Needing another MRI
This past September I had a screening MRI (strong family history of ovarian and breast cancer, BI-RADS D breast density). It showed a "10 x 9 x 11 mm homogeneously enhancing but slightly spiculated nodule in the axillary tail of the left breast". BI-RADS 5. The radiologist recommended targeted ultrasound with possible biopsy.
I had a targeted US two weeks later that showed 1.3 x 1.2 x 0.5 cm ovoid, well-circumscribed mass which is heterogeneously, but predominantly isoechoic…at the posterior aspect of the axillary tail of the left breast. There is no internal Doppler flow…No other potential correlates within that region…Impression: Possible correlate to the mass" found on MRI. The radiologist's impression was that it didn't have any definitive suspicious sonographic features, but given the concerning MRI appearance, they recommended an US-guided biopsy and clip placement. BI-RADS 4. If the biopsy result is benign, the radiologist recommended a repeat MRI.
Finally, on Monday—10 weeks after my MRI—I had the biopsy and clip placement. My GP called the next day to tell me the pathology report said it is a fibroadenoma. I'm delighted that the biopsy has come back as benign, but now I need to have another MRI—I'm assuming it is to confirm that the suspect nodule from the MRI was correctly identified on the US.
I've done a bit of reading (medical journals—I'm a retired RN) and from what I've read, it seems highly unlikely that the MRI would misidentify a fibroadenoma as a spiculated, highly suspicious nodule. My relief that the biopsy came back benign was short-lived, and now I'm back stressing that I'll have a long wait for the repeat MRI. (I waited 3 months for the original MRI, but it was for screening since I was asymptomatic. I hope this follow-up MRI will receive priority booking.)
Sorry for the long post. Hubby was really stressed while we waited for the biopsy, and now that we know it is benign, he seems to want to put all this out of mind and focus on returning to normal life, Christmas, etc. He knows I need the repeat MRI, but based on something he said yesterday, I don't think he understands my ongoing concerns: That I am worried the ultrasound didn't find the suspicious nodule found on MRI, and if that's the case, then I'm still facing a possible cancer diagnosis. Also, I'm dreading I might have a long wait for the follow-up MRI.
I'm just putting this 'out there' knowing there are folks here who'll understand how I'm feeling right now.
Barbara
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Hi Barbara, It’s SOC to correlate the biopsy clip with the original scan using the imaging mode that triggered the biopsy to make sure the correct location was sampled. MRI machines are much more in demand than mammography machines so there is a longer wait for an appointment. Unfortunately, since you are not an emergency case there is not much that can be done to hurry things along.
Most of the time the images correlate but there are about .5 to 1% that don’t. It’s good that the biopsy was benign but I understand why you are worried since you don’t have that reassurance yet. I wouldn’t obsess over the differences in appearance and size since lesions look different depending on the type of scan used. The wait is really difficult so all you can do is keep busy and try to distract yourself. That is easier said than done, however. I hope you get an appointment soon and the imaging confirms a correct biopsy location. If nothing else dealing with breast cancer teaches us patience. All the best.
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Hi maggie15,
Thank you for your kind words. I didn't realize it was standard procedure to correlate the biopsy clip with the original scan using the original mode. I don't think my GP knew that either since she seemed surprised to see the radiologist's recommendation referring to repeating the MRI on the US report.
I usually tell medical personel that I'm a retired nurse so they don't talk to me in layman jargon, but it frequently has the opposite effect where they assume I know everything already and end up not explaining anything.
I especially appreciate the reassuring statistics on image correlates. Knowing this will help me while I wait for the MRI, since I might be waiting until February or even longer for confirmation the biopsy correlates with the mass seen on the initial MRI. Health care here in British Columbia is excellent if it is an emergency, but for pretty much anything non-urgent, the wait times can be long and frustrating. I guess I need to get better at being patient.
Thank you so much, Maggie!!
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I'm still waiting for the MRI appointment. I called my doctor's office yesterday and found out my GP requested it priority 2 which means it should be done within 7 days. I was also told that a radiologist at the hospital reviews all the requisitions and can re-prioritize requests to a less urgent priority. Priority 3 is max 30 days and priority 4 is max 60 days. I'm hoping the benign biopsy result combined with the benign appearing mass on the second look ultrasound doesn't result in a downgrading of the priority status.
If I were convinced they biopsied the correct place, a longer wait would be fine with me. Unfortunately, I've gone from asymptomatic at the time of the screening breast MRI in September to a noticeable 'bump' I could feel in my axilla when I applied deodorant in October. The 'bump' wasn't palpable, though. By Nov. 1st I could feel a lump if I very carefully palpated my axilla. By mid-November, the lump has become quite easily palpable. It is mobile and firm/hard.
The lump is in my axilla—between 1 and 2 o'clock positions—right where the MRI noted the highly suspicious nodule. When I removed the rather large dressing post biopsy, it looks like they biopsied the outer part (lateral aspect) of my breast at the 3 o'clock position, nowhere near the axilla and axillary tail. I know this lump might be a lymph node and not the nodule noted on my MRI, so I have made an appointment to see my GP next week so she can assess it. In the meantime, I'm keeping my fingers crossed that the MRI is done soon and that it confirms that the biopsied site correlates with the MRI result and that the axillary lump is nothing to be concerned about. Hope floats.
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