great team of drs really getting you the best surveillance possible. I am glad for you. My post on here the other day was just frustration surfacing due to my struggle w getting increased surveillance. I am so sorry of how it sounded. I have not left my onc of 10 years. I tried to. I went to another dr and he said doing a bmx was a lot to do then w risk etc. He did say he would let me get the mammogram every 6 months but I may have to pay for second one. He was going to do what I wanted, well I really wanted MRI once yearly, but I can't remember if I asked or what he said. I ended up seeing him two times, and the office was so foreign and different to me. It was a lot smaller and they didn't do blood work on the spot. That would have been a little inconvenient to go to a lab Corp or Quest in enough time for dr to get results prior to my appointments. Being a teacher would just make it an extra step to plan for. Eventually I just decided I would stay w the female onc I have had so long. Not sure if it was right choice idk. She has been there for me and office staff when needing to come in with rash on breast that she thought was mastitis. They saw me that very same day. She gave me an antibiotic and it cleared up in 2 days very quickly. After that she scheduled me for mammogram or MRI . I think she actually ordered MRI for me. This was about a year ago. MRI was normal. Anyway, have a great weekend. That is so impressive that you found a 4mm lump. Wow! You got skills, girl!! Lol . Getting more anxious by the day waiting on results. I could have tried to go after them on Friday but for me that's not my style bc I am so afraid to call. I am a definite squeaky wheel for other health issues like the mastitis, etc. Its these diagnostics. I think it stems from my mom who had br ca for 19 years who was always waiting on results, and it was so difficult for her (and her children). I prayed a lot for her and was by her side for many diagnostics from pet scans to ct scans to dr appointments , infusions for bone health, and more. She really did quite well especially for the time period. She had a very active life for the 19 years w exception of last 6 months. She was only on infused chemo one time when she was initially diagnosed in 1987. She was able to do hormonal "chemo" pills like Faslodex etc. as hers was extremely hormone responsive. She went through so so many tests, was a victim of medical negligence that I'll have to tell you about some day. You will not believe it. I just know what this disease involves and you'd think that would make me worry less, but it doesn't. Have a great long weekend! I'm happy to be off Monday! I hope and pray for good results next week. I also prayed tonight for any and all sisters on this site and mentioned the ones I know by name or username including you, Tami! Take care

Susan JCP

kel25: MRI or additional breast cancer screenings are not difficult to get insurance to pay for if you have any symptoms or dense tissue. Also I have a breast dr who advocates for me. Very important. Having extremely dense breast tissue qualifies me for additional screening in my state. Most states have laws as well for women with dense breast tissue to qualify for more screening. They never saw my breast tumor on a 3D mammo. Pure and simple it was missed! Ultrasound was the important screening tool for me in 2017. But I know ultrasound isn’t perfect either all the time for everyone. My breast dr wants me to have two different screening diagnostics per year. Mri she’d like me to think about adding She is a good dr.

If you’ve never seen this website it’s pretty amazing all the stories women share about their cancer being missed:

https://www.areyoudense.org/stories/

You're welcome!

kel 25: how are you doing?? We haven’t had any updates from you I don’t think. So just checking with you. Hope you have a good weekend everyone

kel25:sorry for my slow reply. Thank you for updating us on how your treatment is going. 💐I hope all continues to go well. We are here if you want to chat or if you want to update us. Sending a hug your way. Hope your week is going well.