Confused about MRI results

[viddie]

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?

[CCF-RN,MSN-rf]

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.

[catiacc]

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

[cyn17]

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!

[lizziecee]

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.

[boninclyde]

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.

[boninclyde]

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?

[sue-aloo]

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

[laure113]

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.

[viddie]

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.

[carme]

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