To MRI or not to MRI?

That is such a tough question.

I am doing MRIs after a relatively young IDC diagnosis combined with family history. After my second one they called me back for an MRI biopsy. It turned out to be scar tissue but it was a terrifying ride. I just had another MRI this past Saturday and I'm waiting for results. I'm not super nervous but I'm also definitely not NOT nervous.

(Actually realizing it was already Thursday just made me super nervous and I went to my online portal and there were no suspicious findings! PHEW!!. So yeah, nervewracking).

That report makes the note that "American Cancer Society recommends annual screening MRI for individuals with a lifetime risk of 20% or greater." It sounds like you are that high just over the next ten years.

It really does feel like a big time sink both logistically and emotionally. What I kept telling myself while I was waiting for my biopsy results last year was that if they were negative, then this roller coaster was what I'd signed up for with the enhanced screening (I'd requested it), and if it were positive, then as much as it would suck it would definitely justify the decision by finding it as early as possible.

Anyway, I'm sticking with the MRI monitoring for now. I'm doing what your nurse oncologist suggested, alternating between MRI and mammogram every six months. On the one hand, it does sometimes feel like a LOT. On the other hand, I do kind of think that combining them would be giving up a huge chunk of the potential benefit (at minimum, 6 month earlier detection) while still having to deal with going through the procedure and the risk of false positives.

I don't know that any of this is remotely helpful, but that's my experience and where I've ended up at least for now.

PandoraX, I had dense breasts, too. A research study in Italy had good results with a combination of mammogram and ultrasound. So when there was a similar study at UPMC, I signed up. It was a 3-year study and they found my cancer the third year. I heard they also found cancer in other women in the study.

Because I had lobular cancer in my right breast, it was not visible on my mammograms. After I had an MRI, they found a small DCIS tumor on my left side, which was too small to find on the mammogram or the ultrasound.

If your insurance won’t pay for MRI, maybe try to get them to pay for the mammogram and ultrasound combination.

There is a risk of needing more biopsies when you have more imaging, but instead of thinking of these as unnecessary, try to see them as a good thing. If a negative biopsy lets you avoid a mastectomy,then I think it is a small price to pay to keep your breasts and avoid lymphedema and other side effects.

One word of caution about biopsies: I actually had a biopsy in my right breast the year before I started the research study. They placed a butterfly clip to mark this area on future imaging, but I think this was actually a bad thing because they didn’t biopsy that area again until three years later and that allowed my cancer to spread. The doctors saw the clip and thought that because there was a negative result one year that they didn’t need to test that area again, but they didn’t consider the possibility that the same area could have new cancer or that there was an error during the first biopsy. Don’t let your doctor make the same mistake.