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Confused about MRI results
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Confused about MRI results

Hi- Thanks for answering questions. I previously asked a question about digital mammograms. I was diagnosed on Nov 27 with IDC. The tumor is 2 cm at 3:00.
I just got the results today of the MRI and I am very confused as what do do next. My surgeon will call me tomorrow with his opinion after he talks with the tumor board, but feel I need to have more feedback. I feel I cannot wait til tomorrow.  MRI results summarized: "In same breast at 12:00,there is a progressively  enhancing nodule, .8x.6x.6cm. This may represent  a second focus of malignancy or a intramammary lymph node that may or may not be involved with metastases and should be included in a wide resection. At level 7:00, there is a irregularly enhancing patch of tissue about 3 cm. If breast conserving therapy is considered, this area should be evaluated with a second look ultrasound."
My surgeon told me last week that if he has to take out more areas that are not close to the first one, he might suggest a mastectomy. He was very convinced that  I would only need a lumpectomy based on the info he had last week. i do not know what to think or do. The radiologist is too busy to call me today and the office suggested I call my primary care. I cannot do that because he called and yelled at me last for having an"unecessary procedure"- the MRI---I am changing Doctors next week, but that does not help me today. My surgery is scheduled for Monday. What do you think- lumpectomy or mastectomy?
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Avatar_n_tn
Dear viddie:  Without reviewing the mammogram, ultrasound, and MRI as well as performing a breast examination, it is not possible for us to make a recommendation.  We can tell you, however, that MRI is being used commonly for pre-surgical evaluation of the breast. Because an MRI may be too sensitive and raise a concern in areas that will turn out to be benign, surgeons tend to be very careful about deciding to do a mastectomy base only on MRI findings. Frequently, if a new concern is raised by the MRI, the area can be biopsied (often with ultrasound guidance) and those results may be used in helping to determine the best surgical approach.  If there is more than one focus of cancer, it is not uncommon to recommend mastectomy over lumpectomy.  Your best resource for decision making is likely the surgeon who has all of the information and can discuss all of the potential options with you.
41 Comments
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Avatar_n_tn
Hi Viddie: if it's multicentric (foci of malignancy in different areas of the breast)then they'll strongly suggest a mastectomy. I can't comment on MRI report bc I am not a doctor, obviously, so I'm just saying if that is the case. That's what I had and I am not regretting it. If you think that is a possibility try to see a plastic surgeon asap, to start thinking about reconstruction (which you can have done at the same time if you want - but not all women want to have reconstruction, so it really depends on how you feel about it). I went with immediate reconstruction with expandable implant and so far so good...still in the middle of filling implant up with saline. Good luck and good vibes. catia
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Avatar_n_tn
Personally, I'd go with the mastectomy. Sounds like the MRI did its job by finding other potential trouble. Let us know what your surgeon says. I wish you all the best!
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Avatar_f_tn
I don't know about agreeing with a mastectomy at this stage. When I was dx with a 2 cm idc tumour, I was offered either a WLE (wide local excision) with radiotherapy, or a mastectomy with no rx.  I decided on a WLE as I figured if there was a problem I could always go back for a mastectomy, without losing my breast.  Circumstances changed that significantly, as the sample node removal, done at the same time as the WLE,  showed cancer in the lymph nodes; the total axillary removal showed more cancerous nodes, so I was strongly advised to have chemo, which I did.

The WLE also showed intermediate grade DCIS, comedo and cribriform, which I was assured was removed at the original surgery. However, this was not known beforehand, as I only had mammo, U/S, and biopsy. I have never heard of having an MRI for bc in England, but we do lag behind the USA in diagnostic procedures.

Even if it was known beforehand that I had DCIS as well as the tumour, I would still have opted for the lumpectomy. Luckily - you gotta get lucky sometime! - the DCIS was near enough the tumour to resect it without significantly altering my breast. I am glad I made that decision, even though I didn't know I had DCIS at the time. I would also have been comfortable going back for a mastectomy if the DCIS was widespread. My husband said at the time: "No point in getting disfigured with a mastectomy if it is not warranted" - and he was so right, in my particular case. He would have also been comfortable with my going back to have a mastectomy, if the surgeon advised it.  

I think you have to trust your surgeon in his ability to do what is right for you. Bottom line would be for me - have a lumpectomy and then review your options.
I hope you make the decision that is right for you and get on well.
Liz.
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127512_tn?1193745816
Hay viddie. This is all so confusing but I am sure you will make the right decision. Me personally if I had not had my masectomy they would not have found the invasion. You do have to trust your surgeon. Even though my clusters of calcification were so small (they ran in a ductal path) he felt sure he would find invasion. I also had widespread multifocal DCIS.No need to rush into anything. A second opinion is always a good idea. Wish you well.
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127512_tn?1193745816
Viddie I did not think you would mind me using your post. Sorry.

My world fell apart again today. I was drying my hair trying to get ready to go to dinner with my husband for my birthday and when I raised my arm I saw an indention. Then I felt around and there is another knot on my left breast. I haven't told my family yet. How can I hold myself together long enough to get through my birhtday? My kids have something planned and they are so excited. Does this torment ever end?
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Avatar_n_tn
OK...let's not panic...it may be nothing, maybe scar tissue from a surgery?  Maybe a cyst?  Don't go THERE just yet.  GO AND ENJOY YOUR BIRTHDAY THE BEST YOU CAN and tell your husband tonight after dinner.  I will definitely keep you in my prayers and please keep us posted.  I pray that you will be fine....and you will be.  TAKE CARE OF YOU!
Susan
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Avatar_n_tn
I'm so upset for you. I pray it is something else. The torment you are going through is unimaginable. I know you were looking forward to your birthday and were feeling better. Hopefully, it is nothing.
Had my biopsy today. Seemed to go okay. Thanks for your prayers. Mine are with you.
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Avatar_n_tn
I am so sorry you have to go through this today, or any day. I have been  thinking about you since I read this post. Hopefully it is just a false alarm and it is just a benign cyst or just a nothing bump. I can't imagine how you must feel. Hopefully your husband will help you through this until you get some answers. I became a big fan of digital mammographies. Maybe you can get a quick appointment.
I hope you still had a Happy Birthday. Again I am sorry you have to go through this torment again.
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Avatar_f_tn
You can choose not to have "torment". Take a deep breath, hold your head up high, hug the ones you love, pray, and be ready to fight another battle if needed. You can do it. You've already been through some of the bull this disease dishes out...but you are going to keep on fighting! Pray, let your loved ones be of comfort to you. Keep busy, keep focused, you can do it.
I'm praying for you.
Carme
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Avatar_f_tn
Sorry this had to happen today or any day for that matter. I hope you can get in soon to get it checked out. Remember, there's a very good chance it will turn out to be ok. I will pray for you.
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127512_tn?1193745816
Good to hear things went well. Yes the waiting is awful. Wish I could make it go quickly for you.

viddie - still thinking about you. I am be glad your waiting will be over Monday. What decision did you make about your surgery? Lumpectomy or masectomy? What a decision to have to make. Thoughts are with you.
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Avatar_n_tn
Hang in there. I'm praying for you too. Maybe it is scar tissue or a cyst or something nonmalignant. Keep writing, keep letting it all go out. Let us know. catia
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Avatar_n_tn
Thanks. Keeping you in my prayers and sending good thoughts your way.
Lauren
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Avatar_n_tn
You are in my prayers. You have been through so much already...I pray that this is nothing.
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Avatar_n_tn
Hi-Boninclyde,
   How are you? I have been thinking about you and hoping that you are okay. Were you able to see anyone today? My thoughts are with you.
    I received my results Tuesday morning. They faxed them to me, but unfortunately my surgeon's day off was Tuesday and I could not get in touch with the radiologist until 3:00- I was confused and uncertain how to understand the report and needless to say I had a very hard day and harder night. When the radiologist called me back, she explained the report to me, but also told me that she had a disagreement with the radiologist that is part of the team at the hospital where my surgery will be performed. They are two separate breast care centers and I chose the one with a digital mammograph. Six months prior, I had a regular mammograph at the hospital breast care center and apparently they didn't see my 2 cm IDC tumor. My radiologist found two other masses on the MRI that concern her and wants the surgeon to remove them at the same time of the surgery. The hospital radiologist wants them biopsied first and wait for the results, which will further delay my surgery. The tumor board met yesterday and I was afraid they would agree with their radiologist (she was at the meeting). I didn't sleep good Tuesday night. At this point, rather than postponing my surgery, I decided I would want a mastectomy- I just want it out now. I was prepared with a long speech. Luckily, when the surgeon called yesterday morning after the tumor board meeting, I didn't have to say a word. I just listened to him first, and he suggested what I think is a great solution. He will remove all three masses Monday along with doing the SNB. He will then freeze the suspicious masses and have the pathologists read them immediately. If they find the mass that is on the opposite side of my same breast malignant, he wants to know if I would mind waking up to a mastectomy. That sounds great to me! If I minded, he would do a mastectomy at a later date. If they cannot determine that yet, I would only have a lumpectomy, with the understanding that I might have to come back for a mastectomy if it later comes back malignant. Finally a plan- and a win-win situation- as best as it can be. If I wake up without my breast, then I will know that the MRI did it's job in finding an unknown malignant tumor. If I have a lumptectomy, then I will know the MRI did it's job in finding all suspicious tumors,and the surgeon got rid of them and if found benign, I can feel reassured.
Sorry for such a long post, but I am excited for the first time since I found out. I finally have a plan and some answers! I am very happy with my surgeon!!
  Boninclyde, please post soon and let us know how you are doing. You are in my prayers.
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Avatar_n_tn
Boninclyde
You are incredibly brave. I sincerely hope it is nothing significant. Did you say you will see your MD soon for answers?
Keep strong & be your own assertive advocate. Trust your own intuition on your options that seem right to you.


Viddie
My thoughts are with you in your wait and decision making. Trust your instincts and demand what feels the path to take.

Thank you for sharing your most unique, intimate, private situations. You all are my support during my wait. I visit this site often to feel I am not alone....humbly, Barbara
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127512_tn?1193745816
What a strong and encouring person you are. I am glad you have a plan. It does make you feel better to have a treatment plan. I hope they can save the breast with a lumpectomy. It sounds a little like mine. They did not find my invasion (did not show up on mamo or ultrasound) until I had the masectomy so it was the best decision for me. I wish you well. Sounds like you are in good hands except for the radiologist that shared personal info about the conflict with others. Seems a little unprofessional to me.

Still waiting for my doctors to schedule me a mamo.

Thanks all.
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127512_tn?1193745816
OK just to let everyone know I have a mamo and biopsy schedule for Tuesday December 12th.

I would like to ask everyone that reads this to go to thebreastcancersite.com. On there (the middle of the home page) is a place to click to give needy women and men free mamograms. Just click there and the sponsers will donate enough money for someone to have the test. You can go there every day and click. Thanks for giving to someone else.
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Avatar_n_tn
Thanks for letting us know your appt date.
Went right on the site and will tell my friends to do the same.
Hope you have a nice weekend.
Lauren
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Avatar_f_tn
It's great to hear your surgeon can get a tissue sample quick enough to make the decision the day of your surgery. What is a SNB? I'm also glad they came up with a plan that will work so well for you. Sorry you have to go through this. You're in my prayers.
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Avatar_f_tn
I'm glad you got your appointment soon. What type of biopsy will you have? My prayers will be with you, too.
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127512_tn?1193745816
Don't know yet what type it will be. My conversation with the dr.s office was very brief. I guess they are busy.
Oh and SNB means sentinal node biopsy. Where they inject dye into the breast, it then goes to the first nodes closest to the suspious (spelling - I think I fluncked it LOL) area or the cancer.
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127512_tn?1193745816
Don't know yet what type it will be. My conversation with the dr.s office was very brief. I guess they are busy.
Oh and SNB means sentinal node biopsy. Where they inject dye into the breast, it then goes to the first nodes closest to the suspious (spelling - I think I fluncked it LOL) area or the cancer.
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Avatar_n_tn
Hi- Here is a site that explains Sentinel Node Biopsy better than I can:
   http://www.breastcancer.org/research_surgery_080703.html
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127512_tn?1193745816
What is your user name at breastcancer.org? Maybe we can talk there some also. Mine is the same. Just spelled a little different. Maybe you can PM me there. We can't share but so much personal info here.
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Avatar_n_tn
My user name is the same as here.
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127512_tn?1193745816
My thoughts will be with you tomorrow. Please post as soon as you can and let me know how things go. You want be alone. Bless.
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Avatar_f_tn
I have Viddie down for a lumpectomy and/or masectomy Monday,
Bonninclyde for a biopsy Tuesday
and BarbaraRN for a biopsy Wednesday. God be with each of you.

Hopefully, Lauren will have some good news to share with us on Monday from her biopsy.
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127512_tn?1193745816
Yes Montana girl alot going on here this week with several ladies. I also am sending thoughts their way.

Also Barbra RN goes back to the doctor on the 13th to find out whats next.

I'm also trying to find out when vermont girl goes back to the doctor. I think she is waiting on the doctor to get her appt scheduled hopefully this week.

Wanted to post this close to your post so maybe we can keep up with it. Hope we did not leave anyone out.

As for me I think I am going to cancel my appt tomorrow. My daughter has an othrodontist appt that really doesn't need to be canceled. If I cancel and she runs past the date it is time to get her braces off then it's out of my pocket (my fault), if I stay on course (no canceled appts)then it's the ortho's fault for not scheduling her braces to be on longer and no out of pocket expense for me. And another reason, I called back to the surgeons office and they only had my scheduled to see the PA to do mamo and biopsy. I'd rather wait for the surgeon. I also had my PCP working on getting me an appt for another mamo and biopsy and he called to tell me I have a mamo scheduled with the same office as before that found my other cancer on December 22nd. So I think I'll wait until the 22nd. I have a great group of doctors. Seemed to work out better this way.

My heart goes out to all of you while we wait.
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127512_tn?1193745816
Noac should also get results this week.
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127512_tn?1193745816
Montana girl - I meant to say scaredkathy.
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Avatar_n_tn
I'm okay! No malignancy. I am still in a state of shock from the roller coaster ride, these last 2 months. Yet, nothing compared to what some of you ladies are going through. Thanks for your prayers. I have been so touched by everyone. I have to call my son. Thank you again. You are all in my prayers. Will check back when I get home.
Lauren
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127512_tn?1193745816
I am so happy for you. What a hurdle you had to climb. It is amazing how strong we are and don't even realize it. Yahoo!
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Avatar_f_tn
This time you can truly celebrate because you have no more biopsies to worry about. I am very happy for you.
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Avatar_f_tn
I had no idea PA's could do biopsies! I'd want to wait for a surgeon, too. It's just that waiting is so hard...  Hmmm. I'm still waiting to hear about your name...
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Avatar_n_tn
I could not have made it through this without any of you! My doctor said I don't have to be checked for a year. Does that sound right to you? I was thinking 6 months because of what I have read. I still feel out of it but I guess that's normal. Whatever that means. Thanks again. I think I'll stick around for a while. You are amazing women.
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Avatar_n_tn
Hi,
   Thanks everyone for caring. I had a lumpectomy. I told the surgeon that if the questionable mass even just looked suspicious, that would be enough for me to have him remove the breast. He originally told me he would  only remove  it if it was 100% malignant after two radiologists and himself examined it after it was frozen. He agreed to my request and had me sign papers to acknowledge that. He did remove the other two malignant tumors that were close to each other.
  They all agreed that the preliminary results for the third mass was benign! Also no node involvement!!!  Of course I have to wait until next week to be sure, and I will try to stay optimistic until then.
  I am pretty sore right now- going to take another Vicodin and try to get comfortable. Thanks again for being there.
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Avatar_n_tn
Wow, that's great news.  Get some rest!
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Avatar_n_tn
God Bless!!!  I am so happy and relieved for you!  Get a good rest and enjoy the holidays!  When I had microcals, I went back after six months and then once a year after that.  Take care of you!  

And all my prayers continue to be with all on this website.  What a fantastic group of strong women.  May God grant you all good health, strength and peace.

Susan
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Avatar_f_tn
I'm happy to hear the 3rd tumor was benign and there was no node involvement. It's good that you got a surgeon who could go either way with the surgery. I'm sure you'll be busy with appointments to figure out where to go from here. May the Lord keep you strong.
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