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Topic: MRI Finds BC at Earlier Stage Than Mammos in High-Risk Women

Forum: High Risk for Breast Cancer — Due to family history, genetics, or other factors.

Posted on: Jul 3, 2019 09:34AM

Moderators wrote:

MRI Finds Breast Cancer at Earlier Stage Than Mammograms in High-Risk Women, but May Result in More False Positives
June 29, 2019

Screening with MRI finds breast cancers at an earlier stage than mammograms in women with a family history of the disease, but this benefit may come with the risk of more overdiagnosis and false-positive results, especially in women with dense breasts. Read more...

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Jul 3, 2019 09:56AM MountainMia wrote:

My understanding is that women who've previously been diagnosed with breast cancer and who have dense breasts should be getting MRI with their mammograms. I read this recently and can't remember which cancer/health organization was recommending this as the standard practice. Can someone help out with a link? It would help us to be able to advocate more forcefully for full screening. thx.

The rain comes and the rain goes, but the mountain remains. I am the mountain.
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Jul 3, 2019 10:05AM Garnersuz77 wrote:

I would love that link too. My breast cancer was found incidentally during an MRI ordered for looking at something on the opposite side. Had a completely clean mamo just weeks before on the RT side which actually had a pretty good sized tumor and node involvement! I just finished active treatment and was frustrated to be told that MRIs would not be part of my annual screening?!

Dx@41; Oncotype 9 Dx 11/2/2018, DCIS/IDC, Right, 3cm, Stage IIA, Grade 2, 1/4 nodes, ER+/PR+, HER2- (FISH) Radiation Therapy 4/10/2019 Surgery Lumpectomy: Right Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin)
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Jul 3, 2019 12:29PM Moderators wrote:

Hi MountainMia and Garner,

Here is a link to all of Breastcancer.org's Research News articles regarding dense breasts -- perhaps the article you're referring to is one of these?

We hope this helps!

--The Mods

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Jul 3, 2019 11:12PM Sam0623 wrote:

I recall coming across a similar article as well, but all I could find is below:

https://academic.oup.com/jnci/article/108/3/djv349...

I spoke with my local MO about this and she was willing to order it, but warned me my insurance may deny it. I went to see my radiation oncologist at MD Anderson shortly after and mentioned it to his NP and she said there is recent research to show there is value in doing these exams, even for women with masectomy and they would be willing to fight my insurance if they denied it. Luckily I didnt have to fight anything, they approved it pretty quickly and the plan is I will have one every year. I definitely think it's worth a discussion with your Dr.

Dx 2/14/2017, DCIS/IDC, Left, 2cm, Stage IIIA, Grade 3, 8/15 nodes, ER-/PR-, HER2- Chemotherapy 3/2/2017 AC Chemotherapy 4/27/2017 Carboplatin (Paraplatin), Taxol (paclitaxel) Surgery 9/1/2017 Lymph node removal: Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Radiation Therapy 10/24/2017 Whole-breast: Breast, Lymph nodes, Chest wall Chemotherapy 12/15/2017 Xeloda (capecitabine) Surgery 9/30/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jul 4, 2019 08:34PM rockymountaingirl wrote:

For those looking for statements on this, see "Breast Cancer Screening in Women at Higher-than-Average Risk: Recommendations from the ACR," which was published by the American College of Radiology last year, and the "Position Statement on Screening Mammography" issued by the American Society of Breast Surgeons a few months ago. Both groups support MRI for women with dense breasts and a personal history of breast cancer.

Dx 3/8/2018, IDC, Left, 1cm, Stage IA, Grade 3, 0/3 nodes, ER-/PR-, HER2- Dx 4/24/2018, DCIS, Left, Stage 0 Surgery 4/24/2018 Lumpectomy: Left Surgery 5/15/2018 Lumpectomy: Left Chemotherapy 6/9/2018 Carboplatin (Paraplatin), Taxol (paclitaxel) Radiation Therapy 9/26/2018 Whole-breast: Breast
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Jul 4, 2019 11:04PM DiagnosisDisruption wrote:

I'm supposed to have alternating MRI/Mammograms every 6 months. I did the mammogram in February, but don't want to do the MRI in August because of all the false positives. My oncologist was okay with that and didn't push it (my being headstrong couldn't have anything to do with that, could it?). My first MRI after diagnosis showed two other spots that were biopsied and turned out to be nothing but another procedure and needle. I guess I'm not in the norm about wanting all the scans. I might feel different in a couple months, but right now I just want to bury my head in the sand.

Dx 12/8/2017, IDC, Left, 2cm, Stage IIA, Grade 2, 0/2 nodes, ER+/PR+, HER2+ Targeted Therapy 1/23/2018 Herceptin (trastuzumab) Targeted Therapy 1/23/2018 Perjeta (pertuzumab) Chemotherapy 1/23/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 5/22/2018 Lumpectomy: Left Surgery 6/12/2018 Lumpectomy: Left Radiation Therapy 7/18/2018 Whole-breast: Breast Hormonal Therapy 10/10/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jul 5, 2019 06:23AM MountainMia wrote:

Here is a link on ACR recommendations for women with a history of breast cancer and dense breasts, as well as other categories at higher risk.

https://www.itnonline.com/content/acr-recommends-more-aggressive-breast-cancer-screening-higher-average-risk-women

My tumor wasn't palpable or visible on mammogram. Fortunately I had microcalcifications that were visible. Otherwise I may have gone 2 more years before the next screening. With TNBC, that wait could have killed me.

The rain comes and the rain goes, but the mountain remains. I am the mountain.
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Jul 5, 2019 06:28AM MountainMia wrote:

Here is the BCO article on the subject, based on a particular study. (Moderators, why couldn't you give us this link directly?)

https://www.breastcancer.org/research-news/mri-finds-bc-at-earlier-stage-than-mammos

This BCO article gives the American Society of Breast Surgeons' recommendations

https://www.breastcancer.org/research-news/asbrs-issues-updated-screening-guidelines

The rain comes and the rain goes, but the mountain remains. I am the mountain.
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Jul 5, 2019 06:50AM Rah2464 wrote:

MRI picked up my cancer when repeated mammograms and ultrasound did not. I just got very very lucky that my BS listened to me and went for further imaging on my dense breasts. While we caught it early, I might have been stage zero if I would have had the option the year prior for an MRI due to density. This after several years of imaging with the 3D mammography. I am glad things are changing and hope that more women with dense breasts will at least occasionally get an MRI.

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/26/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/26/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jul 10, 2019 01:22AM - edited Jul 10, 2019 01:24AM by Jons_girl

I have extremely dense breasts. They aren't large which might be why I felt the tumor? Not sure. But it was also close to surface of my breast. I don't do manual exams normally. Now I do!

When I went to my breast specialist appt she felt my lump too and another spot as well that she wanted checked. Of course diagnostic mammo was then done. I went to have the 3D diagnostic mammo and the tech put stickers on the areas the breast specialist was concerned about then theywould show in the mammo film. The stickers showed but my tumor was invisible.

Then I was sent for a diagnostic ultrasound and it showed the tumor clearly with blood source even!

My breast surgeon when I pushed to have a MRI after surgery said that she doesn't have her pts do them. Only if needed. According to her (she's been in practice for 30+ yrs) there is big time caution because of gadolinium contrast building up in the brain. They don't know what that could cause down the road. She said gadolinium is banned in Europe. I'm not sure if all this is true? But apparently they use something else in Europe now for contrast with mri.

So I'd be interested to hear any info on this. I had thought having a mri for my breasts would be good to do down the road at some point. For now I have ultrasound every 6 mo. And manual exam by a breast surgeon yearly.

Dx 6/2017, IDC, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 7/5/2017 Lumpectomy: Left; Lymph node removal: Sentinel
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Aug 24, 2019 04:08PM Spoonie77 wrote:

Just bumping this back up for any new members that these links may be helpful to.

I know for me, knowing that I am getting alternating MRI's and 3D Mammo's has been a source of peace of mind for me....something that is greatly needed in my life right now.


Life long "Spoonie" that entered BC World @ 41. DXd @ 42 w/MS. Treatment: LX/SLNB/RADs. Plan A: 5mg Tamox = 0 QOL. Plan B: OS/AI = Rare allergy to OS meds. Plan C: Only option left, Diet & Exercise. PS: Not a dr, just an avid Googler. Dx 7/20/2018, IDC, Left, 3cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 8/30/2018, DCIS, Left, 1cm, Stage 0, Grade 2 Surgery 8/30/2018 Lumpectomy: Left; Lymph node removal: Left, Sentinel Radiation Therapy 10/1/2018 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 3/30/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 7/2/2019 Zoladex (goserelin)
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Sep 19, 2019 03:03PM Spoonie77 wrote:

bumping again for new members Heart

Life long "Spoonie" that entered BC World @ 41. DXd @ 42 w/MS. Treatment: LX/SLNB/RADs. Plan A: 5mg Tamox = 0 QOL. Plan B: OS/AI = Rare allergy to OS meds. Plan C: Only option left, Diet & Exercise. PS: Not a dr, just an avid Googler. Dx 7/20/2018, IDC, Left, 3cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 8/30/2018, DCIS, Left, 1cm, Stage 0, Grade 2 Surgery 8/30/2018 Lumpectomy: Left; Lymph node removal: Left, Sentinel Radiation Therapy 10/1/2018 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 3/30/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 7/2/2019 Zoladex (goserelin)
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Oct 8, 2019 01:38PM Spoonie77 wrote:

bumping again for newbies Heart

I have my very first post-lumpectomy/rads Breast MRI this week. My Mammo/US 6 months ago didn't do much to relieve my anxiety about recurrence. Am hopeful that my MRI comes back clear/stable so that I can have some peace of mind. I just trust MRI's more so for my case.

Wishing everyone health and healing and stable/clear scans!

Life long "Spoonie" that entered BC World @ 41. DXd @ 42 w/MS. Treatment: LX/SLNB/RADs. Plan A: 5mg Tamox = 0 QOL. Plan B: OS/AI = Rare allergy to OS meds. Plan C: Only option left, Diet & Exercise. PS: Not a dr, just an avid Googler. Dx 7/20/2018, IDC, Left, 3cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 8/30/2018, DCIS, Left, 1cm, Stage 0, Grade 2 Surgery 8/30/2018 Lumpectomy: Left; Lymph node removal: Left, Sentinel Radiation Therapy 10/1/2018 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 3/30/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 7/2/2019 Zoladex (goserelin)
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Oct 9, 2019 07:55AM LynnVB wrote:

I hope this study helps with MRI’s being covered by insurance. Our insurance renewal is always one month before my yearly MRI. We have a high deductible that we never will meet, so most of the MRI is out of pocket @$2,000 plus. We have saved several years of MRI payments, but it sure would be nice to have this covered as it is is part of my 6month wait and watch screening due to being high risk.


1/2017 -Biopsy results Focal Atypical Lobular Hyperplasia involving adnosis with calcification.
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Oct 9, 2019 12:34PM Jons_girl wrote:

I agree. Insurance companies need to pay for these...process needs to be easier. And the cost really needs to go down on these.....I don't understand why they are still so expensive.

Dx 6/2017, IDC, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 7/5/2017 Lumpectomy: Left; Lymph node removal: Sentinel
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Oct 9, 2019 12:57PM mammalou wrote:

Anthem pays for MRI if you’ve had cancer and have dense breasts

DX 12/2018 ADH right breast Dx 1/11/2011, IDC, Left, 3cm, Stage IIIB, Grade 2, 1/9 nodes, ER+/PR-, HER2- (FISH) Surgery 1/11/2011 Lumpectomy: Left Chemotherapy 3/2/2011 AC Surgery 5/13/2011 Mastectomy: Left; Reconstruction (left): Tissue expander placement Radiation Therapy 6/16/2011 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 7/29/2011 Arimidex (anastrozole), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/13/2012 Reconstruction (left): Silicone implant Surgery 6/26/2013 Reconstruction (left): DIEP flap
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Oct 9, 2019 01:06PM mac5 wrote:

Thanks for bumping this up.

Just recently had a Breast MRI done for recurring Breast Cancer. I had a mastectomy for the first BC but they would not do a bilateral. Theory was that IF it came back it would be a different type.

It was different. Instead of IDCIS it’s ILC. Big f’ing “difference.”

I’m having Genetic Testing done now because it’s a recurrence.

Medicare is paying for the Breast MRI and the Genetic Testing.

If you have had Breast Cancer it is my understanding your Insurance MUST cover Testing needed for diagnosis and prevention.

Neither of these Breast Cancers showed on a mammogram. I have “dense” breasts. It took ultrasound and Breast MRI to find them. The first was StageIIIb. Waiting for Staging on this one.

Ladies, we have to be our own advocates! I was so sick of doctors and medical routines it took 8 years to gather courage to do it again.

If I had known Breast MRI was available I might not be in this again

Dx 7/20/2010, DCIS/IDC, Left, 2cm, Stage IIIB, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Dx 9/25/2019, LCIS/ILC, Right, 6cm+, Grade 2, ER+/PR+, HER2- (IHC)
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Oct 9, 2019 01:22PM Jons_girl wrote:

I have a health savings acct. So our insurance pays only after deductible..... It is just so expensive. I think women would have these done more often if it didn't cost so much. I have to pay out of pocket for whatever isn't in my health savings account. There is a negotiated rate of course that the insurance co negotiates with the diagnostic center that you go to. But it still costs alot....to those of us not on medicaid or medicare or kaiser. So that is a bummer to me. I miss the days of just paying 10.00 co-pay at kaiser and having everything else covered.

Just sharing what I have to go through to get a MRI. Once I pay my 2700.00 the insurance then pays like 80%. But it is sad to me that the costs of MRI are so high when women like myself and mac5 and myriads of others with dense breasts could really use a less expensive diagnostic that is reliable. Thankfully ultrasounds aren't expensive. So I have stuck with those for now. MRI would be nice to have one of these days. I haven't used them tho for my breasts I don't think yet.

Dx 6/2017, IDC, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 7/5/2017 Lumpectomy: Left; Lymph node removal: Sentinel
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Oct 9, 2019 01:39PM mac5 wrote:

I can understand the cost of a Breast MRI being a huge factor. There’s also the availability. Not every Treatment Center has a dedicated Breast MRI machine.

But if you have at least two factors considered high risk, I think you would have ground for Appeal to your Insurance company.

Medicare doesn’t pay for it all, but you could contact the ACS in your area to see if there is financial aid to help with the copay or deductible. That’s sort of what the “Pink Ribbon” is supposed to be about isn’t it

Dx 7/20/2010, DCIS/IDC, Left, 2cm, Stage IIIB, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Dx 9/25/2019, LCIS/ILC, Right, 6cm+, Grade 2, ER+/PR+, HER2- (IHC)
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Oct 9, 2019 02:41PM LynnVB wrote:

I had ALH which puts me at higher risk. Although I am grateful that it is not a cancer diagnosis, it disqualifies me for insurance recognizing an MRI as important. I have appealed and was told it wasn’t medically necessary. Yes, things need to change.

1/2017 -Biopsy results Focal Atypical Lobular Hyperplasia involving adnosis with calcification.

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