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Yearly Scans

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I was diagnosed in at the end of July 2021. Stage 1, low Ki67 - 3%, 4 nodes removed, none with cancer. Had lumpectomy and radiation only, no chemo, and I am not taking hormone blockers because the benefit - for me - was less than 1% and my oncologist agreed.

I had a tough time with my scans last year, as my BCS was the one to order then, and she refused to order supplemental screening even though on my mammogram report it said my breast were very dense and things could be missed, and supplemental screening should be considered. I fought her for almost a year, and finally she relented and "let me" have an ultrasound, but no MRI.

At my ultrasound appt, the radiologist came in and told me "as far as she could see" everything looked fine, but my breasts were SO dense, it was like trying to find a needle in a haystack. She told me she was "amazed" that they even found my cancer on a mammogram. I told her I was having an ultrasound, and she said that wasn't much better, and I needed an MRI. So after the appt, the way it works, is you go directly up to the BCS office and they go over the results. I told the NP (because the BCS doesn't see her patients anymore unless it's surgery) what the radiologist said about the MRI and again got pushback, saying that wasn't in her report. I wouldn't back down, so she said she'd talk to the BCS.

Long story short, I got my MRI. But that left me with a bad test in my mouth. It was very stressful having to fight when my BCS for a year to get what I felt - and what the radiologist confirmed - was needed. I tried to enlist the help of my RO, my PCP, my GYN doc and my oncologist, and they all deferred to my BCS. Maddening.

So since my oncologist is at another hospital system, I decided to transfer my scans there. It was bittersweet as the other hospital was the one who miraculously found my cancer.

Anyway, the mammogram seemed unusually short (not as many images as the one in 2022), and when I got the report, I was surprised to see it said it was a combo of 2D images and tomosythesis. I think tomosynthesis is 3D, but why on earth with someone with dense breasts would they use 2D at all?

After the mammogram, but oncologist had scheduled an ultrasound for my "supplemental screening" as mentioned on my mammogram reports as necessary due to my dense breasts. When I get in there, the tech told me "we have to talk" and I panicked, thinking the cancer was back. She said "there's no abnormality with your mammogram, so you don't need the ultrasound". So I had to explain to her this was not for an abnormality, it was due to having dense breasts. She told me the order was wrong and left the room, and seem annoyed.

In any case, that report came back with no abnormalities either.

So I guess I should feel good, but I just feel a bit uncertain. The confusion of why the mammogram was so short, and why the 2D, so I messaged my oncologist who got right back to me and he told me "the imaging people have changed things, and are now doing screening mammograms on women who have achieved some stability vs diagnostic mammograms and since you are having a yearly MRI, I feel comfortable that you are being closely monitored".

So, just curious, because I don't know the protocols after cancer, except that my RO told me I would be "closely watched" for "many years" but it seems - other than the MRI - that I am just being treated like any other woman, not someone who has had breast cancer.

What do you all have for your scans? Does what I have seem appropriate or should I go back to my old hospital system and get the more extensive 3D mammograms, but have to fight with my BCS yearly to get the MRIs, or just trust my oncologist (which I do) and that what I am having done is enough?

Comments

  • cookie54
    cookie54 Member Posts: 684
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    @macdebbie Hey there so here is what I know.

    • A diagnostic mammo is performed when a patient has a lump or a specific area of concern that is being looked at. Otherwise other mammo's are considered screening.
    • Sometimes yes that is an imaging center protocol to use both 2D and 3D tomo images. The 3D images are so thin and there are so many that at times it can make nothing look like something. If you also have the 2D images it can help radiologist decipher if it is really something to further investigate. Overall yes 3D gives us more info but some centers will use both.

    So yes having the yearly MR and mammo is close monitoring . If they are scheduled 6 months apart at least you are being looked at every six months. Can something pop up in between,perhaps but then you can always report it and have a diagnostic mammo. After my 1st diagnosis this is how I was followed plus I had bloodwork and MO visits that decreased over time each year after initial diagnosis.

    I hope this helps you feel more comfortable. I know it's such a scary thing to worry about cancers return but it sounds like you are doing a great job advocating for yourself. Remember your always a phone call away form your MO if something pops up.

    Wishing you all the best!

  • 75nowarranty
    75nowarranty Member Posts: 9
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    I was 2 years after lumpectomy and had my last Diagnostic mammogram in feb. 23 with all being NED. At first of Feb 24, I had my first screening mammogram - bilateral, and it came back with questionable area in opposite breast. (fyi in all the many years that I had regular screening mammograms, I had never had anything questionable until my BC 3 years ago.)

    BS ordered a diagnostic mammogram with possible ultra sound ASAP. I scheduled it but first appt anywhere in the Emory Wellstar Image locations was 5 weeks away in Mid March. BC was stage 1, grade 2 with Mammoprint in new catagory of very low risk. Radiation was not recommended due to risk catagory and age. Took Tamoxin for 5 months and stopped with full approval of MO - due to side effects giving me a double dose of old age and a new research study results in June 21. Waiting these 5 weeks is difficult, so I am researching others. Of course am hoping it was positional and have now read a lot about language used in report e.g. "focal" asymmetry vs asymmetry and number of views it was visable. Any of you had reoccurance in opposite breast after a few years?