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MRI Finds BC at Earlier Stage Than Mammos in High-Risk Women

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moderators
moderators Posts: 8,055
edited March 2021 in High Risk for Breast Cancer

MRI Finds Breast Cancer at Earlier Stage Than Mammograms in High-Risk Women, but May Result in More False Positives
June 29, 2019

Screening with MRI finds breast cancers at an earlier stage than mammograms in women with a family history of the disease, but this benefit may come with the risk of more overdiagnosis and false-positive results, especially in women with dense breasts. Read more...

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  • mountainmia
    mountainmia Member Posts: 857
    edited July 2019
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    My understanding is that women who've previously been diagnosed with breast cancer and who have dense breasts should be getting MRI with their mammograms. I read this recently and can't remember which cancer/health organization was recommending this as the standard practice. Can someone help out with a link? It would help us to be able to advocate more forcefully for full screening. thx.

  • garnersuz77
    garnersuz77 Member Posts: 36
    edited July 2019
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    I would love that link too. My breast cancer was found incidentally during an MRI ordered for looking at something on the opposite side. Had a completely clean mamo just weeks before on the RT side which actually had a pretty good sized tumor and node involvement! I just finished active treatment and was frustrated to be told that MRIs would not be part of my annual screening?!

  • moderators
    moderators Posts: 8,055
    edited July 2019
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    Hi MountainMia and Garner,

    Here is a link to all of Breastcancer.org's Research News articles regarding dense breasts -- perhaps the article you're referring to is one of these?

    We hope this helps!

    --The Mods

  • sam0623
    sam0623 Member Posts: 67
    edited July 2019
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    I recall coming across a similar article as well, but all I could find is below:

    https://academic.oup.com/jnci/article/108/3/djv349...

    I spoke with my local MO about this and she was willing to order it, but warned me my insurance may deny it. I went to see my radiation oncologist at MD Anderson shortly after and mentioned it to his NP and she said there is recent research to show there is value in doing these exams, even for women with masectomy and they would be willing to fight my insurance if they denied it. Luckily I didnt have to fight anything, they approved it pretty quickly and the plan is I will have one every year. I definitely think it's worth a discussion with your Dr.

  • rockymountaingirl
    rockymountaingirl Member Posts: 48
    edited July 2019
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    For those looking for statements on this, see "Breast Cancer Screening in Women at Higher-than-Average Risk: Recommendations from the ACR," which was published by the American College of Radiology last year, and the "Position Statement on Screening Mammography" issued by the American Society of Breast Surgeons a few months ago. Both groups support MRI for women with dense breasts and a personal history of breast cancer.

  • DiagnosisDisruption
    DiagnosisDisruption Member Posts: 20
    edited July 2019
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    I'm supposed to have alternating MRI/Mammograms every 6 months. I did the mammogram in February, but don't want to do the MRI in August because of all the false positives. My oncologist was okay with that and didn't push it (my being headstrong couldn't have anything to do with that, could it?). My first MRI after diagnosis showed two other spots that were biopsied and turned out to be nothing but another procedure and needle. I guess I'm not in the norm about wanting all the scans. I might feel different in a couple months, but right now I just want to bury my head in the sand.

  • mountainmia
    mountainmia Member Posts: 857
    edited July 2019
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    Here is a link on ACR recommendations for women with a history of breast cancer and dense breasts, as well as other categories at higher risk.

    https://www.itnonline.com/content/acr-recommends-more-aggressive-breast-cancer-screening-higher-average-risk-women

    My tumor wasn't palpable or visible on mammogram. Fortunately I had microcalcifications that were visible. Otherwise I may have gone 2 more years before the next screening. With TNBC, that wait could have killed me.

  • mountainmia
    mountainmia Member Posts: 857
    edited July 2019
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    Here is the BCO article on the subject, based on a particular study. (Moderators, why couldn't you give us this link directly?)

    https://www.breastcancer.org/research-news/mri-finds-bc-at-earlier-stage-than-mammos

    This BCO article gives the American Society of Breast Surgeons' recommendations

    https://www.breastcancer.org/research-news/asbrs-issues-updated-screening-guidelines

  • rah2464
    rah2464 Member Posts: 1,192
    edited July 2019
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    MRI picked up my cancer when repeated mammograms and ultrasound did not. I just got very very lucky that my BS listened to me and went for further imaging on my dense breasts. While we caught it early, I might have been stage zero if I would have had the option the year prior for an MRI due to density. This after several years of imaging with the 3D mammography. I am glad things are changing and hope that more women with dense breasts will at least occasionally get an MRI.

  • jons_girl
    jons_girl Member Posts: 444
    edited July 2019
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    I have extremely dense breasts. They aren't large which might be why I felt the tumor? Not sure. But it was also close to surface of my breast. I don't do manual exams normally. Now I do!

    When I went to my breast specialist appt she felt my lump too and another spot as well that she wanted checked. Of course diagnostic mammo was then done. I went to have the 3D diagnostic mammo and the tech put stickers on the areas the breast specialist was concerned about then theywould show in the mammo film. The stickers showed but my tumor was invisible.

    Then I was sent for a diagnostic ultrasound and it showed the tumor clearly with blood source even!

    My breast surgeon when I pushed to have a MRI after surgery said that she doesn't have her pts do them. Only if needed. According to her (she's been in practice for 30+ yrs) there is big time caution because of gadolinium contrast building up in the brain. They don't know what that could cause down the road. She said gadolinium is banned in Europe. I'm not sure if all this is true? But apparently they use something else in Europe now for contrast with mri.

    So I'd be interested to hear any info on this. I had thought having a mri for my breasts would be good to do down the road at some point. For now I have ultrasound every 6 mo. And manual exam by a breast surgeon yearly.

  • Spoonie77
    Spoonie77 Member Posts: 532
    edited August 2019
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    Just bumping this back up for any new members that these links may be helpful to.

    I know for me, knowing that I am getting alternating MRI's and 3D Mammo's has been a source of peace of mind for me....something that is greatly needed in my life right now.


  • Spoonie77
    Spoonie77 Member Posts: 532
    edited September 2019
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    bumping again for new members Heart

  • Spoonie77
    Spoonie77 Member Posts: 532
    edited October 2019
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    bumping again for newbies Heart

    I have my very first post-lumpectomy/rads Breast MRI this week. My Mammo/US 6 months ago didn't do much to relieve my anxiety about recurrence. Am hopeful that my MRI comes back clear/stable so that I can have some peace of mind. I just trust MRI's more so for my case.

    Wishing everyone health and healing and stable/clear scans!

  • lynnvb
    lynnvb Member Posts: 5
    edited October 2019
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    I hope this study helps with MRI’s being covered by insurance. Our insurance renewal is always one month before my yearly MRI. We have a high deductible that we never will meet, so most of the MRI is out of pocket @$2,000 plus. We have saved several years of MRI payments, but it sure would be nice to have this covered as it is is part of my 6month wait and watch screening due to being high risk.


  • jons_girl
    jons_girl Member Posts: 444
    edited October 2019
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    I agree. Insurance companies need to pay for these...process needs to be easier. And the cost really needs to go down on these.....I don't understand why they are still so expensive.

  • mammalou
    mammalou Member Posts: 293
    edited October 2019
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    Anthem pays for MRI if you’ve had cancer and have dense breasts

  • mac5
    mac5 Member Posts: 85
    edited October 2019
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    Thanks for bumping this up.

    Just recently had a Breast MRI done for recurring Breast Cancer. I had a mastectomy for the first BC but they would not do a bilateral. Theory was that IF it came back it would be a different type.

    It was different. Instead of IDCIS it’s ILC. Big f’ing “difference.”

    I’m having Genetic Testing done now because it’s a recurrence.

    Medicare is paying for the Breast MRI and the Genetic Testing.

    If you have had Breast Cancer it is my understanding your Insurance MUST cover Testing needed for diagnosis and prevention.

    Neither of these Breast Cancers showed on a mammogram. I have “dense” breasts. It took ultrasound and Breast MRI to find them. The first was StageIIIb. Waiting for Staging on this one.

    Ladies, we have to be our own advocates! I was so sick of doctors and medical routines it took 8 years to gather courage to do it again.

    If I had known Breast MRI was available I might not be in this again

  • jons_girl
    jons_girl Member Posts: 444
    edited October 2019
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    I have a health savings acct. So our insurance pays only after deductible..... It is just so expensive. I think women would have these done more often if it didn't cost so much. I have to pay out of pocket for whatever isn't in my health savings account. There is a negotiated rate of course that the insurance co negotiates with the diagnostic center that you go to. But it still costs alot....to those of us not on medicaid or medicare or kaiser. So that is a bummer to me. I miss the days of just paying 10.00 co-pay at kaiser and having everything else covered.

    Just sharing what I have to go through to get a MRI. Once I pay my 2700.00 the insurance then pays like 80%. But it is sad to me that the costs of MRI are so high when women like myself and mac5 and myriads of others with dense breasts could really use a less expensive diagnostic that is reliable. Thankfully ultrasounds aren't expensive. So I have stuck with those for now. MRI would be nice to have one of these days. I haven't used them tho for my breasts I don't think yet.

  • mac5
    mac5 Member Posts: 85
    edited October 2019
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    I can understand the cost of a Breast MRI being a huge factor. There’s also the availability. Not every Treatment Center has a dedicated Breast MRI machine.

    But if you have at least two factors considered high risk, I think you would have ground for Appeal to your Insurance company.

    Medicare doesn’t pay for it all, but you could contact the ACS in your area to see if there is financial aid to help with the copay or deductible. That’s sort of what the “Pink Ribbon” is supposed to be about isn’t it

  • lynnvb
    lynnvb Member Posts: 5
    edited October 2019
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    I had ALH which puts me at higher risk. Although I am grateful that it is not a cancer diagnosis, it disqualifies me for insurance recognizing an MRI as important. I have appealed and was told it wasn’t medically necessary. Yes, things need to change.

  • jons_girl
    jons_girl Member Posts: 444
    edited October 2019
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    Lynn and Mac I agree! Things do need to change. MRI is really the best diagnostic tool there is for breast cancer although I realize there are some women on here where mri didn’t see their Br cancer. It does see it in most people.

    Also I just called up to wash state recently where they are getting ready to start a clinical trial. They are trialing MRI without contrast especially for women who have dense breast tissue. I will be interested in what they find. Study is for women who have breast cancer now birad 4 or 5

    I was told by this person that they CAN see breast cancer on a mri without contrast. Course contrast makes it easier to see I’m sure. But I’ve been told by my breast surgeon that gadolinium has been pulled in the UK. And we just don’t know what long term affects are. It apparently builds up in the brain. So I’m going to see if I have one in the future if I can have it without contrast. Just thought that was interesting info!

    Hope you all have a great wk


  • Spoonie77
    Spoonie77 Member Posts: 532
    edited November 2019
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    Just bumping this back up for any new members.

    I know for me, knowing that I am getting alternating MRI's and 3D Mammo's has been a source of peace of mind for me, something that is greatly needed in my life right now as I face Thyroid Cancer and another surgery on Dec 4th.

    Thankful that my first MRI (post surgery/treatment) came back NED. May the rest fall in line for years to come.

    Wishing you all the same as well.



  • jons_girl
    jons_girl Member Posts: 444
    edited November 2019
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    thanks for bumping this thread spoonie.

    Congrats all is going well! Glad to hear that!

    I wanted to also let you guys know there is a clinical trial right now that I think is VERY interesting people can join!

    https://clinicaltrials.gov/ct2/show/NCT03607552

    I may join. Not sure yet. I’ve been holding off having a mri cause of the contrast. Also my breast surgeon said I should stay away from having too many MRI as they apparently have banned gadolinium in the UK. She said they haven’t done that here yet but that I should not have too many because of it.

    I think this study looks like they are trying to find a way to have breast cancer pts have mri without contrast

  • gb2115
    gb2115 Member Posts: 553
    edited November 2019
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    At my last mammogram the radiologist insisted I need a yearly mri in addition to the mammogram. I honestly don't want to do it. The surgeon told me I can think about it and decide. She didn't say she wanted me to have it done Honestly, having had cancer already I am not that afraid of a local recurrence. Metastatic yes, but that's not what the MRI is for.

    I guess part of it is the misery of trying to plan an MRI being premenopausal with irregular periods from tamoxifen. Last time I had a screening mri, the scheduling uncertainty sucked up about 2 months during which I couldn't plan much else in case I needed to schedule the test. And then the only local place that could schedule me quickly was an awful place I wouldn't want to go back to. I don't know. It's a lot of hassle plus contrast exposure. I'm also not an easy IV stick.


  • redhead403
    redhead403 Member Posts: 65
    edited November 2019
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    I was at high risk too. Had Genetic testing(Neg), Mammogram with suspicious microcalcifications, had MRI and Ultrasound and they showed nothing suspicious. Had a bx of the microcalcifications and was dx with IDC. I guess you just never know

  • Spoonie77
    Spoonie77 Member Posts: 532
    edited December 2019
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    bump Heart

  • Spoonie77
    Spoonie77 Member Posts: 532
    edited March 2020
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    ...bumping for new members....

  • Yogatyme
    Yogatyme Member Posts: 1,793
    edited March 2020
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    If it weren’t for MRI, I would likely be walking around with bc and not know it for who knows how long. BC was never seen on mammogram but picked up on 1st MRI (high risk monitoring BRCA1). Medicare paid for all of my screening & treatment. it is completely ridiculous that insurance co.’s deny this screening. Because mri caught my bc so early I did not have to have treatments beyond bmx and therefore saved Medicare $. That is the bottom line w insurance co......not our health.

  • jons_girl
    jons_girl Member Posts: 444
    edited December 2020
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    I’m having a screening mri this month as one of my two screenings this year (every 6 mo screening). And to rule out pain I’ve had in breast. I’m also joining a study that includes a DWI and the screening mri. The study info below at the link is for DWI as well as Mri screen: https://clinicaltrials.gov/ct2/show/NCT03607552

    This DWI diagnostic in the future if study or studies prove it is good diagnostic tool, maybe in the future we will have more non contrast options for diagnostics!

  • sasamat
    sasamat Member Posts: 43
    edited December 2020
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    Has anyone heard of a trial similar to the one Jons_girl just linked (studying abbreviated breast MRI for screening), but in Canada? Or does anyone know a good way to search for trials in Canada?


    Related, my radiologist friend shared some short videos with me about the value of MRI in screening women with dense breasts and also about the promise of abbreviated MRI for screening. Here's one of the best:


    https://www.itnonline.com/videos/video-use-breast-mri-screening-women-dense-breasts