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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@rosy54

I may ask my general MD to order an MRI otherwise I have to wait till my doctor’s replacement arrives

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No reason why your PCP can’t especially as you are temporarily without your specialist.

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@anjalima

No reason why your PCP can’t especially as you are temporarily without your specialist.

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Good plan!

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@anjalima

No reason why your PCP can’t especially as you are temporarily without your specialist.

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I’m wondering if my insurance company would pay for MRI if my last mammogram was within a year. It makes no sense, you buy health insurance for when you need it but if it’s within a certain timeframe from the last test I had done ,they don’t cover. Seems unfair 😒

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@nemo1

I am so sorry for all your worry. I didn’t realize you had cancer. I’m so so sorry. Could the soreness be scar tissue? You should be given answers. My mom had breast cancer as well and she had to follow up with the specialists until years later. Maybe you could go to the primary care and ask for a breast exam? I know it isn’t expediting the specialists job, but if they feel something, that doctor can call the other doctor on your behalf. If that is not something you can do, perhaps you could go on the patient portal. It sounds like you need to bypass the nurse. Maybe you could be put on the cancelation schedule in case someone cancels and you could take their place? Patient portals are good to use. Most doctors respond. Maybe put a note this way the doctor is on notice. I would try the pcp and to call and ask to speak to the doctor. Are you having any discharge, dimpling, pea sized felt? I’d be ticked at that unreassuring nurse. That nurse should be aware of what cancer patients endure and react appropriately, not dismissively. I’d try to bypass the nurse and speak directly with the doctor. I wish I had more helpful advice for you. 🤗

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Just had appointment with my surgical oncologist, I also have sharp pain in two areas of the lumpectomy, which was done in August of 2022. She tells me can have injection to stop pain or take inflammatory meds. Allergic to anything with aspirin. I do not want injection at this time. She said to take 500 mg. Tylenol three times a day. If it does not help I may have to get injection. Hope this helps in some way. Also stopped Letrosole, too may side effects.

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Hi @jaynep I had dense breast and had my mammogram in Dallas and they said all looks good and my physical wear my dr examined my breast.
Within a year after moving back to Utah, my nipple started turning inwards.
I decided to call Huntsman Cancer Institute and see if that was normal. They suggested I do a mammogram. A dr did an exam on me before going in and said, “plan on being here for a couple of hours as you have some kind of cancer. I can feel it in your breast and your lymph node and I want to have a breast MRI done right after.”
It didn’t show my cancer and one of them was over 3” long.
They went ahead and did the MRI and then the biopsy. Called me 2 days later on a Saturday, to tell me it was cancer. Turned out I had 2 different kinds and Stage III.

The law in Utah is now that they have to offer you an MRI if you have dense breast. The mammogram is great at showing small tumors but not large ones and especially with dense breast.
I hope by now you have gotten your MRI!
Best wishes.

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@badassi

Hi @jaynep I had dense breast and had my mammogram in Dallas and they said all looks good and my physical wear my dr examined my breast.
Within a year after moving back to Utah, my nipple started turning inwards.
I decided to call Huntsman Cancer Institute and see if that was normal. They suggested I do a mammogram. A dr did an exam on me before going in and said, “plan on being here for a couple of hours as you have some kind of cancer. I can feel it in your breast and your lymph node and I want to have a breast MRI done right after.”
It didn’t show my cancer and one of them was over 3” long.
They went ahead and did the MRI and then the biopsy. Called me 2 days later on a Saturday, to tell me it was cancer. Turned out I had 2 different kinds and Stage III.

The law in Utah is now that they have to offer you an MRI if you have dense breast. The mammogram is great at showing small tumors but not large ones and especially with dense breast.
I hope by now you have gotten your MRI!
Best wishes.

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It will be in August when I have my six month follow-up appt with the surgeon’s office. I asked about it at my February appt and didn’t hear anything back. I saw my surgeon’s nurse practitioner and she agreed to me having a MRI but then nothing was scheduled. I called twice and luckily I spoke to a young lady with whom I had spoken to frequently l…I had two lumpectomies and a mastectomy within two months and she gave me her direct number then. I know we all dread these follow-ups but I think I’ll feel better after the MRI. The surgeon wanted to do one initially when I was diagnosed but I had recently had a spinal fusion and was unable to lie on my stomach at that point in recovery. Thank you for your kind words and I pray you do well and feel well in your journey down this tangled road we’re all traveling. God Bless🌹

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This is just all so stressful as very little consistency. I am at Dana Farber-live in Boston considered one of the best and I'm thinking maybe in addition to crazy shortage of nurses we just have nationwide shortage of oncologists too. I had my lumpectomy in early Dec 2022 ILC, 20 rounds radiation followed month later and now on Letrozole (been 10 weeks and brain fog, fatigue biggest complaint and general feeling of malaise when I know I should feel grateful as no node involvement). My next appt is with a NP 6 months after surgery and a mammo was scheduled in Oct 2023 which is my annual mammo month. An MRI was not scheduled and when I asked the scheduling person she said that would be discussed with NP in May 2023 as MRI are not routine even with very dense breasts. I have private insurance (pay $2K a month which leaves me basically just above poverty limit - self employed 58 yrs old-HMO) and will probably have to fight to get MRI covered - I almost can't wait for Medicare because it seems Medicare covers a lot more. I'm wondering with all the media attention Katie Couric has given to dense breasts and to the inequities in our health care system, docs and administrators are worried that everyone asking for an MRI will "strain" the system. But the cost of treating my cancer which my radiologist said would have been caught earlier with an MRI would seem much higher than the cost of a MRI. Do I beg for an MRI at one year mark - or even a mammo 6 months after surgery or is it typical to wait a year after surgery for any more imaging?? Sorry to be such a complainer! xo

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@patclem

Just had appointment with my surgical oncologist, I also have sharp pain in two areas of the lumpectomy, which was done in August of 2022. She tells me can have injection to stop pain or take inflammatory meds. Allergic to anything with aspirin. I do not want injection at this time. She said to take 500 mg. Tylenol three times a day. If it does not help I may have to get injection. Hope this helps in some way. Also stopped Letrosole, too may side effects.

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Make sure you eat with all that tylenol. I’m glad they are helping you. I hope tylenol helps. Good Luck.

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@rosy54

I’m wondering if my insurance company would pay for MRI if my last mammogram was within a year. It makes no sense, you buy health insurance for when you need it but if it’s within a certain timeframe from the last test I had done ,they don’t cover. Seems unfair 😒

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You can google non profit breast cancer assistant programs that will help pay for screenings.

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@semurrey

This is just all so stressful as very little consistency. I am at Dana Farber-live in Boston considered one of the best and I'm thinking maybe in addition to crazy shortage of nurses we just have nationwide shortage of oncologists too. I had my lumpectomy in early Dec 2022 ILC, 20 rounds radiation followed month later and now on Letrozole (been 10 weeks and brain fog, fatigue biggest complaint and general feeling of malaise when I know I should feel grateful as no node involvement). My next appt is with a NP 6 months after surgery and a mammo was scheduled in Oct 2023 which is my annual mammo month. An MRI was not scheduled and when I asked the scheduling person she said that would be discussed with NP in May 2023 as MRI are not routine even with very dense breasts. I have private insurance (pay $2K a month which leaves me basically just above poverty limit - self employed 58 yrs old-HMO) and will probably have to fight to get MRI covered - I almost can't wait for Medicare because it seems Medicare covers a lot more. I'm wondering with all the media attention Katie Couric has given to dense breasts and to the inequities in our health care system, docs and administrators are worried that everyone asking for an MRI will "strain" the system. But the cost of treating my cancer which my radiologist said would have been caught earlier with an MRI would seem much higher than the cost of a MRI. Do I beg for an MRI at one year mark - or even a mammo 6 months after surgery or is it typical to wait a year after surgery for any more imaging?? Sorry to be such a complainer! xo

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You’re not a complainer. You’re just trying to be proactive with you treatment. It sometimes feels as if the health practitioners are very casual about our treatment after the surgery is over. I don’t think we should have to push for everything we need to have done to fight our cancers! Best wishes and I hope you continue to heal.

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