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So what to do with this information

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marinochka
marinochka Member Posts: 82
edited February 2023 in High Risk for Breast Cancer

Hello, my daughter had a mammogram and ultrasound, everything was ok. She is 44 years old. this is the first time she had breast cancer risk determined and it is 22%.

Because i had a few years ago breast cancer.

We are confused now. Should she every year have 3 tests done: mammo, ultrasound and MRI. It seems too many tests without any clinical issues(of course if she will have any, it is a different story).

And insurance covers in those circumstances to have also MRI.

Please share your information because we only the first time were given those numbers. thank you

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  • sarahmaude
    sarahmaude Member Posts: 338
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    I wonder how they calculated that number. Lifetime risk for all women for breast cancer is 1:8, or about 13%. So her risk is less thandouble that. She is likely to have some false positives with all 3 tests, and also more likely to catch any cancer at an earlier stage. Have they told her she has dense breasts? If so, recent studies say MRI is more sensitive at catching cancer, and results in more false positives.

    What does her doctor recommend? What are her preferences?

  • marinochka
    marinochka Member Posts: 82
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    Doctor recommended for her to figure out how she feels: do more testing or not.

    She at this point does not plan to have MRI(this year), but I would be interested how you really make this decision.


  • nopur32
    nopur32 Member Posts: 1
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    I, myself, have had concerns. I am 48. mother had breast cancer - I did not grow up around her so I do not have her details. My 5yr = 3.9%, Lifetime=28%. My risk number increased this year due to last biopsy. I have had 6 mammograms since I turned 35. I have had 3 biopsies, 2 on right - both for architectural distortion, radial scar & 1 on Left - can not remember since it was the first biopsy but it was benign. Last month I had another mammogram (increased in density from prior scan) that lead to my pcp ordering an MRI due to my high risk. I had my MRI last Friday (stated moderate background parenchymal enhancement, multiple scattered T2 hyperintense enhancement, multiple scattered foci contrast enhancement, and 6mm circumscribed mass enhancement at medial aspect of nipple *did mention no abnormal axillary or internal mammary chain lymph node* - that lead to getting a call Monday to have an ultrasound yesterday. Ultrasound yesterday states: in deep tissues of inferior margin of left nipple there is a mass measuring 6x5x3mm that does not correspond with MRI, in nipple areolar complex there is a questionable nodule within the dermis at medial aspect of the nipple - could not be reproduced. So the radiologist spoke with my pcp and surgeon who had done the prior biopsies and let me know that she is sending me to the surgeon for evaluation and to find out my options. I am glad that I had the MRI, it showed something they could not find on the ultrasound and due to being dense it is making it difficult for them to see what is under the nipple on any scan. Sooo….I have had all 3 scans and still do not technically have a clinical diagnosis - other than we don't think we like what we see but we can see it well enough to decide, so we will do more tests.

    I'd rather know now and catch something very early on than wait and see.

  • cookie54
    cookie54 Member Posts: 698
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    @marinochka Hi ,In my experience over the years before I was diagnosed and watched closely the brisk tool was used by my doctor to access risk, https://bcrisktool.cancer.gov/calculator.html So anyone with risk factor above 20 percent is typically also followed by MRI yearly. For me I was imaged every 6 months with a yearly mammo and MRI performed 6 months apart . This way you are being evaluated every six months in hopes to catch something early. Ultrasound is not the best screening tool alone. It should be used in conjunction with mammo if something is seen or can be used if a lump pops up on exam.It becomes a "fishing expedition" if used alone and no specific target is known.

    Obviously this is just my experience which was from 2007-2016 being watched. I'm unsure as to if the protocol could have possibly changed over the years. The brisk tool has been used for several years for risk assessment. Figured this is a starting point to discuss with her doctor and see what they are thinking.

    Hope this helped. Wishing you and your daughter all the best!