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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I am so sorry for all the heartache you've endured. My story is that at a young age in my early 30s I got a mammogram. It locked on my breast and they had trouble getting it to release. It was painful but I survived. I swore at that time that I would never never have another mammogram. So I lived with that decision and I was quite lucky that I had no ill effects. However, last year I knew that my right breast was all wonky with inverted nipple Etc. I went into the University of Wisconsin hospital Carbone Cancer Treatment Center. They gave me a 3D mammogram and the ultrasound. I can't believe that I was this lucky all this time. Neither could they. I hear stories like yours and know how lucky I am. Thank you for writing.

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@mjwhearts22

I was diagnosed with Invasive Lobular Carcinoma 2 years ago. It’s a pretty familiar story in that I have dense breasts but had annual mammograms regularly. For so many years now ( I was 70 at the time of diagnosis), got the letter declaring nothing had changed and to come back in a year. The cancer didn’t show up on a mammogram or the ultrasound but they did a MRI to find my left breast was so full of cancer they couldn’t do a mastectomy at that time. It’s quite common with this type of cancer to not be seen on mammograms and it’s a slow growing cancer but it had metastasized in my skin (our largest major organ). After 6 months of taking Exemestane, the margins were good enough for surgery so they did a bilateral mastectomy. That showed it had metastasized in my lymph nodes. They removed 19 nodes, 17 of which were cancerous . They couldn’t remove any more so now J am trying to learn to live with incurable cancer.

The medical system is broken in this way. Insurance companies won’t pay for MRIs unless it’s absolutely necessary so this cancer goes undetected but when it is detected it’s usually Stage 3 or 4.
It’s seldom felt I’m a lump so so one does anything.

My daughters are now in High Risk Breast Cancer Clinics in their respective cities where they get 2 screenings a year - one mammogram and 1 MRI. If nothing else good comes of this, my daughters will have far better imaging than I did. No one ever suggested this to me but they certainly should have!

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I am so sorry this happened to you. I am one who also gets the letter about dense ribrous breasts and usually have a 6 moth mamo. I had my first biopsy in my early 20s. I,m 66 now but can remember this because i used to laugh at how my insurance wouldn't cover my left breast because of the biopsy. Luckly that is illegal now. My ILC was accidently found. They found a suspicious area on my rt breast and ordered an ultrasound that showed nothing so they ordered a MRI. The MRI showed the cancer in my left breast and the right suspicious area was calcifications. I am so lucky. It was small and slow growing. I was coaxed into a lumpectomy even though I wanted a DMX. At the time my MRI showed areas of concern again, so I sought out another facility to do the DMX. I didn't want to go through radiation because of the side effects. Six months after the lumpectomy I had the DMX and the biopsy found ILC in situ in my left breast and numerous areas of precancer in both breasts. I am so happy I went with my gut and fought for what I wanted. On a side note, prior to my lumpectomy I was talking with my insurance company regarding a different claim. I mentioned that "now I came down with breast cancer". He was so nice. He asked if he could talk to me as though I were his sister. Of course he could. He said I should get a double masectomy and ask for a PET scan. He has been in the business over 20 years and he either had personal experience with ILC or professional experience. I am so thankful to him because I may not have fought as hard for the DMX and who knows when the ILC in situ would have popped our and not been found by a mamogram until it was too late. Two oncologists said a yearly mamogram would have been my yearly followup. I interviewed 3 oncologists before I found one I trusted. And I am also so thankful for the radiologist who had me do all the tests that eventually found the sneaky ILC. Just remember we have to go with out gut and go elsewhere if we feel we are not getting the answers we want.

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@mjwhearts22

I was diagnosed with Invasive Lobular Carcinoma 2 years ago. It’s a pretty familiar story in that I have dense breasts but had annual mammograms regularly. For so many years now ( I was 70 at the time of diagnosis), got the letter declaring nothing had changed and to come back in a year. The cancer didn’t show up on a mammogram or the ultrasound but they did a MRI to find my left breast was so full of cancer they couldn’t do a mastectomy at that time. It’s quite common with this type of cancer to not be seen on mammograms and it’s a slow growing cancer but it had metastasized in my skin (our largest major organ). After 6 months of taking Exemestane, the margins were good enough for surgery so they did a bilateral mastectomy. That showed it had metastasized in my lymph nodes. They removed 19 nodes, 17 of which were cancerous . They couldn’t remove any more so now J am trying to learn to live with incurable cancer.

The medical system is broken in this way. Insurance companies won’t pay for MRIs unless it’s absolutely necessary so this cancer goes undetected but when it is detected it’s usually Stage 3 or 4.
It’s seldom felt I’m a lump so so one does anything.

My daughters are now in High Risk Breast Cancer Clinics in their respective cities where they get 2 screenings a year - one mammogram and 1 MRI. If nothing else good comes of this, my daughters will have far better imaging than I did. No one ever suggested this to me but they certainly should have!

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My daughter also was advised to have mammograms and MRI annually too after my diagnosis. Like you, I’m glad she will be monitor more closely.

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As I said, if nothing g else good comes from our experiences, our daughters are going to have better care than we did. That’s a true blessing!❤️

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@kimogi57

I am so sorry this happened to you. I am one who also gets the letter about dense ribrous breasts and usually have a 6 moth mamo. I had my first biopsy in my early 20s. I,m 66 now but can remember this because i used to laugh at how my insurance wouldn't cover my left breast because of the biopsy. Luckly that is illegal now. My ILC was accidently found. They found a suspicious area on my rt breast and ordered an ultrasound that showed nothing so they ordered a MRI. The MRI showed the cancer in my left breast and the right suspicious area was calcifications. I am so lucky. It was small and slow growing. I was coaxed into a lumpectomy even though I wanted a DMX. At the time my MRI showed areas of concern again, so I sought out another facility to do the DMX. I didn't want to go through radiation because of the side effects. Six months after the lumpectomy I had the DMX and the biopsy found ILC in situ in my left breast and numerous areas of precancer in both breasts. I am so happy I went with my gut and fought for what I wanted. On a side note, prior to my lumpectomy I was talking with my insurance company regarding a different claim. I mentioned that "now I came down with breast cancer". He was so nice. He asked if he could talk to me as though I were his sister. Of course he could. He said I should get a double masectomy and ask for a PET scan. He has been in the business over 20 years and he either had personal experience with ILC or professional experience. I am so thankful to him because I may not have fought as hard for the DMX and who knows when the ILC in situ would have popped our and not been found by a mamogram until it was too late. Two oncologists said a yearly mamogram would have been my yearly followup. I interviewed 3 oncologists before I found one I trusted. And I am also so thankful for the radiologist who had me do all the tests that eventually found the sneaky ILC. Just remember we have to go with out gut and go elsewhere if we feel we are not getting the answers we want.

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What a gift that conversation with your insurance guy was! We must be unrelenting advocates for ourselves!

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I have dense breasts and a couple of years ago, the mammogram tech put it in report that I should have more than mammogram screenings because of it. Doctor did nothing, and I didn't see that report until recently. Then DCIS last September. Just finished up 6 rounds of chemo and heading for surgery, then radiation, then oral chemo. I will be asking for MRI's after reading these posts. Thanks everyone.

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@neekie2

I have dense breasts and now get the 3D Mammogram.

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We pretty much ALL have experience with this! I have dense breasts, and that has led to 3 stereotactic biopsies, one of which turned up a 11 mm tumor (12/6/2021). I also was called back in 2018 because of dense breasts, had a stereotactic biopsy, and it was declared benign. (I still think sticking a 3 foot long into my right breast may have stirred it up and set the scene for the 12/6/2021 experience. I also had to have one on Valentine's Day, 2023. I have 3D mammograms, but, in my own experience, my doctors never want to order anything that could be considered expensive, even if it is more accurate or better. My Illinois oncologist refused to order an oncotype, which means that I never found out that my oncotype score was 29 until 17 months had passed and I had moved to another oncologist in Texas who secured it for me long after the fact. I have asked about MRIs and I have not gotten very far. I have asked about the Signaterra test for staying on top of recurrence: same reaction. I have asked about the C-27 or C-29 markers (I may have the numbers wrong). Nobody wants to order any of these, citing a variety of factors, including that the tumor was not of a bad enough grade and the seminal lymph node biopsy did not show any spread. I'm getting the definite message that 3D mammograms is about as good as it is going to get for me. I did pay for an ultrasound (HerScan) out-of-pocket ($300) and that led to the plan for a third biopsy, which was averted by gathering up all of the routinely administered mammograms and examining them for any change in the calcification that exists in both breasts. It is disconcerting that the expense of a test (eg., an oncotype) makes it off limits for the patient because her doctor "doesn't want to get dinged by Medicare."

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@meomurian

My endocrinologist told me that breast cancer likes to metastasize to the bones. My twice a year Prolia injections are a good protection against that, he says.
I haven’t heard of it going to the skin, but my dermatologist said I shouldn’t be surprised to find new growths (not cancerous ) popping up randomly on my body.

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Since my radiation (33 sessions) and my lumpectomy I have had random growths popping up on my decolletege and I now make an annual trip to the dermatologist to make sure they aren't anything bad. I just went in before going to Cancun in April.

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@mjwhearts22

I was diagnosed with Invasive Lobular Carcinoma 2 years ago. It’s a pretty familiar story in that I have dense breasts but had annual mammograms regularly. For so many years now ( I was 70 at the time of diagnosis), got the letter declaring nothing had changed and to come back in a year. The cancer didn’t show up on a mammogram or the ultrasound but they did a MRI to find my left breast was so full of cancer they couldn’t do a mastectomy at that time. It’s quite common with this type of cancer to not be seen on mammograms and it’s a slow growing cancer but it had metastasized in my skin (our largest major organ). After 6 months of taking Exemestane, the margins were good enough for surgery so they did a bilateral mastectomy. That showed it had metastasized in my lymph nodes. They removed 19 nodes, 17 of which were cancerous . They couldn’t remove any more so now J am trying to learn to live with incurable cancer.

The medical system is broken in this way. Insurance companies won’t pay for MRIs unless it’s absolutely necessary so this cancer goes undetected but when it is detected it’s usually Stage 3 or 4.
It’s seldom felt I’m a lump so so one does anything.

My daughters are now in High Risk Breast Cancer Clinics in their respective cities where they get 2 screenings a year - one mammogram and 1 MRI. If nothing else good comes of this, my daughters will have far better imaging than I did. No one ever suggested this to me but they certainly should have!

Jump to this post

Your story brings back so much emotions and memories. 2016 I was diagnosed with hormonal Estrogen Breast Cancer in my left breast. I needed only a lumpectomy. I had chemotherapy and radiation which were successful!! It’s been (8 yrs) cleared ,but still worry about cancer returning to my other breast. I know, worrying isn’t going to prevent cancer from coming back, but eases my mind with my prayers…..Nancy B

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@mazingrace

May I ask your age?? I’m new at this dx and I’m 71.

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Hi @mazingrace, I see from your profile that you are not stranger to cancer having been diagnosed with non-Hodgkin's lymphoma in 2012. And now a new diagnosis of DCIS. Thank goodness it was found early. How was it detected? Do you have your treatment plan? How are you doing with all this?

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