MRI "hot spots" what are they?

[scottishgirl21]

Hi, I am a 49 yr old survivor of breast cancer. I had my annual mammogram which showed some inconsistencies and my doctor ordered a bilaterla breast MRI. The mri has been reported to show "hot spots" and I am scheduled to have a MRI guided needle loc and a lumpectomy next week. I don't understand what hot spots are and my doctor is away for a few days. I am seriously considering having a mastectomy at this point in time as I do not want to live in fear of this kind of situation every other year. I have had 4 surgeries in 5 years and up until now was not ready to considered a mastectomy, but at this point in my life I'm thinking just take them off! Any help would be most appreciated.     Thank you.

[Greta_L]

I too had first the CAT scan that pointed to something lesionlike on the liver and then an MRI.  The MRI couldn't confirm what it was, so I ended up having to have that biopsied.  That wasn't much fun and it was all very rush rush so as not to postpone my mastectomy surgery.  They said if it turned out to be cancer they would have cancelled the surgery and gone straight to chemo.  First they called it a hemangioma (sort of an internal birthmark) and then possible focal nodular hyperplasia. But the key thing I remember is they are benign and that most people never know they have them or have any problems from them.  With today's use of MRIs and CAT scans we are becoming more aware.

[scottishgirl21]

Thanks for sharing your experiences, I feel better with a little knowledge. My surgeon will be back Monday and I will talk to him then and my lumpectomy &  mri needle loc is scheduled for Tuesday. Keep well!

[katarina777]

My surgeon told me that MRI is not very good at detecting lymph node involvement.  He used the phrase that MRI was notoriously bad at detecting lymph node status and he was a very experienced breast surgeon. And indeed, there were no 'hot spots' for the lymph nodes even if 18 were positive for metastatic bc as came out with surgery. the breast tumor was very accurately displayed but it shows up differently after you had chemo, and which I did. it's mostly the lumps of scar tissue showing, or fibrosis. Then, the MRI showed two hot spots in my liver, and which the pathologist identified as lesions. He said they could be ganglions, or something else, or cancer and recommended follow up with ultrasound, and which was never done as nobody seemed that concerned, it appears. What I did not like was that a later CT scan showed not only the same lesions in the liver but they had grown and now there were three rather than two. i was never even told about this, and I accidentally found this information in my charts. I try not to think about it, and I do not really understand why those things have been ignored. i guess the point is as has been already suggested with you. there is something most likely there , and an experienced radiologist will have an idea about what is suspicious looking for cancer, and more than another hot spot, just by experience.  But he cannot be sure without a biopsy.  Sometimes, i think, having all these different oncologists, like the one for chemo, the one for surgery, and the one for chemo, and the radiologist and pathologist, and all that accomplishes the opposite of what it is supposed to serve, the many eyes and experience. Sometimes many eyes can be like no eyes looking carefully.

[twowonteat]

Here's what I know from my own experience.  I have had more breast MRI's than I can count and the "hot spots" are actually areas that enhance or light up on the scan once the contrast agent is injected into your vein.  The contrast agent shows areas of blood flow and the flow could be feeding a tumor so that's why they do the contrast.  MRI's are great at detecting cancer, however the do also couse a lot of false positives.  In other words, they are non-specific, but quite sensitive, thus resulting in many unnecessary biopsies as in my case.  I seem to light up quite often and thank God, nothing has been found, all benign.  I hope I helped, I am not a medical professional, just a porfessional at having them done I suppose.  Good luck and I will watch to see how things are going for you.

[scottishgirl21]

Thanks for the hug and the info, the radiologist's comments were "areas of activity" or "hot spots" and it sounded ominous. I was hoping to get some explanations of that but I suppose I sholuld wait for my surgeon to return, unless anyone else is familiar. Thanks!

[Greta_L]

You sound like you could use a big bear hug!  I don't think "hot spots" are technical terms.  Sounds like your Docs slang.  My doc says that MRI's can point out "possible" areas of cancer, but you need biopsy to determine if that is what it is. Says MRI's can also cause false alarms.  I had a mastectomy 2 years ago cause I didn't have a choice due to tumor size and location, but I wish I could have stuck to the lumpectomy.  I know that the fear of recurrence is strong, but the consequences of a mastectomy aren't fun either.  Reconstruction is not always easy and in my case had many long-term complications.  Try to stay calm and ride this one out.  If it is definitely cancer than you can still consider the mastectomy.  I had both.......first the guided lumpectomy, then the mastectomy.
Good luck!!!!