Breast MRI before prophylactic mastectomy and reconstruction

Posted by sandyjr @sandyjr, Feb 27 2:36am

I have had bilateral breast cancer with lymph node removal (2007 and 2018) and have learned that I have the CHEK2 mutation so am getting a prophylactic mastectomy with reconstruction. My surgeon has suggested that I get an MRI before the surgery because if they find any cancer in the removed tissue after surgery, then I will need lymph node analysis and after the breasts are removed, this step becomes more complicated. Has this been suggested to anyone getting mastectomy?

Hi, @sandyjr,

While I've not had breast cancer personally, I have read posts from other members on Connect who have had an MRI of the breast. It seems that the MRI can picture more of the tissue and problems/tumors than can the typical mammography or ultrasound. If it were me, I would want to have as much information as possible before proceeding. I hope that others will post as well.

What is your main concern regarding having the MRI?

Liked by Dee

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About 11 years ago I was part of an imaging study that was approved by the fda. You are injected with a tracer and 20 minutes later they do a procedure similar to a mastectomy. Not many places have the machine but do ask around. It locates the cancer with great precision.

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@hopeful33250

Hi, @sandyjr,

While I've not had breast cancer personally, I have read posts from other members on Connect who have had an MRI of the breast. It seems that the MRI can picture more of the tissue and problems/tumors than can the typical mammography or ultrasound. If it were me, I would want to have as much information as possible before proceeding. I hope that others will post as well.

What is your main concern regarding having the MRI?

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Hi Sandy. Further MRI testing is a good thing. In my case the September 2019 mammogram indicated one tumor while further MRI testing indicated an additional tumor in same breast with multiple suspicious individual calcifications between the two. Changed the treatment plan from lumpectomy to mastectomy. Had those calcifications joined with the two tumors, my story would have been much different. Initially diagnosed with Stage 2 invasive lobular cancer. The diagnosis remains the same but the outcome had they combined would have been a whole new ballgame. Hope this helps.

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@sandyjr
Your surgeon has offered you the best advice. Prior to my lumpectomy, I asked my surgeon about having an MRI as I was worried about the other breast. The other breast turned out negative, but the MRI showed that I had a second tumor on the other side of my affected breast. Had we not gone ahead with that MRI, who knows where my health would be at this point. The MRI can find even small tumors not seen on body scan.

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@1065408

Hi Sandy. Further MRI testing is a good thing. In my case the September 2019 mammogram indicated one tumor while further MRI testing indicated an additional tumor in same breast with multiple suspicious individual calcifications between the two. Changed the treatment plan from lumpectomy to mastectomy. Had those calcifications joined with the two tumors, my story would have been much different. Initially diagnosed with Stage 2 invasive lobular cancer. The diagnosis remains the same but the outcome had they combined would have been a whole new ballgame. Hope this helps.

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To me this whole thing is quite interesting. I wasn’t sure how to get this whole thing in motion because you have different doctors doing different sections and I first scheduled with a breast surgeon… She happen to be in the same practice as the person that I’m going to use… Not only was she rude and a bit crude, but she never mentioned having an MRI and she also told me that I’d have to go for a stress test before the surgery. There were other differences too but these kind of come to mind right now. Actually I was quite pleased that the second surgeon mention this because if they get in and find cancer and they’ve taken the breasts then we have a whole other bad thing to deal with. I’ve had breast MRIs before ( unfortunately both of them said that my cancer was benign and it was invasive so I’m not really to trusting of radiologists and MRIs). The second surgeon was very good at explaining the different scenarios and I do think it is wise to get the MRI. I’m very hopeful that there is no cancer left in my breasts. But it will save me a lot of anguish and physical and mental stress in the long run. I think I don’t get that the first surgeon was certainly a negative person in my view and I do feel sorry for the people that don’t move on when they get treated like that. The second surgeon was just so clear on everything and I think she pointed out all the scenarios and the first one didn’t. The first one also said that I was not a candidate for a certain type of reconstruction because I was too old and the plastic surgeon said no problem. The first surgeon had a plastic surgeon that she worked hand-in-hand with and sent her people to and I had been to a lecture by the second plastic surgeon and that’s who I wanted to go with. I felt that I was being bullied by the first surgeon. I felt that the first surgeon was going to set me up for the easiest surgery for her to do and then pass me on to her plastic surgeon for him to do the easiest reconstruction possible. It is unfortunate that doctors are like this and seem to take advantage of the patients’ fears. I guess my advice to anyone would be to get a second opinion no matter what, just for this reason. But I really did think it was very interesting that The second surgeon suggested the MRI and I certainly will get it.

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It sounds as if you are making very good decisions for yourself, @sandyjr, and that you are advocating for yourself quite well! Congratulations on that!

I'm really sorry to hear that your first doctor was rude and crude! A doctor with a bad attitude is the last thing a person with breast cancer needs. You have enough to deal with already! You are right, of course, that a second opinion is very important, as well as working with a doctor who can express some kindness as well as helpfulness in dealing with a medical problem.

I look forward to hearing from you again. Will you keep posting and let me know how this process is going?

Liked by Dee

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