Detecting cancer in women with dense breasts: MRI?

Are you on traditional Medicare or Medicare Advantage?

I think your strategy is the best one as ultrasound not great for dense breasts! My ILC was only discovered with a MRI! Unfortunately even after ILC treatment my onco at Dana Farber, Boston was reluctant.. I was so upset and had to practically beg! Shameful but all these docs get reviewed on their ins referrals!

That doctor was rude and stupid. I'm sorry you went through that.

I've been getting routine mammos the last 18 years. Report has always stated dense breasts, nothing more. This year, they found suspicious calcifications. Biopsy report determined DCIS high grade hormone receptive. The rad techs know to look more carefully at dense breast mammo results. Just keep getting those routine mammos.

IMHO, both the Illinois and Iowa oncologists have been rather dismissive and rude.
The first one (Illinois), when I tried to tell him about all the horrible side effects that I was having after 7 months on Anastrozole (and my left knee was incapacitated and I was in a wheelchair at the time) said, "Don't take them then" and walked out! I had thought we would discuss alternatives to the drug I was currently on, but that didn't happen,. When my SURGEON suggested that a ki67 test might give me the peace of mind (re recurrence) that I craved, the oncologist refused to order that, also, and said, "I won't order that for you, You'll have to get someone else" and walked out (again), (He was fond of saying something terse and abrupt, like, "Your knee gave way because you're old" and walking out. ) I have been very disappointed that the Iowa City physician has really not given me the time of day, but I keep trying to remind myself that this could be because he thinks I am doing really well. But am I?

If it is at all possible for you to switch to a different oncologist, you should do so. I am really sorry you are being treated this way. It is not right and it is not professional.

I also would encourage you to know that respectful treatment is not a privilege, it's a right. How far from Mayo Clinic Rochester are you? I just started this journey and gratefully drive the 2 hours to the AZ Mayo Clinic location. One of the best aspects of care is the respectful attitudes of all persons working there, as it a cultural expectation. They support my empowerment by education, open communication and genuine caring support. You deserve better that the current situation. Blessings

I began my treatment in Moline, Illinois (Unity Point) after a diagnosis that took place at the Genesis Facility in Davenport, Iowa. I went in for a routine mammogram, but I hate Trinity Hospital so much after the way I was treated during a 2018 mammogram that I actually drive to a different state to have my mammograms. I intended to stay on that side of the Mississippi River for all the rest of it, but my surgeon (Dr. Hartmann) at Genesis up and disappeared (this was during the pandemic) and nobody would ever tell me what happened to him. It became apparent that it was a going to be a looong wait, if I had to wait for Dr. Hartmann to service all the people already booked, plus me. Plus, radiation was looming (according to both hospitals in the IA/IL Quad Cities) and the closest hospital was Trinity.
I did not really want to go there, because, when I showed up for a routine mammogram in 2018 the woman supervising ("Jane") was really not nice. I was shocked that they were planning to plunge a very long needle into my right breast, as I had been under the misconception that this was simply a second mammogram. I asked to see a doctor and they rounded up a radiologist (on his lunch hour) who said that they could have just observed the calcification to see if anything happened in 6 months or so, but "Jane" was very rude and said something to the effect of, "If you're too frightened to go through with it, just get up and put your clothes back on and go home." (At the time, my boobs were hanging down through holes in what looked like a Middle Ages torture machine.) That got my dander up. I went through with the stereotactic biopsy with the huge big core needle and they went very deep into my right breast, almost to my rib cage, and it hurt like a son of a bitch! (It also didn't heal for about 6 months). On the way out, I was given one ice pack thingie and---thinking ahead---I asked, "Could I have a second one to put in the freezer for when the first one has thawed" and "Jane" said, in a very mean voice, "You can make your own!" She was so mean that I went home and wrote a lengthy letter "To whom it may concern" and sent it to the hospital. Jane had also said that I would HAVE to go to a meeting with an oncologist or Medicare would not pay for the insult to my right breast that had just occurred. This was weird, because the biopsy came back as benign, but I had to trot in and speak with Dr. Mitch McKenzie, who, by luck of the draw when I was forced back to the Illinois side of the river (we are on the border) became my surgeon (even though it is not a specialty of his). Dr. McKenzie remembered me from the letter of yester year. I asked him whatever happened to the letter, since I never did get any response. I said, "Did that just go in the round file?" And he said, "Oh, no. We had a meeting. Jane doesn't work here any more." (Although I don't know that there is any connection between my complaint letter and Jane's exit. It was Dr. McKenzie who had an exit interview with me after my 1/27/2022 surgery and went right to the phone and said, "You need to see this patient" to the oncologist's office. He, himself, not his nurse receptionists. I was in tears and in distress and he noticed (and cared). Of course, the oncologist refused to order that ki67 test suggested by Dr. McKenzie, as I have related above. (Never have gotten it). I remember that---several days after the 2018 biopsy---I received a letter from the hospital (Trinity) saying that the mammogram I had had earlier suggested that I needed another because of "dense breasts" and suggesting I consult with my physician about what to do next---after they had already plunged a 3-foot long needle into my right breast and taken a sample to examine, which was benign. (I have always wondered if this precipitated the tumor that formed 3 years later.) I wrote another letter following the treatment I have received (or not received) from the office of the oncologist at that hospital and have never received a single acknowledgement of it. I also left a nice card with cash in it for one of my radiologist technicians, who was graduating that day. That got confiscated by the hospital, who wrote to thank me for "contributing" to the hospital. I was trying to gift a girl I had gotten to know, not to bestow cash on the hospital! I did fine with my radiologist and my surgeon and the technicians at the radiology center of Trinity, but the oncologist was awful. Later, I learned that 3 of my former employees whose mother had been his patients had a b.c. recurrence many years after her initial treatment. She felt something was '"off" but this doctor refused to order tests to confirm that until the 3 sisters (all my former English students in 7th grade and my former employees when grown) insisted, and began trying to take their mother (Diana) to the Mayo Clinic. The oncologist's response was to tell them that, "After I talk to you 3, I need therapy," to attempt to deny access to Diana's tumor on ice (illegal) and to say, "I don't know why you want to take her to the Mayo Clinic. I interned there. I know everything they know." This oncologist only saw me 2 times in the entire time I doctored with them, which was from December of 2021 until October of 2023. He never showed up for any appointment to see me and was very terse, brusque, unsympathetic and generally rude on the two occasions I did see him. He also basically lied to me about the potential side effects of taking an A.I. pill and either knew nothing about my over 20 years in a study for osteoarthritic joints or didn't care what the pills would do to me, if he knew. His office also coded the bone density test wrong, so that it took from May of 2022 until March of 2023 to straighten it out with Medicare so that they would pay for it. It was definitely merited, and I had not had one since 2019. (My OB/GYN had ordered them in 2017 and 2019 and this was 2022, so there should have been no question that it was covered and merited.) I hope to never have to go to that hospital ever again. I spent THREE HOURS on the phone with Medicare trying to sort out why they said it would not be covered, with a raging back ache. I never got the impression that anybody (including "the minions") at this oncologist's office cared whether I lived or died. On the other hand, my surgeon attempted to intercede on my behalf (to no avail) and the radiologist was very nice (and dropped the clue about how the oncologist didn't want to have his knuckles rapped by Medicare, so he just doesn't order any expensive tests for you if he can possibly avoid it. So you die because of that, like Diana? Too bad. Make another appointment. (!!!)

I am really so sorry you had to go through all that! What terrible experiences. I also had the biopsy with the large needle, but they explained everything carefully ahead of time - what would happen and how it would be done. They also gave me several ice packs to take home with me. I live in San José, California. It took me a long time to get an appointment, but when I finally got in, they were very nice (Silicon Valley Radiology). Honestly, if you can get into Mayo Clinic, I would recommend that you do so. I have never been there, but many people highly recommend it. I don't know how far you have to drive, though. Good luck!

I get 3D mammogram and MRI annually, 6 months apart as others have noted. The out-of-pocket cost is about $1500, dependent on your insurance plane coverage. I recommend that women with dense breasts visit a website called My Density Matter. It has information on effectiveness of the various breast screening technologies. Stay well friends.