mri vs mammo

[mammoquest]

recent visit to dr discovered a lump . dr recommended diagnostic mammo & ultrasound. husband & i feel mri will give more accurate info and would like to have this procedure first.
we would also follow w/ca27.29 bloodtest. we feel mammo misses much and compression in breast with prior plastic surgury (breast lift w/breast sutured to chest wall) is not going to be easy to read.most dr's aren't familiar w/mri & we feel we are being steered into mammo just because it's standard practice.
we are aware of pro's & cons and feel degree of accuracy will eliminate alot of unneccesary proceedures.
appreciate your experience on this.

[CCF-RN,MSN-rf]

Dear mammoquest:  Regardless of whether or not an MRI is done, we would recommend mammogram and ultrasound.  The reason is that an MRI shows everything in the breast and does not necessarily clarify the area of concern.  In other words, MRI can lead to unnecessary biopsy.  A mammogram and ultrasound can better define the area of concern and would be the proper method of identifying an area should biopsy be required - something an MRI cannot do well.  Regarding the ca27.29; its validity is still very controversial.  IF used, it is generally for the purpose of monitoring a known condition, NOT for screening or diagnosing.  Many reputable cancer centers do not use this test for any purpose because the results are not reliable enough to base treatment decisions on in the absence of any other information.

[surgeon]

In my opinion, MRI is needed only in very special cases, and does not give definitive information, any more than a mammogram. The issue is finding things that would otherwise not be found which MRI can sometimes do. But your lump is found. So it doesn't really matter what the images show: there it is, it needs a plan. Which means either keeping a careful eye on it, or having some sort of sampling. The simplest thing is a fine-needle aspiration which takes 2 seconds in a doctor's office. If the sample looks benign, and the lump feels benign, and the mammogram looks benign, the chance of missing cancer is very close to zero, and it would be safe to follow if you are comfortable with it. Blood tests can't rule cancer out, any more than an image can. You have a lump.

[mammoquest]

Dear ccf-rn;
In regard to your comments above(a)your suggestion to have mammo & ultrasound was well taken and I did these.It was helpful to create more information from which to form a diagnosis. However, the mammo & ultra were diagnosed as negative & no lump was able to be seen on films. There was clearly a lump in breast though, and Dr. said only he could only have about 70% visibility on mammo & ultra because of dense breast tissue. He referred me to a surgeon. I did not pursue that suggestion and instead had 'Aurora Deicated Breast MRI scan with Biopsy' which is the first FDA approved MRI system designed exclusively for breast imaging.It immediatly imaged the lump and we were able to see it clearly. We then used the biopsy feature of scan to check for indications of malignancy. There were none.In contradiction to what you have stated above, the MRI AVOIDED UNNECESSARY BIOPSY and I left within 2hrs. of arrival with a clear mind . Please reconsider your opinion of MRI as a diagnostic tool . It's out there, and many are already taking advantage of it's powerful informative and diagnostic value. thank you.