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MRI Guided Biopsies


I've had 3 BIRADS 4 on ultrasound over time in the past 3 years and each time resulted in a biopsies. All came back benign (thank God). I'm considered as high risk with LCIS and family history so I have to do MRI once in a year.

I did MRI for the first time and it showed multiple BIRADS 4 areas(4 in total) in my both breasts. They can't be identified on ultrasound so I have to do MRI guided biopsies, which I heard is more uncomfortable.

Now I'm just so fed up with all the biopsies and the anxiety I had each time. I don't remember how many times I cried because of the suspicious areas. I don't want any further biopsies in the near term. I also heard of the high false positive rates of MRI.

Do you think I should get a second opinion on the MRI images (not sure if it's possible) or wait for a few months and repeat the MRI, or just go ahead with the MRI guided biopsies?

Thoughts and comments are highly appreciated!


  • cookie54
    cookie54 Member Posts: 701

    @tianhongchanchan Hey sorry you are dealing with all this anxiety, I totally understand. before I was diagnosed I had 8 breast biopsies over 9 years due to ADH and dense breasts. It's a stressful situation for sure but if you are high risk it's a necessary evil.

    Are there false positives, yes. You certainly can get another opinion on the MR. As annoying as all this can be it's crucial that if a biopsy is truly warranted it's better to do it now than wait. We all know early detection is the key. We have to weigh the risk vs the measure. Nobody wants the stress of an unnecessary biopsy but nobody wants to risk being diagnosed at advanced stage either.

    Have a good conversation with your doctor and try to get as much info as possible to make the best informed decision. We never want to be in the position of looking in the rear view mirror saying what if…..

    Wishing you strength and peace with your decision.

  • tianhongchanchan
    tianhongchanchan Member Posts: 13

    thank you so much @cookie54 I am also going to talk to the radiologist to see what her rationals are for giving me 4 BIRADS 4 suspicious areas. It’s just too many biopsies at the same time.

  • tiredofbiopsies32
    tiredofbiopsies32 Member Posts: 2

    I have been in a somewhat similar position. I am higher risk and I have had 2 benign biopsies in each breast within the past 8 years, all bengin. My last mammogram was the first normal mammogram I've had, BRIAD2, July last year. PCP requested an MRI due to my risk. MRI came back moderate BPE bilat, scattered T2 hyperintense lesions, multiple scattered foci of enhancement bilat, and a 8mm mass enhancement under left nipple in the dermis, BIRAD0. PCP ordered an targeted U/S. Radiologist found an enhanced structure measuring 6mm x 5mm x 3mm in the deep tissues of the inferior margin of left nipple that she stated did not correspond with the MRI findings, BRIAD2 and stated that the area needed a biopsy so she sent me to the surgeon for a consult. Surgeon thought that there was not enough information at this time and I went to the wait and see category. Had a follow up MRI in October and the same area under left nipple was noted except this time it was measured as 5mm with very low uptake, BIRAD3. Again, placed in the wait and see category with another MRI in 6 months. Had my 6mo MRI and once again the nodular region of enhancement located in the subdermal of periareolar left breast has increased in size to 7mm x 3mm x 5mm with the same kinetics of last MRI, BIRAD4 and she sent me back to the surgeon for another clinical eval stating a biopsy should be considered. Saw the surgeon again yesterday, was told that unfortunately they have not been able to get a good scan with ultrasound to pin point where she needs to biopsy. She stated that she did not feel like a guided MRI or Ultrasound biopsy were not a good option. Instead she could try and perform a wedge biopsy, taking roughly 1/3 of the skin medial to the nipple and about half of the nipple, and at most likely1-3 of the collecting ducts and/or ducts under the nipple in the hopes of collecting enough of the area in question. Or. We could wait another 6 months, do a repeat MRI, and then possibly the biopsy. She stated that she would be contacting the radiologist directly to see if they could possibly narrow down the area any more in order to conserve as much as she could and still get enough for a good biopsy. After our questions were answered she she ended the appt stating that she would get back with me next week. Until then, she said for me to think on it and decide if I would prefer to wait another 6 months or proceed with the wedge biopsy. I don't like to sit in the wait and see section nor do I enjoy the biopsy section, as I have sat in both sections off an on for years. But I do not want to wait and see too long and definitely do no want to have continued biopsies.

  • moderators
    moderators Posts: 8,081

    @tiredofbiopsies32 what a dilemma. We're sorry you have to go through this. We so wish there was an easier way than biopsies! Difficult decision, but always better to find out early, if there is anything, though likely (and hopefully), all negative!
    We're here for you.