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Breast MRI Results: Confused about next steps

Posted by beats32 @beats32, 5 days ago

Hi All,

I'm hoping for any thoughts and/or opinions on what steps I should take next. 38 yo, high risk for breast cancer, heterogeneously dense. I had my routine 3D mammo in April and it was clear. Then I had my first routine breast MRI at the end of October, which showed a 0.8x1cm signal enhancing lesion (post contrast) kinetics type 2. That’s all the report gave for a description. It was rated BIRAD inconclusive and said additional imaging was required. I had a targeted ultrasound one week later and 2 different techs couldn’t find the lesion, but located 2 complex/complicated cysts nearby. Radiologist rated it BIRADS 3 and recommended another follow-up MRI in one year.

What would you do? I was able to get an appointment with a breast specialist for a second opinion which was scheduled for 12/6, but I just got a call that said they have to push it to Jan 6th, so now I have to wait through the holidays. I'm in a Facebook group for breast biopsy support and it seems like most of the women get a much more descriptive report; mine seems vague so I'm not sure what to make of that.

I would greatly appreciate any thoughts, words of wisdom, advice, etc. Thank you!

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sequoia | @sequoia | 5 days ago

@beats32 maybe call the radiologist department to get a more definitive report and ask to speak with the radiologist. Also, call the breast Dr office and be firm about your appointment and Why You got pushed back to January. IF you cannot get in earlier, then be put on a wait list in case there is a cancellation. Be persistent. We all have to be proactive. Blessings

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Mentor
Laurie, Volunteer Mentor | @roch | 5 days ago

@beats32

I am glad your following up rather than wait for another year for next MRI. I agree with @sequoia about asking to be put on wait list. Or ask if there is another provider that has an opening in Dec.

I understand the anxiety, but the delay of one month is probably not going to change anything regarding treatment plan.

When you say you're at high risk for breast cancer is that due to genetic test or family history?

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1 reply
beats32 | @beats32 | 4 days ago
In reply to @roch "@beats32 I am glad your following up rather than wait for another year for next MRI...." + (show)
@roch

@beats32

I am glad your following up rather than wait for another year for next MRI. I agree with @sequoia about asking to be put on wait list. Or ask if there is another provider that has an opening in Dec.

I understand the anxiety, but the delay of one month is probably not going to change anything regarding treatment plan.

When you say you're at high risk for breast cancer is that due to genetic test or family history?

Jump to this post

Thank you for your reply. I’m on their cancellation list. The reason I was rescheduled (so I was told) was that the doctor will not be in the office that day. Regarding risk factors, my genetic testing was negative, I just have a high rate of cancer in my family.

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dlydailyhope | @dlydailyhope | 4 days ago

I would ask for fine needle biopsy of both cysts and depending on result, get updated MRI/ultrasound in 6 months, not one year. Ask if there is bloodwork that can help detect/identify precancerous changes. Have you done genetic testing to show breast cancer risk?

Praying for you to get the help you need and peace during this challenging and scary time until you can get some answers. 🙏

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lilacs777 | @lilacs777 | 1 day ago

I would recommend biopsy if you're high risk. Also lobular breast cancer is notoriously difficult to see on imaging and often only shows on breast MRI (not visible on US or mammo). Unfortunately many BC organizations continue to propagate the info that all breast cancers are caught early on mammos and its just not true, especially if you have high breast density. Mammos are not very accurate in premenstrual women compared to postmenopausal women due to the difference in density. Ductal cancer is typically visible on mammos starting as DCIS stage 0 or early invasive stage 1. Since 80% of BCs are ductal, that is often what the focus is, but the remaining 20% are still invasive cancers and need other imaging. The downside to breast MRI is that is does have at least twice the rate of false positives compared to mammos. If you're facility happens to have contrast enhanced mammos (CEM), you could ask if that would help in determining if its malignant or not. Good luck to you that everything is benign.

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1 reply
beats32 | @beats32 | 1 day ago
In reply to @lilacs777 "I would recommend biopsy if you're high risk. Also lobular breast cancer is notoriously difficult to..." + (show)
@lilacs777

I would recommend biopsy if you're high risk. Also lobular breast cancer is notoriously difficult to see on imaging and often only shows on breast MRI (not visible on US or mammo). Unfortunately many BC organizations continue to propagate the info that all breast cancers are caught early on mammos and its just not true, especially if you have high breast density. Mammos are not very accurate in premenstrual women compared to postmenopausal women due to the difference in density. Ductal cancer is typically visible on mammos starting as DCIS stage 0 or early invasive stage 1. Since 80% of BCs are ductal, that is often what the focus is, but the remaining 20% are still invasive cancers and need other imaging. The downside to breast MRI is that is does have at least twice the rate of false positives compared to mammos. If you're facility happens to have contrast enhanced mammos (CEM), you could ask if that would help in determining if its malignant or not. Good luck to you that everything is benign.

Jump to this post

Thank you for the information. I met with a breast specialist last week who reviewed my mammogram, MRI and ultrasound. We also did another ultrasound in her office, where she was able to identify the lesion seen on the MRI. All signs right now point to the likelihood of it being a fibroadenoma (smooth, well-defined margins, low kinetics, seen post-contrast, high signal enhancing, oval shaped and horizontally oriented). Since we don't know for sure, I'll be having an ultrasound guided biopsy with her in 2 weeks. Feeling hopeful!

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