MRI after 3D Mammogram - dense breast tissue

Posted by 2r3b @2r3b, Oct 8, 2022

Recently, I had my first mammogram post treatment for IDC with one sentinel lymph node involved (I had surgery, radiation, ovarian suppression--and then ovary removal, and am currently taking Letrozole. I also receive Zometa infusions every six months to prevent osteoporosis). Thankfully, my breast surgeon shared that the Radiology report from the mammogram look great. However, the Radiologist recommended a MRI due to my age (under 50) and dense breast tissue. Even so, my breast surgeon does not suggest I do the MRI at this time as their group feels that there can be too many false positives, potential difficulty getting it covered by insurance, and to keep in mind that my cancer was orginally found on my annual 3D mammogram.

I am unsure what to think of this as the Radiologist recommends the MRI in addition to the 3D Mammogram due to my age and dense breast tissue, yet the Breast Surgeon does not recommend it at this time--even though I now have a history of breast cancer.

Thank you for any thoughts/experiences on this...I appreciate your time!

Interested in more discussions like this? Go to the Breast Cancer Support Group.

My first MRI was after the breast cancer was discovered. I have very dense breasts. I had only been having mammograms until they saw something suspicious then I got a sonogram and then a 3d sonogram. I switched facilities and found out this new one routinely does 3d sonograms on dense breasts so they don’t have so many call backs. Boy I wish I’d known this before. I still wonder if my tumor would have been seen a year ago at my last check up.

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@katrina123

I have dense breasts also. I have shared this on this site before but 2 months after I was told my 3D mammogram was negative for cancer I felt a lump and then an ultrasound detected a 2 cm adeno squamous metaplastic carcinoma. I fought for the ultrasound because I had read that 3D mammograms were missing cancer in dense breast tissue.

Maybe you should get a second opinion. What do you think?

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Thank you for sharing your experience--I hope you are doing well!

After gleaning from other's experiences, I am certainly considering requesting the MRI, or as other's have mentioned, asking to have an MRI/Mammogram at 6 month intervals. Also, I am researching options for a second opinion.

Thank you!!

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@roch

I also have dense beast and use to had yearly mammograms. Yet 7 months after a yearly mammogram in 2018, I found lump that turned out to be cancer and had already moved to lymph nodes.

After treatment (lumpectomy, chemo, radiation, AIs) I had mammogram and MRI for surveillance for first few years. Just had routine recheck with Mayo oncology and going to start alternating. So, I had MRI last week, in 6 months will do mammogram, then MRI 6 months later, etc....

One reason is insurance companies guidelines. I am on Medicare, and they only approve mammograms once a year going forward unless there is new lump.

As far as false negatives, I have had abdominal scans that found cysts that I panicked about. Drs. assure me they are not a issues. All the advancement in technology are great, but they do find things that may never cause you problems or develop into something serious.

Laurie

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Thank you for your suggestion about alternating the 6-month intervals of MRI/Mammogram!

Thank you for sharing, and I hope you are doing well!

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@sequoia

@2r3b In 2019 in had a 3D mammo and results came back normal. I had DCIS in 2004 and after my lumpectomy, I always ent back to my breast surgeon yearly for an exam. I felt, they are in the breast business and know what to feel for vs Gynecologist. When I moved I found that I didn’t have a breast surgeon and that was part of my medical preventative protocol if you will. I continued always having yearly mammograms & all was fine. Finally I made an appointment w/ a breast surgeon, recommended by my PCP. He studied my mammo and said ‘due to your dense tissue, let’s do a MRI’. I didn’t realize they even did MRIs of the breast. Lo & behold they found something, it was cancer.
I now have alternating mammo & MRIs every 6 months. My oncologist was alternating yearly but my surgeon said ‘if we are going to check you let’s Check you & recommended 6 month checks’. I feel you need to insist on the MRI. Blessings

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Thank you--I am so thankful for the replies on this discussion board as they certainly give me things to consider and help me be a more proactive partner with my medical team, as opposed to reactive.

Blessings to you, also--take care!!

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@rene1636

I had a recent diagnosis of DCIS that was found on a 3D mammogram & had a lumpectomy. I’m 62 & have always had dense breast reported on mammograms. I never knew & never did a doctor suggest that I should have more testing done if you have dense breast tissue. Since being diagnosed with DCIS my surgeon told me I need a yearly mammogram alternated 6 months later with a MRI going forward just to be sure nothing shows up in the dense tissue. We need to be our own advocates for our healthcare. Since having DCIS I’ve done extensive research to see what treatment options are available & I speak up at the appointments. If they don’t listen I keep repeating till they do or can explain why they don’t agree or I’ll find another doctor who will listen. My thought is this is my health, my life & I’d like to be here as long as possible. Sometimes the “standard” treatment doesn’t apply to every situation.

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Yes, I agree! Since my experience last week at this appointment, I have been doing even more research than I did when I was first diagnosed. Many of the replies to my question indicate that the 6-month interval with MRI/Mammogram is certainly a reasonable request, so I will likely be following-up and request this. I am strongly considering the second opinion, also.

Thank you so much, and I hope you are doing well!

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@bestpommom

My first MRI was after the breast cancer was discovered. I have very dense breasts. I had only been having mammograms until they saw something suspicious then I got a sonogram and then a 3d sonogram. I switched facilities and found out this new one routinely does 3d sonograms on dense breasts so they don’t have so many call backs. Boy I wish I’d known this before. I still wonder if my tumor would have been seen a year ago at my last check up.

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I am sorry--I hope you are recovering well from treatment.

Since my experience began, I keep realizing how this is not a "linear" process for me. What I think I will be doing after one appointment might change at the next appointment. I think this occurs as new studies/trials are released and standards of treatment might change. Even so, I am learning, as you did, how facilities/medical professionals might have different thoughts on which tests are necessary, etc.

Thank you for sharing your experience. I wish you all the best as you recover!

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@2r3b

I am sorry--I hope you are recovering well from treatment.

Since my experience began, I keep realizing how this is not a "linear" process for me. What I think I will be doing after one appointment might change at the next appointment. I think this occurs as new studies/trials are released and standards of treatment might change. Even so, I am learning, as you did, how facilities/medical professionals might have different thoughts on which tests are necessary, etc.

Thank you for sharing your experience. I wish you all the best as you recover!

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Thank you. My surgery is next Thursday. I’m really worried it’s taken so long to get to this cancer removed and I’m questioning all of my decisions at this point. I’m scared but it just can’t come fast enough.

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@bestpommom

Thank you. My surgery is next Thursday. I’m really worried it’s taken so long to get to this cancer removed and I’m questioning all of my decisions at this point. I’m scared but it just can’t come fast enough.

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I recall the mixed feelings as surgery was approaching. I wish you all the best for your surgery next Thursday and for your recovery. Take care!

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https://densebreast-info.org/legislative-information/state-legislation-map
After hearing a Northwestern physician on the news, I learned that our state, Illinois, requires classification of dense breast tissue on results of a mammogram. Looks like many others do as well. Interestingly, my report comments do not indicate such…just “dense breast tissue” and no suggestion to have further testing. It’s really become up to the individual to know more and ask for more.

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I’ve had a few call backs over the years but never the routine screening that appears to be necessary for dense breasts. The new clinic that I go to said they always do the 3d sonogram in addition to the mammogram on dense breasts. They hardly have any call backs. Katie Couric is trying to get the word out about this as well after she was diagnosed last June. Hers was caught early because she was having additional screening for her dense breasts. This really should be standard practice, at least over a certain age. I’m only 54.

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