Ultrasound or MRI for post-mastectomy follow-up

I totally understand where you are coming from!! May I ask how your LCIS was discovered last year. Having a preventive double mastectomy prior to invasive cancer is just that - preventative, right? However, you deserve to be offered supplemental scans as early detection is all we have!! You can pay your medical bills monthly and as I'm 58 yrs old, self employed I pay $1,000 a month for a not so great HMO in MA. I see my onco tomorrow at Dana Farber for first scan after lumpectomy surgery for ILC in Nov 2022. I am probably going to have to pay for an MRI out of pocket but a mammo is not enough with my dense breasts and lobular diagnosis. I will circle back after my appt tomorrow. But you are of course your best advocate!! xo

I would get an MRI....it will show more than an ultrasound. Also, I would ask your doctor what the standard of care is. If the standard is an MRI every 2 years then your HMO should pay for it. (this is what my daughter is getting post bilat mastectomy) The standard of care should not be different based on insurances. If you can change insurances, I would.

MRI is more accurate and cover entire breast area. I had breast ultrasound every 3 month for a year then every 6 months for another year and the technician only focused on a benign nodule and never followed surgeon’s order to give me entire breast ultrasound every year thus completely missed my tumor. When I finally used mri to see my entire breast, it found the abnormal tumor structure already touched my chest. Why don’t you change to PPO? My blue cross blue shield PPO covers MRI. I had mastectomy too and will have a MRI test end of this year.

resort:

I have ILC and had a mammogram and ultrasound 8/09/23. Next appointment would be mammogram and ultrasound of left lumpectomy breast only in 6 months which I think is odd.

I did not know that an ultrasound could only cover partial breast. Thank you for that information.

Am seeing breast surgeon in November and will discuss MRI then with him. NP said that he had some patients getting MRI's.

Suggest reading
https://www.verywellhealth.com/difference-between-a-mammogram-and-a-breast-mri-430274#:~:text=Comparing%20breast%20cancer%20specificity%20of,89%25%20specificity%20for%20breast%20cancer.

6 months ago I had surgery to clear DCIS margins in my left breast. (Stage 0) I still have calcifications but couldn’t clear margins. Didn’t want to have another surgery. I researched Sonocine ultrasound
which takes 400 images of both breast. My surgeon wouldn’t give my an ultrasound without a
Mammogram and usually they just focus on one area. The Sonocine does the whole breast. Cost $590 out of pocket they will give you a super bill for insurance.
They do recommend a mammogram too.

Hi everyone- reporting in as just back from first follow up scan since the mammo that discovered my ILC back in October 2022. I had a diagnostic mammo (called back for several more views and an ultrasound). Everything looked good and the radiologist thought my dense breasts were slightly less dense and oncologist mentioned might be due to Letrozole a bit. I don't have a follow up for an entire year which makes me a bit nervous and it will be routine mammo (vs diagnostic) as best for insurance but onco assured me I would get many views. Anyway I'm a bit disappointed that my onco didn't think an MRI was warranted but I will ask again when I go back in 6 month for Letrozole review her NP. Now I worry I wasn't demanding enough but honestly a bit worn out. I brought up a lot - liquid biopsy which she doesn't think is that effective for my breast cancer but more to see how later stage cancers are handling chemo treatments. I also mentioned abbreviated MRI which she said has not "taken off" and I'm seen at Dana Farber. Hope this helps.....xoxox

@semurrey Thank you for the update. I'll have mine tomorrow and am a little nervous about it. My standard care is MRI and diagnostic mammo yearly (brca2). Wish you all well.

Hello, thanks to those who responded to my question of whether to do MRI or ultrasound post bilateral mastectomy as a screening tool. My follow up question is for those who has a MRI following mastectomy. How likely is it for false positives to occur when there is scarred and inflamed tissue resulting from the surgery. It has been a year since my preventive double mastectomy without reconstruction for LCIS. I want to pay for a MRI because while my doctors do not think I need it, I will feel better knowing rather than assuming that everything has been removed. But the other part of me is nervous about having to deal with the possibility of having to go through more testing, especially since MRIs are known for its high rate of false positives.

So I was left breast Stage IIIc ILC at age 69 (because I think this matters), diagnosed Feb. 2019. My treatment including surgery (mastectomy L), dose dense chemo and radiation took exactly 6 mos. I have a mammogram every year, and an MRI every year (they are 6 mos. apart). They are watching an area on the right, but this also scans the post surgical left side, and I am satisfied with this approach. I also see some kind of doctor every 3-4 months. As an aside, I had ultrasounds yearly prior to my diagnosis, and apparently it didn't pick it up quite early enough.