MRI results
I had an MRI done today and have results already. I was diagnosed with IDC after 22 years from my DCIS dx. I.cant find the place where someone will help interpret results and have a question on if they now see 2 masses? Can anyone help me?
REPORT
EXAMINATION: Bilateral MR of the Breasts Without and With IV contrast EXAM DATE: 6/13/2022 8:22 AM
TECHNIQUE: Standard protocol MRI imaging of the left and right breast without and with intravenous contrast. DynaCAD software was used to aid in the interpretation of this examination. IV Contrast: The amount and type of contrast are recorded in the medical record.
INDICATION: Malignant neoplasm of unspecified site of unspecified female breast;Malignant neoplasm of unspecified site of unspecified female breast. COMPARISON: Mammogram and ultrasound 5/2/2022, ultrasound biopsy 5/10/2022
FINDINGS:
There is mild enhancement bilaterally. Breast Density: The breast is heterogeneously dense, which may obscure small masses.
The right breast demonstrates no evidence of mass, skin thickening or nipple retraction.
The left breast demonstrates the previously biopsied lesion at 9:00, subareolar, with associated biopsy clip, measuring approximately 0.9 x 0.7 cm in greatest dimensions. Inferolateral to the biopsied lesion in the subareolar area there is a heterogeneously enhancing mass measuring approximately 0.8 x 0.5 cm. Postsurgical changes are seen in the left breast. The remaining breast tissue demonstrates no evidence of mass lesion or fluid collection.
There are no enlarged lymph nodes in the bilateral axilla.
IMPRESSION:
- Previously biopsied lesion in the left breastwith an associated nodule in the subareolar tissue, as described.
- Benign findings in the right breast.
Recommended Follow-Up: NOW. Clinical follow-up recommended.
BI-RADS Category: 6 Known Biopsy Proven Malignancy
Comments
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Hi Bluegirl27, I'm so sorry you've had a recurrence. From what I can interpret, you had an ultra-sound guided biopsy May 10 (I'm guessing this was where the IDC diagnosis came from). The 6/13 MRI "saw" the mass that was biopsied (they know it was the same mass based on the metal clip left behind during the biopsy), and also identified a separate mass of 0.8x0.5 cm in the same breast. "Inferolateral" means the second mass was below (towards your feet) and to the side (farther away from the breastbone) compared to the mass that was already biopsied.
Unfortunately, the MRI can't tell you whether that second mass is also cancer, or is a benign finding. Your doctor may recommend getting a biopsy of the second mass, especially if you are talking about a lumpectomy instead of mastectomy.
Good news is that the lymph nodes look fine on MRI, and nothing suspicious in the right breast!
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Thank you! That is how I interpreted it, so I wanted to make sure it was correct. With it being enhanced it definitely seems more suspicious. I already have to have a mastectomy since I had radiation with my DCIS and can't do it again. Is it possible to have 2 completely different tumors as in genomic testing? My current IDC is ER/PR + and Her2 - with a KI67 =20%
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Whether it's possible to have a second tumor with different characteristics.... I don't know for sure. I think it would be unlikely that the second tumor (IF it does turn out to be a tumor - and yes, enhanced is suspicious but still not a guarantee) would be Her2+, for example, but very little is flat out impossible given the variability of the body. I suppose it is theoretically possible to have both a recurrence and a new primary at the same time, which could be completely different from each other in terms of Her2 or ER/PR. I have it in my head that the odds of that situation are much smaller than this being two sites of recurrence that are genetically linked, but I'm not sure that assumption is based in fact. A great question for your Dr, for sure. I wouldn't be at all surprised if there was some minor variation, like the Ki67 being 10% instead of 20%, or ER being 75% vs. 85%. But if your next step is a mastectomy, you can be sure that the pathologist will measure those characteristics from both sites, so you'll have that information before the subsequent phase in your treatment plan.
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bluegirl27,
Sorry to hear what was happening, I am not sure if that is called multi-focal, and there is a category called mixed type breast cancer in this forum.
Fingers crossed.
Cathy
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