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If you had an MRI prior to surgery, did it change your plan?

eviec1
eviec1 Member Posts: 80

My apologies if this questions is naive, I am still very new to all of this and trying to understand what to expect, possible scenarios, etc.

In brief: My mamm found calcifications that a subsequent biopsy showed as IDC. I was told that I need to have an MRI prior to surgery, which I just scheduled for next week (that was the soonest available appt). Meanwhile, I have my first meeting with the surgeon this Wednesday. So I'm sort of curious about how to expect this to all play out.

I assume when I meet with the surgeon this week she will propose a surgical plan based on mamm and biopsy results.

But since my MRI will happen the following week, what is the likelihood that whatever she proposes will all end up being scrapped?

If you had an MRI prior to surgery, did it greatly affect your surgical/treatment plan? Or was it mainly just a confirmation of the plan? Or?

Comments

  • alicebastable
    alicebastable Member Posts: 1,934
    edited May 2021

    My MRI was just for the surgeon to get a better view of where and what size the tumor was. I guess if some huge difference in size appeared, it could change plans.

  • typhoon
    typhoon Member Posts: 59
    edited May 2021

    Oh, my - your question is not naive at all!! I don't think any of us come into this experience with a full understanding of the terminology or sequence of events. My first few appointments with the breast surgeon and plastic surgeon (and later, with the oncologist) seemed to mainly consist of me saying, "I'm sorry, could you explain that to me, please?"

    To answer your question: yes, the MRI (which took place after the initial meetings with surgeon and plastic surgeon, mainly because of a delay in getting approval from my insurance company) changed the surgical plan. The original plan was a unilateral mastectomy (left side, to deal with IDC and DCIS) with reconstruction. The MRI revealed a very small spot on the right side (missed by all the previous scans), and the subsequent MRI-guided biopsy confirmed it was DCIS. So, we changed the plan to a bilateral mastectomy. Since the surgical pathology report showed that the DCIS tumor on the right side also had a tiny bit of IDC mixed in there as well, I am so thankful for that MRI.

    As in my case, the MRI could possibly reveal additional areas of concern that need to be biopsied prior to surgery. The results of those biopsies could very well change the surgical plan; alternatively, the MRI could simply confirm the original assessment of the surgeon. In either case, though, more information is better.


  • eviec1
    eviec1 Member Posts: 80
    edited May 2021

    Thank you both for your replies - it is so great to hear from other people about their experiences with this.

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited May 2021

    For me, the MRI confirmed the surgeon's recommendation, which was not what I had wanted to do.

    I had two areas of calcifications removed during an excisional (surgical) biopsy. All of it was high grade DCIS, plus there was one microinvasion of IDC. No clean margins anywhere. So more surgery was necessary, plus a sentinel node biopsy. With so many involved margins and so much breast tissue already removed, the surgeon recommended a mastectomy. Not what I wanted. But then I had the MRI, which showed that my breast was full of "stuff". That's what my surgeon called it, because he said that until surgery we couldn't know if it was more DCIS or just various fibrocystic conditions. The surgeon was willing to attempt a re-excision lumpectomy but based on the MRI, the likelihood of getting clear margins obviously was slim. So that convinced me to have the MX. As it turned out, all that stuff was DCIS, with a long list of fibrocystic conditions mixed in.

    There is no harm in meeting the surgeon prior to your MRI, but yes, there's a chance the MRI could change the plans.


  • bcincolorado
    bcincolorado Member Posts: 4,696
    edited May 2021

    Same here. MRI was ordered by the breast surgeon to confirm she knew there was nothing else hiding in there since I had very dense tissues. Best wishes in your treatment.

  • mountainlover
    mountainlover Member Posts: 59
    edited May 2021

    MRI changed plans for me,too. Further to mammo+us+biopsy I was supposed to have lumpectomy + rads for a 1.3 cm mass (IDC+ DCIS). MRI showed more areas of concern in the same breast so I had to have MX.

    I was hoping I could have immediate reconstruction but the surgeon I had been seeing was rushing me into a delayed reconstruction with autologous flap. So I went for a second opinion after the MRI, changed surgeon and hospital and eventually had a nipple sparing MX with TE placement.

    Best wishes.

  • dtad
    dtad Member Posts: 771
    edited May 2021

    eviac1...yes MRI did change my plan. It's really the best screening tool for BC. I was always confused as to why they even have a plan before the MRI is done. However, I am NED 6 years! Good luck and keep us posted.

  • salamandra
    salamandra Member Posts: 735
    edited May 2021

    I met my surgeon in the morning and she sent me for an MRI later that day. It came back clear - she called me that same evening - and did not change my plan.

  • edj3
    edj3 Member Posts: 1,579
    edited May 2021

    I too had an MRI prior to the LX--like so many others, I have quite dense breast tissue and the MRI helped confirm that my right breast was just fine and my left breast had cancer. No change to my treatment plan; I was very glad to have had the MRI and confirm I didn't have something sneaking around in my right breast.

  • Each_day_2018
    Each_day_2018 Member Posts: 66
    edited May 2021

    If I hadn't gotten a second opinion, they would not have done an MRI and seen my internal mammary lymph nodes light up. They were just going to go to surgery and that's that. Luckily, I wanted a second opinion and the new doc ordered an MRI. It changed my whole treatment plan...and I was no longer eligible for immediate reconstruction because I would need radiation.

  • Rozatx
    Rozatx Member Posts: 2
    edited May 2021

    I had a similar experience. Originally a left lumpectomy but found more in the left and a spot on the right. DMX here I come.