Topic: Dense Breasts and History of Breast Cancer

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

Posted on: Dec 2, 2021 11:30AM

Posted on: Dec 2, 2021 11:30AM

macdebbie wrote:

I have dense breasts - Category C - Heterogeneously Dense - and was diagnosed with breast cancer in my right breast 7/29/21.

I had a lumpectomy and just finished 16 rounds of radiation. My tumor was small (3mm) and luckily no lymph node involvement, so no chemo. Because of the tumor size I also was unable to get Oncotype, so my recurrence numbers are a little murky, but they range between 3-5%, 5% being what my oncologist determined. I will see my MO in late Dec to start hormone blockers as my tumor was ER/PR+.

A huge part of this journey has been education. I recently learned that having "dense breasts" - either category C or D puts one in a higher than normal risk category. As does having had breast cancer already. I pulled my last mammo letter and it notes that I have heterogeneously dense breasts, and may be at high risk for breast cancer, and that dense breast tissue makes it harder to evaluate the results of a mammogram and may be assoc with a higher risk of breast cancer. It states that I should talk to my doctor about having additional screenings - US or MRI.

Never once has anyone told me any of this or talked to me about additional screenings. So I've done research on my own and found that the American College of Radiology in 2018 recommended annual surveillance MRI in women with dense breasts and with a personal history of breast cancer. That's me.

So I called my breast surgeon's office, and a message was relayed to me from the PA by an admin person that that's just a standard statement they put on mammo reports, and it only applies to women with Category D, extremely dense breasts. I am kind of floored that this is their response.

I'm guessing (maybe wrongly) that my whole breast radiation probably killed off anything in my cancerous breast, but what about the other breast? Only a 3D mammo has been done. Shouldn't they at the very least do an Ultrasound, or now, given the recommendations by the American College do an MRI? The breast surgeon's office told me that since I had a 3D mammo, that is sufficient.

I don't know what to do here. There are only two doctor groups here. Each group is affiliated with one of two large hospitals. My group that my breast surgeon doesn't belong to does not take my insurance, so I would have to pay out of pocket for any consult or additional testing. I'm afraid every doctor - breast surgeons, oncologists, etc. in the group I am with will tell me the same thing.

I feel like I am being let down here. Am I wrong in thinking that I should be having imaging other than just mammos? I know the next thing they will tell me is there are too many false positives leading to unnecessary biopsies. Well that may be, but I'd rather that than go through breast cancer again, and maybe a worse stage, needing chemo, etc., or have something that has progressed to METS.

Can anyone guide me here?

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Mar 6, 2022 10:36PM dejavue wrote:

Just read your post- Wish you the best.

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Mar 26, 2022 09:37AM - edited Mar 27, 2022 01:12AM by jons_girl


I just read your post. I was you in 2017. I was furious that I had not been educated better about this. I knew some stuff about this tho. I had cat d extremely dense tissue. Mammo didn't even see my cancer at all. Just the sticker they stuck on the 4mm tumor. I got a copy of my mammo cd to see that for myself. Nobody seemed to want to admit that the mammo didn't see it. I think I even asked the radiologist.

I had to push at first as I recall I think for other types of diagnostics. The breast specialist I saw at first did push a bit for other types of diagnostics. But now that I've had cancer they don't push back really when I ask for ultrasound. I've had mri too. I get diagnostics done every 6 mo because I chose to not have rads or any hormone blockers.

Last year I did have a mammo because your breast tissue can change. I've gone down to scattered density. Probably because I've gone through menopause now?? Not sure. Maybe it will change to denser too again. Not sure. But I won't rely just on mammo results ever again. Just my personal opinion.

Starrysky8: I found my tumor myself too If I hadn't found it I wonder when anyone else would have found it it was already invasive at 4 mm

Beesie: Hi! My mom who's in her 70s still seems to have dense tissue and has been told by her breast cancer specialist (bc surgeon who is colleague of my breast surgeon) post genetic testing, that she's got over 20% risk and thus insurance is paying for her breast diagnostics every 6 mo

Interesting what you said about breast cancer returning for those of us who had it around 50 returning in 60/70s. Will see how I do

Have a wonderful weekend!

Breast cancer at age 49. Felt tumor. Wasn’t caught on mammo even after feeling tumor. Ultrasound caught my cancer. Dx 6/2017, IDC, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 7/5/2017 Lumpectomy; Lumpectomy (Left); Lymph node removal
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Mar 27, 2022 06:40AM - edited Mar 27, 2022 06:41AM by jons_girl


Breast cancer at age 49. Felt tumor. Wasn’t caught on mammo even after feeling tumor. Ultrasound caught my cancer. Dx 6/2017, IDC, Left, <1cm, Stage IA, Grade 1, 0/2 nodes, ER+/PR+, HER2- Surgery 7/5/2017 Lumpectomy; Lumpectomy (Left); Lymph node removal
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May 18, 2022 01:12AM k-gobby wrote:

I am grateful my insurance covered all. Grateful. I went to a cancer hospital and at 60 had my first mammogram. Yep, I choose not to have one. I felt the lump, got a mammogram that saw the lump, then an ultrasound to define where it was. The day before the US, they got me a biopsy. Done withe the ultrasound tech nurse. After that, I had a CT.

Last week I had a mammogram on my remaining breast. I have dense tissue, so a US was ordered. I had surgery in Feb. A blood clot formed by early August, so my remaining breast goes when I am better healed. My US said likely benign. My MO needs to read it to me. I do have Brca2. I need this breast gone. No cancer I say! I already had the mastectomy on the other side!!

Chemotherapy 8/14/2021 Other Surgery 2/1/2022 Lymph node removal (Left): Sentinel; Mastectomy (Left): Skin Sparing; Reconstruction (Left): Tissue Expander Targeted Therapy 2/1/2022 Talzenna (talazoparib) Targeted Therapy 2/1/2022 Perjeta (pertuzumab)
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May 18, 2022 01:25PM wondering44 wrote:


It was recommended I do an MRI annually due to dense breasts and breast cancer since I did a unilateral mastectomy. The recommendation came after the cancer dx (wasn't humored). I changed facilities after letdowns. MD Anderson recommended I do 6-month MRIs every 6 months unless I remove my left breast during my next mastectomy for my right breast.

Surgery 8/18/2021 Lymph node removal (Right): Sentinel; Mastectomy (Right): Nipple Sparing Dx DCIS, Right, 1cm, Stage 0, Grade 2, ER+/PR+, HER2- Dx DCIS, Right, 6cm+, Stage 0, Grade 3, ER+/PR+, HER2- Dx IDC, Right, 2cm, Grade 2, ER+/PR+, HER2- Dx IDC, Right, 6cm+, Grade 3, ER+/PR+, HER2- Surgery 8/31/2022 Mastectomy (Left): Skin Sparing; Mastectomy (Right): Skin Sparing

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