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Detecting cancer in women with dense breasts: MRI?

Posted by jaynep @jaynep, Feb 8, 2023

I had my one year mammogram today on my left breast and saw the nurse practitioner at my surgeon’s office. She told me it looked great! I asked about a MRI in six months when I am scheduled for my next appt with her and she agreed. However, when I got home I received the mammo report in their my chart app and it stated that the left breast is heterogenously dense which may prevent them from seeing a mass in some cases. So, this concerns me. Does anyone has any experience with this?

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karen1103 | @karen1103 | Jun 2 11:12am

At one year they have me scheduled for mammogram and ultrasound and mri. Get these tomorrow then meet with the surgeon. Mammogram is difficult for me cause they have to go up under my armpit. Last time it was like 10 tries and very painful. I was in tears. I will tell them to stop trying this time if it takes to many tries.

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1 reply
Rubyslippers | @triciaot | Jun 2 12:00pm
In reply to @karen1103 "At one year they have me scheduled for mammogram and ultrasound and mri. Get these tomorrow..." + (show)
@karen1103

At one year they have me scheduled for mammogram and ultrasound and mri. Get these tomorrow then meet with the surgeon. Mammogram is difficult for me cause they have to go up under my armpit. Last time it was like 10 tries and very painful. I was in tears. I will tell them to stop trying this time if it takes to many tries.

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I’m so sorry that you have to deal with the mammogram imaging of your armpit. Whomever designed the mammogram device put no thought into how it must fit against a human body - which is definitely not square with straight edges.
One mammo technician was telling me (when she was pulling skin and I was practically moaning) that she does this for my own good (true) and that in one case she was able to include enough under breast skin that cancer was found in that area. I can only guess that she pulled hard enough that lung cancer was detected 🙂

Now that I go to a cancer center, they often schedule the mammogram before the MRI, not sure it that’s intentional. But in your case, if they could do the MRI first and know whether there is something that they need to see on the mammogram. Maybe they don’t need to image the armpit area this time, if they don’t see something on the MRI.

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1 reply
karen1103 | @karen1103 | Jun 2 12:36pm
In reply to @triciaot "I’m so sorry that you have to deal with the mammogram imaging of your armpit. Whomever..." + (show)
@triciaot

I’m so sorry that you have to deal with the mammogram imaging of your armpit. Whomever designed the mammogram device put no thought into how it must fit against a human body - which is definitely not square with straight edges.
One mammo technician was telling me (when she was pulling skin and I was practically moaning) that she does this for my own good (true) and that in one case she was able to include enough under breast skin that cancer was found in that area. I can only guess that she pulled hard enough that lung cancer was detected 🙂

Now that I go to a cancer center, they often schedule the mammogram before the MRI, not sure it that’s intentional. But in your case, if they could do the MRI first and know whether there is something that they need to see on the mammogram. Maybe they don’t need to image the armpit area this time, if they don’t see something on the MRI.

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No. It’s mammogram then ultrasound then mri. What you said makes sense though

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meeshodge | @meeshodge | Jun 3 7:59am
In reply to @einnoc "IMHO, both the Illinois and Iowa oncologists have been rather dismissive and rude. The first one..." + (show)
@einnoc

IMHO, both the Illinois and Iowa oncologists have been rather dismissive and rude.
The first one (Illinois), when I tried to tell him about all the horrible side effects that I was having after 7 months on Anastrozole (and my left knee was incapacitated and I was in a wheelchair at the time) said, "Don't take them then" and walked out! I had thought we would discuss alternatives to the drug I was currently on, but that didn't happen,. When my SURGEON suggested that a ki67 test might give me the peace of mind (re recurrence) that I craved, the oncologist refused to order that, also, and said, "I won't order that for you, You'll have to get someone else" and walked out (again), (He was fond of saying something terse and abrupt, like, "Your knee gave way because you're old" and walking out. ) I have been very disappointed that the Iowa City physician has really not given me the time of day, but I keep trying to remind myself that this could be because he thinks I am doing really well. But am I?

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I am second guessing going to The Mayo Clinic after hearing similar. I also have the choice to go to Oschner in New Orleans. A friend of mine just had BC surgery there and was very pleased with her care.

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daisy1282022 | @daisy1282022 | Jun 3 9:58am

Under any concern situation, MRI is the definite answer.

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sam4 | @sam4 | Jun 4 11:19am

Yes—it is infuriating. It is a flaw in the system. Looking back at my mammogram reports for six years prior to an ILC diagnosis, I found "recommended MRI due to heterogeneous dense tissue." Now, after a right breast mastectomy, I am still required to have mammograms, yet alternated with MRIs every six months. Although ILC isn't reliably detected by mammograms, something else must be that MRIs don't find, else why would it be this way? If my nipple had not retracted, which I consider a sign from God, the elusive cancer would still be growing. I am advocating for earlier MRIs per radiology recommendations.

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mitch3194 | @mitch3194 | Jun 5 7:54am

I had dense breast tissue and was never offered an MRI. Last October I felt the lump that was approximately 2 inches and went for a mammogram and it was not detected. I made her feel it. Then she sent me for an emergency ultrasound and it showed it was a few millimeters. Went for a biopsy and the doctor said it was more like an inch. I said are you sure because I’m feeling something that’s more like 2 inches. And he assured me that it was only 1 inch. Went for a lumpectomy, and they removed 29 lymph nodes, 2 were cancer. They removed a mass that was 3 1/2 inches and did not get clear margins. Recently, I had a double mastectomy. Just waiting for the results. It baffles me why MRIs are not being done for women that have dense breast tissue. I’ve been diagnosed with ILC stage three grade 3 which is aggressive. I guess I don’t have to worry about the MRI anymore.

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