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All TopicsForum: DCIS (Ductal Carcinoma In Situ) → Topic: What does an MRI show?

Topic: What does an MRI show?

Forum: DCIS (Ductal Carcinoma In Situ) — Just diagnosed, in treatment, or finished treatment for DCIS.

Posted on: Jan 16, 2012 09:32AM, edited Jan 16, 2012 10:08AM by TJP1071

TJP1071 wrote:

Just wondering what doctors can find out from an MRI?  I see the surgeon this  this wed. And the nurse on the phone told me my next step is probably an MRI.  What new information does this show the doc?  And just another side note question....With a Sterotactic biopsy.....no margins are listed why?  If the diagnosis is DCIS for now ....with no margins on the report and how the samples are taken Can this change with more information?

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Jan 16, 2012 11:43AM crystalphm wrote:

My Mammogram and ultra sound came up clear, but the MRI showed definite problems, which indeed were DCIS.

The "down side" to the MRI is it can show false positives, things will show up as "cancer" but they are not cancer.

So The MRI seems to be very good at finding anything that is not "normal" in a breast.

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Jan 16, 2012 11:47AM AlohaGirl wrote:

Hi, TJP.  As I understand it, mammograms and MRIs see cancer and indications of cancer differently.  So, a mammogram might pick up the calcifications leading to a DCIS diagnosis (like mine did).  The MRI might not be able to see the calcifications, but it could see other areas of cancer.  (For example, when I had an MRI before surgery, it turned out my area of DCIS was a little bit bigger than they had thought from the mammogram.)  The surgeon is probably trying to get as complete information as possible before you have surgery so she knows how much to remove if you are having a lumpectomy or to help you make the best-informed decisions about treatment that you can.

Since the stereotactic biopsy is done with the needle, I think by definition there are no margins (because there is probably still some DCIS left and because the purpose of the biopsy is to see if there is cancer there, not to remove all of it -- the idea being that if there isn't cancer there you wouldn't have to go through a lumpectomy biopsy for no reason).  So, there will be margins when you have a lumpectomy (or mastectomy), but not now.

After surgery, you will know your margins and also will have more information about the DCIS.  Sometimes, women who have DCIS on biopsy turn out to have some invasive cancer (usually a small amount) after surgery that was not seen in the biopsy.

I hope this helps.  It sounds to me like your surgeon is being thorough and careful and I'm sure you'll feel like you have a lot better sense of what is going on after you meet with her on Wednesday.  In the meantime, hang in there!  

Dx 2/18/2009, DCIS, Stage 0, Grade 3, 0/0 nodes
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Jan 16, 2012 11:58AM ma111 wrote:

No margins means no tumor.

I think I would understand your questions better with more information. Like, did they already do a biopsy?

The MRI would show tumors over 1mm.

Dx 8/4/2009, IBC, <1cm, Stage IV, 19/19 nodes, ER-/PR-, HER2+
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Jan 16, 2012 01:05PM Lisa75 wrote:

brace yourself for that MRI. Make sure you face and arms are comfortable....when I was put in, I thought I was comfortable but after a few minutes I wanted to adjust myself and you cant move at all the time you are in it.

37, 3/1/2012 Uni MX w/direct implant. 2 nodes removed

Dx 12/12/2011, DCIS, 6cm+, Stage 0, Grade 2, 0/2 nodes, ER+/PR+
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Jan 16, 2012 03:35PM TJP1071 wrote:

AlohaGirl thanks for the info!

 I had a mammogram which led to another mammogram, which led to the biopsy which led to my GYN calling and saying I had BC.  2 Places on the left breast, one near the chest wall and another near the nipple.  (3:00 quadrant)  Told many times during these tests that the breast is dense.  I wondered if an MRI would be able to show thru the dense tissue?  Path report lists it as DCIS grade 3 with comedo necrosis (sp).  Waiting stinks!  I have 2 appointments on the 18th.  One with the group who diagnosed me and another with U of M.  First opinion and second on the same day!  It will be a day filled with a lot of info I am sure.

Lisa75~~~~~ I had to have a MRI for my head last year and it was trapped down so there was no moving it!  Thanks for the warning!  I do get a bit itchy to move after a bit! 

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 16, 2012 05:23PM crystalphm wrote:

The MRI is the perfect machine to see through the dense breast tissue, it was used in my case because my breasts were so dense...

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Jan 17, 2012 03:19AM TJP1071 wrote:

Thanks Crystalphm!  That was my worry.

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 17, 2012 04:02AM CookieMonster wrote:

After my stereotactic biopsy my surgeon sent me for a MRI. It showed a larger area of DCIS than the mammogram showed and also showed another suspiscious area which they removed when they did my lumpectomy. I've heard that some MRI's can show areas that aren't actually problems so can cause more worry, and for that reason some doctors don't do them. Dr. Susan Love says that she doesn't like to have them done because of that.

Original diagnosis was DCIS surgery revealed area > 7 cm & IDC

Dx 8/2/2011, IDC, 1cm, Stage Ia, Grade 1, 0/12 nodes, ER+/PR+, HER2-Surgery 08/23/2011 Lumpectomy (Right)Surgery 09/27/2011 Lumpectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection (Right)Surgery 10/27/2011 Lumpectomy (Right)Surgery 12/15/2011 Mastectomy (Right); Reconstruction: DIEP flap (Right)Hormonal Therapy 02/20/2012 TamoxifenSurgery 04/05/2012 Reconstruction (Right)Surgery 07/11/2012 Reconstruction (Left)Surgery 01/10/2013 Reconstruction (Left)
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Jan 17, 2012 04:27AM TJP1071 wrote:

I am worried about a false positive but I think more worried  about what they cant see? 

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 17, 2012 04:31AM TJP1071 wrote:

lisa75...your signature says you have DCIS from the chest wall to the nipple?  How do they find that out?  Is it from an MRI? I have one spot by the chest and another by the nipple.  This is why I am worried about what is in that dense tissue? I guess I keep feeling that they can't know till they biopsy something and test it.  Not sure really how they know from pictures on an MRI.

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 17, 2012 04:35AM Moderators wrote:


There is some great information about Breast MRI on the breastcancer.org site
 
We hope this helps!
 
The mods 

To send a Private Message to the Mods: community.breastcancer.org/mem...

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Jan 19, 2012 03:29AM TJP1071 wrote:

!Thanks for all the info.  MRI scheduled for tomorrow friday the 20th.  Genetics testing scheduled for Monday the 23rd.  Then the big decision!  Lumpectomy or Mastectomy.  They have left it up to me.  What a choice.

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 19, 2012 04:58AM ma111 wrote:

MRI is the best method for dense breast tissue. It will show anything above 1mm even in the dense tissue.

Dx 8/4/2009, IBC, <1cm, Stage IV, 19/19 nodes, ER-/PR-, HER2+
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Jan 19, 2012 05:44AM PLJ wrote:

I debated about responding here, as I had a very different experience with MRI than most. While I don't want to alarm anybody, because MRI *is* the current 'gold standard', it can miss things. My invasive was picked up by u/s but not mammo...dense breasts. However, 4 u/s, 1 mammo and a breast MRI all missed a 6 cm DCIS lesion. It was a surprise on my initial pathology report after lumpectomy. Because of so many dirty margins for DCIS and MRI couldn't 'see' it, I opted for BMX. We didn't know if a second lumpectomy would get it all but more frightening to me was we didn't know if it was anywhere else in my breast...or the other one. This was not an easy decision but for me, the correct one. Having said that, I think MRI catches more than it misses but no test is 100%. Good luck in your decision.

Living is not about worrying how much time you have but deciding what to do with the time that you have been given. Choose well. Dx: May 3/11. 1 cm Mixed Mucinous Carcinoma inside 6 cm DCIS Stage 1, Grade 2, 0/1 Node, Oncotype 16, ER+/PR+, Her2-

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Jan 19, 2012 05:52AM mommcat wrote:

I thank God daily that we have MRI's!!  Was going in for a prophylactic mastectomy because of high risk factors, and had two totally clear mammograms, six months apart, as well as a clear ultrasound.  Doctor said that everything looked good, go ahead with surgery, but at the last minute said, "you know, I don't want any surprises...let's just do an MRI to be on the safe side..."  Thank goodness!!  MRI showed a 1.5 cm tumor that everything else missed!!   And it was still very early, no spread.  Please get your MRI's!!!    

Dx 7/24/2010, IDC, 1cm, Stage I, Grade 2, 0/14 nodes, ER+/PR+, HER2-
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Jan 19, 2012 06:48AM TJP1071 wrote:

MRI tomorrow!  I understand also that there can be a lot of false positives.  If the MRI shows mor DCIS or other spots (she is looking at something on the right breast as well, not too woorisome but the area is not on the other films) I will get the mastectomy. 

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 19, 2012 07:22AM AlohaGirl wrote:

Good luck tomorrow, TJP!

Dx 2/18/2009, DCIS, Stage 0, Grade 3, 0/0 nodes
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Jan 19, 2012 09:07AM TJP1071 wrote:

Thanks~~~Alohagirl!

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 19, 2012 11:27AM crystalphm wrote:

Let us know how it all goes TJP...wishing you the best!

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Jan 19, 2012 04:24PM TJP1071 wrote:

I will be sure to post the results...Of the MRI as well as how I handled sitting still for so long!  LOL

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 20, 2012 09:59AM TJP1071 wrote:

So the MRI is over and it really was not that bad at all.  Sitting still was great till the very end.  I got a cramp in my left arm.  It did take a minute to get myself moving again after sitting still that long though.  The results will be in Monday.  I will get them when I go for the genetic testing. 

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 20, 2012 02:51PM AlohaGirl wrote:

Thanks for the update!  I find MRIs rather stressful for some reason (maybe a little bit of claustrophobia) so it is always a relief to have them over.  Good luck with the results on Monday!

Dx 2/18/2009, DCIS, Stage 0, Grade 3, 0/0 nodes
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Jan 23, 2012 08:42AM TJP1071 wrote:

So the update is...that there is no update!  Genetic counseling and blood test today....but the results from the MRI were being done as we spoke.  Doc will call tonight or tomorrow.  More waiting.  Snore!

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 23, 2012 08:56AM azul wrote:

Weighing in late here with my experience...

As others have said, an MRI can be helpful but is certainly not a perfect screening tool.  A mammogram picked up my very small area of calcifications, which a later biopsy confirmed was DCIS.  The follow-up MRI saw nothing more in that area but showed a new area of concern, which a biopsy revealed was benign.  However, my eventual lumpectomy showed over 2 cm more DCIS than what showed on the MRI.  So, the MRI couldn't see my DCIS but yet highlighted another area that turned out to be a false positive.  I know an MRI works great for some, but it was not a reliable screening for me (and I don't have dense breasts).

Good luck with your appointments!  

Lumpectomy 10/7/10 (narrow margins). BMX with TEs 10/27/10. BRCA neg. Exchange surgery 3/3/11. Ooph 5/12.

Dx 9/24/2010, DCIS, 3cm, Stage 0, Grade 2, 0/0 nodes, ER+/PR+
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Jan 24, 2012 04:53AM TJP1071 wrote:

MRI shows only what we already knew was there!  YEAH!  So now that is at least more information to go on when making the choice!

Anyone have genetic testing?  I had the blood drawn but the doc wants to go ahead with the lumpectomy before the results even come in.....if the gene is there wont that be jumping ahead and the more surgery?

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 24, 2012 05:30AM cycle-path wrote:

TJP, the BRCA results in and of themselves don't change what surgery is needed, but some women who test BRCA+ decide to have prophylactic mastectomies. Is this something you've thought about? If so, you should tell your doctor. If you think you'll want a PMX if you're BRCA+, there's no reason to rush ahead with the lumpectomy now. At least IMO.

I am an Uppity Woman. Don't like my posts? Put me on IGNORE.

Dx 12/10/2010, DCIS, 1cm, Stage 0, Grade 2, 0/2 nodes, ER+/PR+
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Jan 24, 2012 05:35AM TJP1071 wrote:

It is something I have been thinking about.  If the gene is present then I will no doubt get them both removed as well as have a hystrectomy (sp)?

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)
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Jan 24, 2012 07:38AM azul wrote:

I had genetic testing done too, and the surgeon recommended waiting until after the results came back before deciding on lumpectomy vs. mastectomy.  My results were negative and I had a lumpectomy but ended up with a mastectomy anyway due to narrow margins.  At that point, I chose to have a bmx because of my family history (even without the BRCA), and because I felt more comfortable knowing my chances for recurrence would be so low.

Good luck!

Lumpectomy 10/7/10 (narrow margins). BMX with TEs 10/27/10. BRCA neg. Exchange surgery 3/3/11. Ooph 5/12.

Dx 9/24/2010, DCIS, 3cm, Stage 0, Grade 2, 0/0 nodes, ER+/PR+
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Jan 24, 2012 09:01AM CTMOM1234 wrote:

Yes, I had genetic (BRCA1&2) testing. BS wanted to wait until MRI and genetic testing results came in before recommending lumpectomy, mx, or bmx (the latter if I had one of the genes plus maybe ovaries).

The MRI resulted in a false positive on the other side (led to an MRI-led biopsy which thankfully wound up being benign) and thankfully genetic tests came back negative. I chose a lumpectomy.

When I grow up I want to be an old woman. Jan'10 lump.for grade 2 DCIS;SURPRISE1.75mm grade 2 idc in path report,stage 1a; Jan'10 snb 0/3 nodes; Mar-Apr'10 rads: 25 full+5 boosts prone position, stickers/no tats; May'10 declined tamox. Doing fine.

Dx 11/1/2009, ER+/PR+
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Feb 1, 2012 03:42PM TJP1071 wrote:

Genetic testing back! Good news!  YEAH!  So now is the time for a choice....Lumpectomy or BMX.....Seeing the Plastic doc on Fri then I will make my chooice by Monday.  Need to ge this thing moving!

Dx 12/30/2011, DCIS, 6cm+, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/16/2012 Mastectomy (Both); Reconstruction: DIEP flap (Both)Surgery 06/05/2012 Reconstruction (Both)Surgery 09/25/2012 Reconstruction (Both)Surgery 02/07/2013 Reconstruction: Nipple reconstruction (Both)