Advice needed - should I get more testing?

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Needadviceplease14
Needadviceplease14 Member Posts: 2
edited December 2021 in Not Diagnosed But Worried

Hi all, I would love some perspective from this community. 35 years old, had a baby around 21 months ago. Had major issues breastfeeding due to oversupply (lots of clogged ducts). This past August I felt a lump in right breast. It didn’t seem like a small lump, but rather like the breast under the nipple had hardened into a “mass” (trying to explain as best I can). Went to the doctor & got a mammogram + ultrasound. Nothing found. Results said it was “dense fibroglandular tissue without appreciable abnormality.” Went back to the doctor to talk about the results. I just thought it was odd this seemed to appear out of nowhere (it didn’t feel this hard previously). Went to another doctor to get a second opinion. From physical exam, he said he wasn’t worried, but I could get a MRI if I wanted. Set up the MRI then read more about the contrast agent (gladolinium) and had second thoughts (particularly about the gladolinium). I want to have another baby in the near future & the web is not fond of gladolinium. The radiologist said not getting contrast would make it difficult to see cancer. The OB said it would still be worth it?

My body is telling me that I should get this checked out again. The “mass” doesn’t necessary hurt, but sometimes it feels tender (not sure tender is the right word?). I’m super aware of how it’s changed.


Has anyone had a similar experience? I would love thoughts / advice from this community! Thanks in advance

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  • MountainMia
    MountainMia Member Posts: 1,307
    edited December 2021

    One option is to ask for a follow-up ultrasound in 3-6 months. Sorry I don't have any other ideas about this.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited December 2021

    I agree about the chemical in the MRI & that there's no point if you don't do it with contract. Maybe explore Mountain Mia's suggestion for an ULS?

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited December 2021

    There is more than one kind of gadolinium contrast, and my MRI tech explained that my cancer center has switched to one that carries less risk. So I would recommend looking into which one they are proposing to use. Here is an article I found that lists the categories:

    https://radiology.ucsf.edu/patient-care/patient-safety/contrast/mri-with-contrast-gadolinium-policy#accordion-choice-of-gadoliniumcontaining-contrast-medium


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  • WC3
    WC3 Member Posts: 1,540
    edited December 2021

    Needadviceplease14:

    My cancer, though palpable, was originally missed on the mammogram and ultrasound due to the extreme density of my breasts, and I think it should be the standard of care to offer MRIs in situations where the patient has a palpable lump that is strange to them that was not seen on imaging.

    Since my diagnosis, I've had a few MRIs with gadolinium contrasts. Yes it is a concern and I am *that* patient who insists on knowing the type/brand they are using. So far the imaging facilities I have gone to have always used the more stable gadolinium contrasts and I try to drink enough fluid that has enough of a diuretic effect on me to flush it out of my system quickly.

    For the breast MRIs though my cancer showed up on the pre-contrast scans and so in hindsight, the gadolinium proved unnecessary in that one instance for me, but in some instances the gadolinium makes visible things that would otherwise be invisible.

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  • Waves2Stars
    Waves2Stars Member Posts: 158
    edited December 2021

    Do you have a history of BC? I wouldn't think fooling around with the contrast is a great idea if you are planning for another baby any time soon. You are not too far out from all the breast changes due to lactation. It seems scary to wait 3 months for another ultrasound, but it's probably the safest bet. If it's still inconclusive then maybe you could get a biopsy. Hugs Momma!

    Edited to add: I am not a BC expert like other women here. But I had three MRI’s this year, two with contrast, one for gynecological issues. I did all the holistic tricks to rid my body of what contrast I could, but it’s not guarantee, you know? Also, the MRI didn’t detect my surprise DCIS, so I don’t think imagining is the end all be all, either. It’s just a tool. If you are low risk, surveillance by a good team can be effective.

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  • Jons_girl
    Jons_girl Member Posts: 696
    edited December 2021

    so when those of you who have MRI have them, do you ask for one of these?

    Gadobenate dimeglumine (MultiHance®)

    Gadoteridol (ProHance®)

    Gadobutrol (Gadavist®)

    Gadoterate acid (Dotarem®)


    in the article that was shared above, I believe these are supposed to be the safest gadolinium correct??

    Needadvice: I’d probably have the MRI if I were in your situation. It is probably your best option with extreme density (I think you said you had extreme dense tissue). I used to have extreme density and my cancer was seen on ultrasound. But I know others here who’s cancer was missed on ultrasound. I’ve added MRI to my diagnostics periodically moving forward for myself. My density isn’t extreme anymore but have chosen to have MRI periodically.

    Sending a hug to you. Keep us posted. We are here for support

    tami

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  • Needadviceplease14
    Needadviceplease14 Member Posts: 2
    edited December 2021

    This is very helpful. Thank you, everyone. I now have a better idea of what questions to ask my doctor. I do have history of BC in my family (mom, grandma), but they both had it at an older age 60+.


    @WC3 How dense are/were your breasts when you had the MRI that showed you didn't need the contrast agent?

    I'm currently debating if I should ask for another ultrasound or go for the MRI without contrast.

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