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Avatar universal

Follow up MRI, it is really necessary?

Since my mom had BC at 38 and I am now 39, my doctors have been vigilant about my screenings.  I have had so many biopsies I can't count them all and most on my left breast, maybe 8 or so I think.  The last "big one" was in October of 2007.  Had a completely normal Mammo and US, but there was a lump present.  My surgeon removed the lump surgically in October and it was just fat necrosis, scar tissue (most likely from all the other biopsies) and other non cancerous things I guess.  Never in any of my biopsies have any atypical cells been found.  My reports used to just say normal breast tissue, but now as a result of the biopsises, there is scar tissue in there too, but nothing bad at all.  With that being said, I was having breast pain and a pulling sensation since the biopsy and  I felt some new lumps, so my surgoen ordered an MRI since I hadn't had one in 18 months due to the fact that I was pregnant.  Had the MRI and of course, the area of the lumpectomy lit up.  Thank God nothing else did.  The other lumps were nothing.  They were able to visualize the area that lit up using Ultrasound so they did a FNA biopsy and placed a clip inside me.  (Mind you, my US and Mammo was clear 5 months prior to this BEFORE I had the lump removed).  I am going on Wednesday for a 3 month follow up MRI to be sure that the place they biopsied using US was in fact the place that lit up on the MRI.  Now, they found the spot with the ultrasound machine using the MRI as a guide and found the spot right away, which was scar tissue by the way.  It looked really scary on the US, BIRADS 4, but all of the ones I have had have been that same rating.  Anyway, here are my questions.

1. Every time I have an MRI pretty much, I end up having a biopsy.  Is this necessary given they have never found anything to worry about?  This last radiologist, after giving me my results, suggested easing up on my protocol so that I won't have to have two biopsies plus every year.

2. What are the chances that the spot they located using US and biopsied is NOT the same spot that showed up on MRI.  THey used the MRI as a guide and found it right away.  No other spots were located in the area on US.  THe radiologist said he could say he was 90 to 99 percent sure it was the same spot because it was the same size and shape and in the exact same area.

3.  Do I really need to go through this MRI?  I know it is precautionary and that they are just looking for the clip, but I have had one surgical and one needle biopsy in the same area in the last 8 months and I am not liking it.

4. Once site I found said that I should not have had the area that lit up on MRI biopsied at all because it was only 5 to 6 months after the surgical lumpectomy and it was going to light up still from healing.  Plus I told the doctor that my baby had kicked me in the scar area only 4 to 6 weeks prior to the scan and the site also said that it would light up from the trauma of that as well.  Is this really true?

Any advice would be helpful.  I am once again a worried mess.  When I worry, the breast pain gets worse and I notice every little thing!  I am still recovering from post partum anxiety on top of all of this and am quite stressed.
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Avatar universal
Not the news I was hoping for.  The spot they biopsied in March is NOT the spot seen on MRI in March.  It is still there but at least it is "stable."  It is the exact same size and shape it was in March, but it has to come out.  Having MRI wire localization followed by surgical removal probably in two weeks.  I am disgusted, scared, and numb.  I suppose I was so nervous because I just knew in my heart that they had missed the spot.  I am not usually wrong about things I feel strongly about.  The spot is small, 1cm so I hope that it is not cancer.  The radiologist says he is thinking more that it is not because it has not grown in three months.  The good news is that the rest of both of my breast look great.  Yay.  I'm sad.
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Avatar universal
Oh my God I'm such a mess!!!!  I was told I would get my results today and I just found out that I'm not.  This was just a follow up to see if they got the spot, how hard could that be to read.  The preliminary report was done yesterday, and we all thought that the radiologist would finialize it today and call me, but he told them to tell me that he will finalize it and then talk to my surgeon tomorrow and he will call me then.  I just can't wait another day.  I feel so sick to my stomach.  Do you think they found something else?  I've never waited this long for results and the radiologist usually calls me himself.  Why do I now have to wait for the Dr?  Soooooo scared.
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Avatar universal
Thank you so much for your response!  Your advice sound a lot like my mom's.  She is a 33 year post halsted radical mastectomy for BC and once her 5 years were up, I think she has had only one female exam and that was probably about 3 years ago.  She too feels like I need to be left alone and I know that she feels responsible for my suffering because of her cancer.  I still am a very anxious person and am sure that the pain I endure in this breast on a daily basis is in part from my biopsies, and inpart due to my own anxiety.  After my first son was born 4 years ago, I was told that I had breast cancer.  The biopsy proved otherwise and I thank God for that every day.  But since that time, I have become cancer-phobic.  Every ache and pain is cancer and I live in fear all the time.  To top this all off, I suffered extreme post-partum anxiety after my first and some issues again with it this time around.  

I totally understand about the allergies by the way.  I too have been questioned about drug interactions and encouraged, to put it nicely to try certain drugs again by doctors.  I have horrible reactions to medicine in general and prefer to take nothing if at all possible.

I too need to start feeling better menatlly and physically.  You have given me the hope that I can in fact do just that, and I will be fine in the process.  You sound like a wonderful person and I am so glad that you responded to me.  I will let you know tomorrow what they say when I get my results...I better get them tomorrow!  My husband keeps reminding me that it was just a "follow up" and that it is just protocol, but here I sit...a mess...with a nice bruise where the IV contrast entered my arm, worried that they might have not biopsied the right spot by using US instead of MRI.

Good luck with your future exam.
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Avatar universal
Hi there:)
I don't have any advice for you...but I am so very sorry you are suffering.  I can't imagine how aweful this must be for you!  

Years ago  I went through the medical circus where i would go every three months so the health care cronies could poke/stick/probe and slice into my person...I found myself feeling worse with each visit...I managed to endure about two years then I decided...enough is enough...
I haven't been in for female checkup since...and miraculously..I started feeling better both mentally and physically.  

Maybe your body needs a rest...or at least a gentler standard of care...

The only thing I can offer...is to read read read, research as much as you can about your particular health issues...get a medical dictionary...read the med journals...these articles for doctors only can be quite enlightening and telling ... In my opinion, we tend to blindly trust doctors tomake the best choices for our health...we need to ask lots of questions and call them on it when they respond rudely or dismiss our concerns.

Here is one of my regular lines to remember while in the hallowed halls of the medical men:  What are my options?  Are there any other options that I might consider as an alternative to your suggested course of action?  I feel uncomfortable and unhappy about ___________________dr knowall...can you explain why your _____________ is better than my _____________.

Quite recently...I was injured and was shocked and amused at how little the doctors  really seem to truly care about my or anyone's well being.  On my chart ...right in front of him..he had finished reading...and there it was in large font view on his computer where we could both see...my record...and the notes regarding my allergy to a  particular favourite and too oft prescribed, convieniently dirt cheap, pain medicine,  (each pharmacy  copayment...was at least ten times the actual cost of the tablets  and his company made a nice easy profit whever they convinced me to accept  this) ...he tried to talk me into giving it yet another try (despite my listed drug reactions and side affects in the medical record)...instead of prescribing another medicine that was gentler on my system and was proven...(also right in front of him on his screen) in my chart to be very milder and much more effective...


My point:  We have to stand up for ourselves and be our own advocates.  These doctors aren't about giving us the best healthcare they can...unfortunately...they answer to the greedy and unscrupulous insurance agencies...the less they care for us... the more their employers make.

My heart goes out to you and your baby.  You both need your emotional ell being...so go do something that nurtures your soul and makes you smile so you can take a break from this pain.  May our bustlines be forever healthy and our lives filled up, overflowing with all the heartfelt joys and loves that life has to offer.  

Keep posting as I am learning so much from your experiences...and preparing to endure the battle of the breast exam myself!
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Avatar universal
Had the MRI today and I am a mess.  I have been waiting for three months to have this confirmed that the spot biopsied on US was the same as found initially on MRI and I may ahve to wait another day.  I am not sure how this usually works, but I called the radiologist because he is the same one who almost always reads my studies.  I was told he was reading my MRI and I would hear from him.  When I called back to check, I was told he left for the day and that only a preliminary report was in the computer and that I would have to wait until it was finalized for the results.  I am now thinking the worst!  Why would he not finalize the report?  I am an absolute mess!  Is it common for radiologists to write a preliminary report and not finalize it right away?  What would cause the delay?  It is just a matter of him wanting to read what was typed before he signs to make sure it is what he wanted to say?  I have no idea.  Can anyone offer any assistance?  I need some vallium!
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Avatar universal
I knew it!  Why did they do this second biopsy?  I knew I was still healing and that it would light up.  John Hopkins site said that too.   The initial biopsy in October was because of a very large mass that had to come out surgically.  It was really big.  It was just a mess of junk and nothing abnormal was found in it at all.  When I had the MRI in March, the surgical spot lit up and they also saw it on US, thus the secnd needle biopsy...which was found to be scar tissue...go figure.  I feel like a pincushion and am hoping for a clear scan tomorrow so that I can be left alone for a while.  I think the constant pain I have in that breast is because of all of the biopsies.  So many things have been disturbed.  I couldn't even breastfeed this time because my first lumpectomy severed milk ducts and when my milk came in, none would come out...it was horrible.  As for the gene...I am scared to have that done, but I probably should.  Thank you so much for your response.  I am an anxious mess as usual.
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322973 tn?1239904438
MEDICAL PROFESSIONAL
Hi

There are fixed guidelines for MRI recommended by the American Cancer Society.Any scan after the biopsies cannot be interpreted in totality due to the associated scar tissue, fibrosis etc.

I woud also like to know the reason for the initial biopsy..was it a mobile lump  or pain associated with a lump..its better to go for a fine needle aspiration cytology than to go in for a biopsy everytime..its less cumbersome and heals up faster and better..

Since your mother had a breast cancer at an age of 38 years, I would advise you to test for a BRCA mutation to identify your risk factors though you do not come traditionally under the category of people really needing the test..the test, however will allay your fears and will help you and your doc decide the future course of action..

best of luck
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