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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Sue, this might help. My surgeon's NP told me that the standard of care right now is mammogram yearly, and MRI yearly (these are are scheduled alternately at 6 mos. apart) -- I had my yearly mammogram a couple of weeks ago, and they even have in the result that dense breasts might negate the good news of "no malignancy" -- throws the ball back into our court regarding self exams. Well what I always say to them is, "it's YOUR job" I missed this the first time and there's no guarantee I'm going to find it the next time! I would, however, have great confidence in what DF recommends...they are so thorough. It might be an insurance thing, but you need to advocate in getting the most out of your insurance, especially when it comes to the diagnostics (also in MA).

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I had double mastectomy in April this year and when I met w oncologist after the surgery she said since I had mastectomy there would never been any mammograms, mri or ultra sounds going forward unless I complained of symptoms that warranted a test. So that tells me if I had a reoccurrance by the time I have a physical complaint I would be at a late stage.

Should I advocate for myself and ask for ultrasound every year?

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I am 110% fan of MRI. I had nipple discharge in left side. My GYN had me get ultrasound and mammo. They told me not too worry. It’s nothing and tests are perfect. How we and thank God, the radiologist said that I should have an MEI because of how dense I am and because my mom was diagnosed at age 75 with DCIS. So I did and was really confident. Then I received the call. 3 spots. Did another ultrasound and it could only fine 1 of the 3. So then I had to have MRI guided biopsy to find the other two. Ps. That is an awfully painful test. Results. One is ILC stage 1 grade 1 and less than 1 centimeter. Second one was benign and third was ADH. So to say I trust mammogram or ultrasound right now would be an outright lie!!!! Im scheduled for double mastectomy and small reconstruction in July. I will not have to go through this again. It is super scarey that I had this going on and if that tech would not have done an MRI I would be in a way worse situation. I’m in a couple chat groups and EVERYONE that was dense eventually had an MRI. My recommendation anyone with density should fight for an MRI even if you have to pay for it.

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I had my biopsy and they marked where the mass was. My surgeon did a lumpectomy and she also saw a spot where the tissue didn’t look normal so she did a biopsy of it. Sure enough it was cancer and I had to have a 2nd lumpectomy. Since this didn’t show up in the original biopsy nor the MRI they tested the tissue in the OR until there was clear margins. She took a lot out the 2nd lumpectomy that it left my breast much smaller and kind of deformed looking. Both of my oncologist mentioned that she took a lot of cancer out of me. It scared me because such a large amount didn’t show up in the mammogram, biopsy and the MRI. I will be getting a MRI every year six months after my mammogram.

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@semurrey

I appreciate your feedback, Chris. I think docs also are held to certain number of prior authorization requests by many powers of "be". I couldn't agree with you more on insurance industry - so terrible that I almost can't wait for Medicare in 8 yrs. Early detection is all we have - I wish I had requested MRI last year when mammo reader did mention at 57yrs she would have expected my breast density to somewhat "lessen". I'm almost 5 months out from radiation for ILC (1.8 cm, ER+) and taking Letrozole. My diagnostic mammo is scheduled for Oct ( regular mammo month) as oncologist at Dana Farber feels mammograms prior to year post surgery not helpful. There seems to be little protocol on timing of scans post treatment. My margins weren't great (less than 1mm) and did 19 radiation treatments with boost. Should I expect a 6 month scan?? Thanks again, xoxo

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@sueellen i would tell you to fight hard and don’t give up for that 6 month scan. It is your life and you Deserve to get tests done to endure that there isn’t cancer. Knowing your margins weren’t great, your surgeon Should be fighting for scan in 6 months. Ask lots of questions, like ‘what is your “opinion” that mammos prior to a year post surgery’ based on. Show me the study. I do not understand how these doctors can make statements like that instead of Doing What Is Good for the patient. Ego??! It’s about $$$ too. So sad

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@jgallagher04921

I had double mastectomy in April this year and when I met w oncologist after the surgery she said since I had mastectomy there would never been any mammograms, mri or ultra sounds going forward unless I complained of symptoms that warranted a test. So that tells me if I had a reoccurrance by the time I have a physical complaint I would be at a late stage.

Should I advocate for myself and ask for ultrasound every year?

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Yes. Go fir everything they throw at you. My friend is now in a wheelchair 17 years after she had her mastectomy NCOs a rogue cell git into her spine and lungs!! There’s no guarantee that even with aftercare treatment that all will b well but at least giving the cancer a good kick, makes me feel better. Keep fighting cid no one can do this, except u. Xx

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@semurrey

I appreciate your feedback, Chris. I think docs also are held to certain number of prior authorization requests by many powers of "be". I couldn't agree with you more on insurance industry - so terrible that I almost can't wait for Medicare in 8 yrs. Early detection is all we have - I wish I had requested MRI last year when mammo reader did mention at 57yrs she would have expected my breast density to somewhat "lessen". I'm almost 5 months out from radiation for ILC (1.8 cm, ER+) and taking Letrozole. My diagnostic mammo is scheduled for Oct ( regular mammo month) as oncologist at Dana Farber feels mammograms prior to year post surgery not helpful. There seems to be little protocol on timing of scans post treatment. My margins weren't great (less than 1mm) and did 19 radiation treatments with boost. Should I expect a 6 month scan?? Thanks again, xoxo

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I did not get anything for one year post treatment either. My doctor said there would be distortion of all kind from all the surgery and radiation.
If you are worried then maybe you could ask your doctor why you can’t have a scan?
Boy there sure a lot of us pushing to get what we need. There are some very inspiring stories here, that have helped me be grateful for today.
Is any or all of this helpful to you?

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@auntieoakley

I did not get anything for one year post treatment either. My doctor said there would be distortion of all kind from all the surgery and radiation.
If you are worried then maybe you could ask your doctor why you can’t have a scan?
Boy there sure a lot of us pushing to get what we need. There are some very inspiring stories here, that have helped me be grateful for today.
Is any or all of this helpful to you?

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I’m exhausted, mentally and physically, fighting my corner but at least I’m
Now on the ‘emergency referral’ fir an MRI!! 👍👍🤷‍♀️👏👏👏❤️

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Very helpful feedback everyone! I'm just so exhausted about fighting insurance and now docs on certain diagnostic scans etc. I feel grateful we have fabulous researchers/ scientists working on cancer - we have improved tools for surveillance but I feel like out of arm's reach. I see radiation onco after 6 months but I know she will defer to onco. I will stay in touch - thanks again. xoxo

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Yes, I detected a lump, had a breast ultrasound and then a ultrasound guided biopsy. The diagnosis was ADH (atypical ductal hyperplasia) - non cancerous. However my doctor recommended removal (lumpectomy) because the lump was large and the cancer because of the dense breasts could be missed. Also this diagnosis makes one 4x as susceptible to get cancer. I'm 78 and reluctant to have the surgery because the percentage of women that go on to contract cancer is very small according to research statistics. I'm getting a second opinion and also looking into a MBI (MOLECULAR BREAST IMAGING) which is the latest test to find cancer that is often missed by a mammogram or biopsy.

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