Is recent biopsy showing up in MRI as a non mass enhancement?

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erineleven
erineleven Member Posts: 11
edited May 2021 in Waiting for Test Results

Hello,

I had an MRI on Friday 5/21. It came back that I will have to have a biopsy because of two areas of non mass enhancement in my upper left breast. I am wondering if that is the incision site and the bruising from the biopsy I had in March that they are seeing. The site they biopsied was in my upper inner quadrant but they entered it from the upper outer quadrant. My radiology report came in late Friday so while I can read it, I have not spoken to my breast surgeon yet. (The biopsy I had in March was negative for cancer but I had Flat Epithileal Atypia).

This is what it says:

Left breast: There is focal nonmass enhancement in the upper outer left breast (LOC 6.1, axial image 68 of 134), measuring 1 cm, which demonstrates washout kinetics. Adjacent to this and posterior and slightly inferior to this, there is a regional area of nonmass enhancement (axial images 69-75), which demonstrates progressive kinetics. Clip artifact is noted in the upper left breast from recent biopsy (sagital image 37, axial image 62). There is focal nonmass enhancement adjacent to the clip measuring 0.9 cm, which demonstrates progressive kinetics. There is no nipple retraction or skin thickening. There is no axillary or internal mammary adenopathy.

If you know anything about how incisions/bruising from recent biopsies show up on MRIs let me know. Hoping that is all that was.




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  • eviec1
    eviec1 Member Posts: 140
    edited May 2021

    I don't know the answer, but I am curious about this, too! I had a biopsy about a week and a half ago and have developed a very large hematoma (like a big hard lump). I have an MRI this Thursday and I don't think the hematoma will be gone by then, so I wonder if this will throw off the results?

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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    I had a hard lump too, the radiologist told me that might happen. So, I found some info in the following article (I cant link it here but you can google it).

    Magnetic Resonance Mammography

    Author Preeti Gupta MD

    It says biopsy should not change tissue enough to affect MRI but also says "Postbiopsy changes, including the biopsy tract, may be visualized in cases with recent biopsy"

    I met my breast surgeon about 3 weeks after my biopsy and at that point I still had a huge huge bruise on my breast. She said to me "The radiologist will see that". But, I ended up having to wait about 5 weeks for the MRI since you have to go on day 7-14 of your cycle. So my bruise is gone (on the outside) so I didn't think the radiologist would see any sign of it. Hopefully my breast surgeon will clarify this for me tomorrow. Good luck with your MRI!

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  • eviec1
    eviec1 Member Posts: 140
    edited May 2021

    Huh, my surgeon never mentioned anything like that to me. She just looked at it and said, yup, that's a hematoma, and I didn't even think to ask about the MRI (I was already so overwhelmed with everything that it didn't occur to me at the time). Also interesting about the cycle - no one told me that, either, nor did anyone ask. I'm at the end of my cycle right now with MRI on Thursday - wonder if that will throw anything off? And if that weren't enough, I had the second covid vaccine a few days ago - I've heard that can show up in the lymph nodes. My goodness, I was stressed enough about this MRI and now I wonder if the results will even be meaningful given all the other things (hematoma, end of cycle, covid vax)?

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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    I will let you know what my doctor says. I'm sure that they wouldn't let people make appointments for MRIs shortly after biopsies if it could make the results difficult to read. So if something does show up where your lump from the needle is they can rule out anything more serious. I was told when trying to make an appointment for the MRI it had to be Day 7-14 of your cycle because hormonal changes in your cycle show up in MRI. I was told this is mostly so that they can see your breasts in the same state in future MRIs to compare apples to apples. So they will always have you come days 7-15. I actually even called another radiology office to see if they had a Saturday appointment and they told me the same (they said say 8-14). You can call them and ask. Maybe at your place they just ask you what day you are on and then you have to make sure you have repeat MRIs at the same time in your cycle? I totally get being stressed. All the waiting and stress and time taken off work for appointments is a total drag

    PS my bruise was what she was referring to the radiologist seeing not my bump. My bruise was huge

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  • eviec1
    eviec1 Member Posts: 140
    edited May 2021

    Interesting...Goodness, apologies for hijacking your thread, I didn't mean to do that! I'll step off, but keep reading. Hopefully others will have some helpful info for you on your question.

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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    You didn’t hijack! Glad to know we both had the same question. If I get any more info when I talk to my doctor I will let you know.

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  • eviec1
    eviec1 Member Posts: 140
    edited May 2021

    I'll keep my eye out for updates :)

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  • LoverofJesus
    LoverofJesus Member Posts: 255
    edited May 2021

    I am curious about this as welll! I have an MRI coming up and had a biopsy last week.

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  • LivinLife
    LivinLife Member Posts: 1,332
    edited May 2021

    I don't know about bruising, etc. with MRI's and biopsies soon after. I can tell you I had a 3 cm area of non-mass enhancement on MRI. Upon final surgery pathology the area turned out to be a bunch of benign and precancerous issues.

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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    That is good news!!! Thanks for telling me that.

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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    So, to LoverofJesus and eviec1, I spoke with my doctor today. She told me I do need to have a biopsy. I asked could the area of concern be the bruising and the marble from the entrance of the needle and at first she was confused. She said no, it couldn't be from the biopsy. The MRI refers to some inflammation from the biopsy and the breast clip being in Upper Inner left breast. The area of concern here is in your Upper Outer Breast. I reminded her that is where the needle went in and that's where the marble is. She realized what I meant. She said she didn't think that would enhance in an MRI. She thinks this is something else.

    I have to be honest, I am having a hard time understanding that she doesn't think there is any weight to my theory. Like, has this never happened before, someone has a little marble or a bruise from a biopsy and it shows up in the MRI. I am telling myself she knows way better than I do. Also, in my case, there is no way to know. I suppose I could wait forever for this thing to heal and get another MRI but I need answers now so I have to do the biopsy especially since my doc thinks it's something else.

    Anyway as it applies to others, I don't think either of you need to be concerned. It sounds like it is very routine to do an MRI after a biopsy and that bruising/marble would not show up as a suspicious finding.

    I called the biopsy scheduler at my radiology place and she never called me back. Oh well! I will try again tomorrow. The last biopsy I had was on a Friday and I was hoping I wouldn't have to do an end of the week biopsy again and worry all weekend.

    Good luck with your MRIs ladies!




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  • eviec1
    eviec1 Member Posts: 140
    edited May 2021

    Your theory makes sense to me, but what do I know? Nothing, that's what.

    Sorry you have to go through another biopsy - hopefully it will come back clear!

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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    Lol thank you! I guess I will trust the doctor.... Good luck with your MRI, hope it goes well!

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  • Beesie
    Beesie Member Posts: 12,240
    edited May 2021

    A biopsy is not recommended because something showed up on the MRI imaging. A biopsy is recommended because of how it looked. It's the shape, T1 and T2 weighted imaging and the enhancement pattern that determines the need for a biopsy.

    Lots of people have biopsies prior to having an MRI (I did). My guess is that a bruise from a biopsy will not have the same concerning appearance as something that requires a biopsy and a radiologist will be able to distinguish between something so obviously benign vs. something that may be concerning.


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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    of course I understand that. I didn’t say I was having a biopsy because something showed up did I? If I did I may have been simplifying concepts that I have just recently learned, these are all new to me.

    Apparently fat necrosis (the hard lump i got from the incision site of the biopsy) can appear/show up on MRI in a variety of ways (including non mass enhancements). Also, fat necrosis can be mistaken for malignancy in MRIs. All things I’ve read in the last few days. So, I do think my concerns are valid.

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  • LivinLife
    LivinLife Member Posts: 1,332
    edited May 2021

    If it makes you feel any better I had a biopsy before my MRI. When the MRI showed the area of non-mass enhancement another biopsy was recommended. I was having a mastectomy, well... bilateral...., so the additional biopsy was not necessary. It was after surgery they found the original area deemed DCIS was indeed DCIS - no invasion as they suspected thankfully. the additional 3 cm as I said before turned out to be lots of benign and precancerous stuff, some of which would have led to surgery to excise had I not been having a mastectomy on that breast.... Deep breaths.... you can do this even though the waiting is really difficult. Hopefully you at least get a date soon, then more waiting and so it goes unfortunately...

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  • erineleven
    erineleven Member Posts: 11
    edited May 2021

    Thank you for the encouragement. You have been through so much, I hope you are doing well now. I found out today that the biopsy coordinator I have been leaving messages for today doesn't work there anymore so the new person is going to call me in the morning. It's annoying to have to wait 2 days to make the appointment and then have to probably wait a week to do it and a few more days for results. I have been waiting since September to really know what's going on. I really feel for you and others who have been at this way longer than me. It's a very up and down road.

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  • LivinLife
    LivinLife Member Posts: 1,332
    edited May 2021

    It definitely is an up and down road! I generally believe this is behind me now.... I have other health issues where I still experience a lot of waiting and the up and down roadsssss.... so I can still relate to what many on these boards still go through, or just starting to go through for newbies.... You are dealing with a lot and you will get some concretes in the near future.... really stinks about the coordinator not being there after leaving messages....

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