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One confirmed malignant mass and now MRI shows additional suspicious areas

I had a mammogram and ultrasound at the end of April which showed an abnormality in my left breast. I had an ultrasound-guided core needle biopsy on this mass over two weeks ago. The pathology report came back a couple of days later showing that the mass is malignant -- "moderately differentiated invasive ductal carcinoma." The breast surgeon talked about a lumpectomy and I was gradually reaching acceptance on that that.

The breast surgeon ordered some additional pre-operative tests -- PET scan, CAT scans and breast MRI. My insurance company would not cover the CAT scans as they said they were not medically necessary. I had the PET scan and the MRI the Friday before last (29 May).

The PET scan results came back first showing no abnormalities. I was delighted. But my relief was short-lived ...

The MRI results came back later the same day. They showed additional suspicious areas in both breasts -- two areas of "enhanced nodular enhancement" in the right breast and one area of "enhanced nodular enhancement" in the left breast. But more worrisome is that close to the already confirmed malignant mass, the MRI showed "a spiculated nodule measuring 1.2 x 0.7cm."

Now I need to have these additional areas biopsied. The bs said that in normal circumstances the areas that showed up in the right breast would be "wait and see" but in view of the confirmed malignancy on the other side, she wants these biopsied too. This time it will need to be an MRI-guided as none of these showed up with ultrasound. I'm still waiting for the insurance company to approve this before I can get an appointment.

One question I have is what to expect of an MRI-guided biopsy? Will I have to lie face down for the entire procedure? Or will they use the MRI to mark the area to be biopsied first, then turn off the machine and do the biopsies while I'm lying on my back. How long is the whole procedure likely to take?

The bs said this latest news now changes my surgical options, at least if one or more of the new areas is found to be malignant. She put the aesthetic argument of it being hard to make the breast look normal if two lumpectomies were needed but I suppose the bigger argument is that if I have more than one malignant area now, who knows what else might crop up in six months. So I think I'm looking at a mastectomy now and I'm really scared.
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Avatar universal
2 1/2 hours! Was that for a single biopsy site or for multiple areas?
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Avatar universal
Hello
I had the mri guided biopsy and yes you have to lie down on same table like you are having the breast mri, only they compress your breast alittle more.  They will numb you and leave your breast compress throughout the whole procedure.  Mine took appx 2 1/2 hrs to complete.  but you are in and out of the mri machine while they are lining everything up.  It is not that painful at all during or after (the numbing needle is the worst pain you will have and even that is not bad)...it is just uncomfortable to be laying still for such a long period of time.
After you have the biopsy done, they may put clips in your breast to mark spot, you will then have mammogram to verify where clips are.  You are sent home to rest for the remainder of the day.
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