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.

@2r3b

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!!

Jump to this post

@2r3b, if you would like to inquire about a second opinion at Mayo Clinic, here's how to get started: http://mayocl.in/1mtmR63

REPLY

I got diagnosed recently with DCIS and it was first only ADH ( Atypical ductal Hyperplasia). I did go into surgery to remove the 1 cm mass and then now I have to take radiation ( 5 times) and then antihormone pills. ( Aromatase inhibitors). Hope I will get better and DCIS does not recur. I have dense breast too so I will get mammogram/MRI every 6 months.

REPLY

A 3D mammo missed 2 tumors in one of my dense breasts. MRI picked it up. So glad I insisted.

REPLY
@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.

Jump to this post

I look forward to “ looking back” with you. This group supports you in each step of the journey. Best wishes. 🌸

REPLY
@anjalima

I had a unilateral mastectomy in February’22 and my ONCOTYPE suggested that chemo was not a benefit in my case. Breast surgeons did not recommend radiation ( it’s a long story) so I am taking Aromatase for 5-10 years . Tolerating well for the stuff one can observe. Will do a DEXA in one year ( verses 2 ) to get an early handle on bone mineral density. Of course insurance will only pay every 2 years … IMO an oz. prevention is worth a pound of cure !

I’m recovering well so far 🌸

Jump to this post

@anjalima would you mind sharing about your experience with unilateral surgery? I think my choice is to go with mastectomy, on the left side. I am curious why your doctor said no to radiation. How was your healing after the surgery?

REPLY
@polianad22

@anjalima would you mind sharing about your experience with unilateral surgery? I think my choice is to go with mastectomy, on the left side. I am curious why your doctor said no to radiation. How was your healing after the surgery?

Jump to this post

In a tight time spot … will respond in full later. Bottom line recovery went well.

REPLY
@anjalima

In a tight time spot … will respond in full later. Bottom line recovery went well.

Jump to this post

Thank you. I am glad that went well.

REPLY
@nambu

I got diagnosed recently with DCIS and it was first only ADH ( Atypical ductal Hyperplasia). I did go into surgery to remove the 1 cm mass and then now I have to take radiation ( 5 times) and then antihormone pills. ( Aromatase inhibitors). Hope I will get better and DCIS does not recur. I have dense breast too so I will get mammogram/MRI every 6 months.

Jump to this post

How did you determine which treatment to choose? I, too had surgery and was offered radiation and AI. I’m still unsure of either, or both. Let us know how you’re fairing. Thanks, Elliej

REPLY
@polianad22

@anjalima would you mind sharing about your experience with unilateral surgery? I think my choice is to go with mastectomy, on the left side. I am curious why your doctor said no to radiation. How was your healing after the surgery?

Jump to this post

Polianad22 hi!

So, I had a multi centric IDC with a tumor at 9 o’clock and 6 o’clock on the right breast. A lumpectomy would have meant a good bit of deformity and definite radiation. I opted for a unilateral mastectomy on the right with reconstruction (tissue expander) at the time of surgery. I also had 2 positive sentinel nodes and 5 nodes above those ( next in line) were negative. So 2 sentinel nodes and 5 axillary nodes removed. THAT part of the surgery is the most … weird… I would say because the nerves are severed…so weird vs painful but I have gotten a good bit of sensation back under arm ( and down to elbow on underside of upper arm) I’m now getting back sensation on top half of breast and along vertical surgical line; I always had good sensation on the left side of right breast ( away from armpit).

I was same day surgery and only took one narcotic med at home that night then switched to Tylenol then Advil. The drains are cumbersome and annoying … two-3 weeks and things get easier after those are gone! But I have good tolerance for pain and felt ok from the surgery but foggy from anesthesia. I walked several times a day and up to a mile by day 4. It helps to walk.

Sleeping half sitting up for 4 weeks is not the most comfy but neither is lying down! But it’s short lived and then you can lay on your side. At 2.5 months after exchange surgery I can lie face down with a bit of pillow support ( surprised me)!

I heal well in general and I did not have trouble with the surgery per se. I took the antibiotics for 2 weeks. As I healed and got more sensation back the expander got less comfortable ( and mine sort of dropped off a chest wall support suture so it was awkward) . 5 months later I got my exchange silicon implant. It’s not like having your natural breast back, but it went well and is pretty comfortable. Much improved from expander. No more armpit surgery so much easier second surgery.
RADIATION:
So… first off my breast surgeons did not think I needed radiation and recommended AI for 5 years but… suggested I speak to oncology. Oncology wanted me to have a Referral to radiation oncology… who said hands down YES… standard 5 day/5week radiation protocol.

But I did A LOT OF RESEARCH Compulsively reading every article published for 10 years! I was not convinced and I was concerned about side effects.

Finally I found a clinical trial called TAILOR RT ( it is to radiation what the ONCOTYPE ( developed from TAILOR DX) is to chemo . MSK was a participant. One arm of trial is AI only and one arm is AI PLUS standard protocol radiation. If you read the trial it says up front … for women meeting a particular profile we are NOT SURE if radiation is necessary… so… a trial to find out.

I met the BC profile requirement to join the study BUT for a non BC reason I was eliminated ( I had an early colon cancer, surgically removed, no nodal nor any other treatment … 2 annual clean colonoscopies… etc BUT the study required 5 year interval if any other cancer was in your history and I was only 3 years. SO… because I had qualified from a BC perspective and they cannot offer an inferior arm in a clinical trial … I proceeded with my own “ AI treatment Arm” so to speak which I could have been randomized into anyway. PS Had I been randomly selected into the radiation AI arm of the study it was likely that I would have opted out.

The radiation oncologist who said I absolutely needed radiation , telephoned me and wished me luck said it was a great study and she hoped I got the AI only arm because she knew it’s what I wanted.

Radiation as a standard protocol is definitely under investigation including lower amounts and fewer treatments. It’s definitely worth looking around . That said, there is a very PARTICULAR BC PROFILE where this hopefully great option is offered. I was lucky that I fit the BC profile and therefore felt safer to forgo radiation.

I hope this helps you as you gather your information and make your decision. We each have a unique journey. I wish you the best and hope to hear from you as you progress. 🌸

REPLY
@anjalima

Polianad22 hi!

So, I had a multi centric IDC with a tumor at 9 o’clock and 6 o’clock on the right breast. A lumpectomy would have meant a good bit of deformity and definite radiation. I opted for a unilateral mastectomy on the right with reconstruction (tissue expander) at the time of surgery. I also had 2 positive sentinel nodes and 5 nodes above those ( next in line) were negative. So 2 sentinel nodes and 5 axillary nodes removed. THAT part of the surgery is the most … weird… I would say because the nerves are severed…so weird vs painful but I have gotten a good bit of sensation back under arm ( and down to elbow on underside of upper arm) I’m now getting back sensation on top half of breast and along vertical surgical line; I always had good sensation on the left side of right breast ( away from armpit).

I was same day surgery and only took one narcotic med at home that night then switched to Tylenol then Advil. The drains are cumbersome and annoying … two-3 weeks and things get easier after those are gone! But I have good tolerance for pain and felt ok from the surgery but foggy from anesthesia. I walked several times a day and up to a mile by day 4. It helps to walk.

Sleeping half sitting up for 4 weeks is not the most comfy but neither is lying down! But it’s short lived and then you can lay on your side. At 2.5 months after exchange surgery I can lie face down with a bit of pillow support ( surprised me)!

I heal well in general and I did not have trouble with the surgery per se. I took the antibiotics for 2 weeks. As I healed and got more sensation back the expander got less comfortable ( and mine sort of dropped off a chest wall support suture so it was awkward) . 5 months later I got my exchange silicon implant. It’s not like having your natural breast back, but it went well and is pretty comfortable. Much improved from expander. No more armpit surgery so much easier second surgery.
RADIATION:
So… first off my breast surgeons did not think I needed radiation and recommended AI for 5 years but… suggested I speak to oncology. Oncology wanted me to have a Referral to radiation oncology… who said hands down YES… standard 5 day/5week radiation protocol.

But I did A LOT OF RESEARCH Compulsively reading every article published for 10 years! I was not convinced and I was concerned about side effects.

Finally I found a clinical trial called TAILOR RT ( it is to radiation what the ONCOTYPE ( developed from TAILOR DX) is to chemo . MSK was a participant. One arm of trial is AI only and one arm is AI PLUS standard protocol radiation. If you read the trial it says up front … for women meeting a particular profile we are NOT SURE if radiation is necessary… so… a trial to find out.

I met the BC profile requirement to join the study BUT for a non BC reason I was eliminated ( I had an early colon cancer, surgically removed, no nodal nor any other treatment … 2 annual clean colonoscopies… etc BUT the study required 5 year interval if any other cancer was in your history and I was only 3 years. SO… because I had qualified from a BC perspective and they cannot offer an inferior arm in a clinical trial … I proceeded with my own “ AI treatment Arm” so to speak which I could have been randomized into anyway. PS Had I been randomly selected into the radiation AI arm of the study it was likely that I would have opted out.

The radiation oncologist who said I absolutely needed radiation , telephoned me and wished me luck said it was a great study and she hoped I got the AI only arm because she knew it’s what I wanted.

Radiation as a standard protocol is definitely under investigation including lower amounts and fewer treatments. It’s definitely worth looking around . That said, there is a very PARTICULAR BC PROFILE where this hopefully great option is offered. I was lucky that I fit the BC profile and therefore felt safer to forgo radiation.

I hope this helps you as you gather your information and make your decision. We each have a unique journey. I wish you the best and hope to hear from you as you progress. 🌸

Jump to this post

Thank you so much for the info! My friend had mastectomy, chemo and no radiation as her tumor wasn't close to the chest.

REPLY
Please sign in or register to post a reply.