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Topic: Anyone have something show up on MRI that mammo missed?

Forum: DCIS (Ductal Carcinoma In Situ) — Just diagnosed, in treatment, or finished treatment for DCIS.

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Posted on: Jan 28, 2020 10:08PM - edited Jan 28, 2020 10:08PM by Khakitag

Khakitag wrote:

Hi everyone,

I started this journey just before thanksgiving, and this last week was handed my Dx of DCIS 6mm, intermediate grade, clear margins with lumpectomy. Waiting for ER/PR status. Pretty sure I'm comfortable with doing nothing but surveillance. I'm 48, and perimenopausal. Mom had stage IV breast ca at age 40 but my genetic tests came back negative. My question, after all that, is did anyone have an MRI that showed Anything the mammo missed? That's the only thing I'd feel more comfortable having before I sit on this. I've been reading that MRI Catches DCIS that mammo misses. I have an axillary lump on the opposite breast and wonder if the mammo missed something on that side.

Shari taglavore Surgery 1/4/2020 Lumpectomy: Left Dx 1/14/2020, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+
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Jan 29, 2020 01:54AM Veeder14 wrote:

yes, had mammograms yearly and no tumors showed up. Due to being BRAC2 it was suggested I get an mri to check and it found a tumor ILC. Tumor didn’t show up on ultrasound either. I don’t trust mammograms anymore.

Dx 1/2/2018, ILC, Left, <1cm, Stage IB, Grade 1, 0/7 nodes, ER+/PR+, HER2- Surgery 1/25/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 3/7/2018 Hormonal Therapy 2/28/2019 Hormonal Therapy
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Jan 29, 2020 03:33AM Rah2464 wrote:

Yes, I had dense breast tissue. My tumor was not detected by Mammography or Ultrasound. Thank goodness my BS ordered an MRI. Given your family history and your personal history, I would want MRI baseline at the minimum.

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/27/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/27/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jan 29, 2020 04:08AM lifeb4me wrote:

Yes, I have had the routine follow up mammon’s and everything was clear. As I ch as need doctors this year she asked for a bone scan, an mri, and a thoracic and abdominal ct, just to have a baseline. The mri found a big lump on one of my rotter nodes which turned out to be a recurrence. It is out of the mammo field. Lucky it was found before stage IV.

Dx 8/29/2016, IDC, Left, 6cm+, Stage IIIA, Grade 3, 0/6 nodes, ER-/PR-, HER2+ (FISH) Chemotherapy 9/16/2016 AC + T (Taxol) Targeted Therapy 12/6/2016 Herceptin (trastuzumab) Targeted Therapy 12/6/2016 Perjeta (pertuzumab) Surgery 3/8/2017 Lumpectomy: Left; Lymph node removal: Sentinel Dx 12/5/2019, IDC, Left, 5cm, Stage IIIA, Grade 3, ER-/PR-, HER2- (IHC) Chemotherapy 12/17/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 3DCRT: Breast, Chest wall Chemotherapy Chemotherapy Xeloda (capecitabine) Chemotherapy
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Jan 29, 2020 04:41AM Beesie wrote:

Yup, my mammo had picked up two areas of calcifications that turned out to be DCIS and a microinvasion of IDC. After my surgical biopsy, which removed both those areas (but with involved margins), I had an MRI. The MRI showed a lot more high grade DCIS.

When you say you are considering doing nothing but surveillance, does that mean passing on rads and, if hormone positive, endocrine therapy? That may not be unreasonable with a small non-high grade DCIS with clear margins, but I would advise that you have an MRI before you make that decision. Also consider that if you are hormone positive, endocrine therapy will not only reduce your risk of recurrence, but will reduce your risk to develop a new primary breast cancer in either breast. Talk to your oncologist about this risk. With your mother having been diagnosed so young and now with your own diagnosis, your risk to develop a new primary will be significantly higher than the risk of the average woman.

And did you have full panel genetic testing or just BRCA?

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Jan 29, 2020 06:46AM SummerAngel wrote:

Yes. The multifocal tumor in my right breast was not visible on a mammogram (I had extremely dense tissue). It was found by MRI.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Jan 29, 2020 06:53AM dtad wrote:

Yes, MRI picked up a ILC tumor that the mammo and ultrasound missed. Its the best screening tool for dense breasts. I would definitely ask for a MRI. Especially since you are young and because of your moms history. Good luck and keep us posted.

Dx 3/20/2015, IDC, Left, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Dx 4/10/2015, ILC, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 5/21/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jan 29, 2020 06:58AM - edited Jan 29, 2020 07:00AM by April0315

yes, mammo and US missed IDC in my right breast entirely. MRI picked that up.

All scans and biopsies missed the ILC in my left. Those were only found after surgical biopsies.

Dx 2/28/2019, IDC/IDC: Papillary, Right, Stage IB, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 4/12/2019 Lumpectomy: Left, Right Dx 4/18/2019, ILC, Left, 2cm, Stage IB, Grade 3, 0/1 nodes, ER+/PR+, HER2- Chemotherapy 5/12/2019 AC + T (Taxol) Hormonal Therapy 10/15/2019 Femara (letrozole) Surgery 11/15/2019 Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right)
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Jan 29, 2020 07:15AM Yogatyme wrote:

I had a fibroadenoma in one breast and small tumor in the other and neither showed up on mammogram (even a week before breast surgery) but both showed up on my first MRI. I am BRCA1+ so was doing close monitoring of breast health. I agree with those who have encouraged you to get an MRI given your moms hx.

Yogatyme Surgery 3/3/2019 Prophylactic ovary removal Dx 7/19/2019, IDC: Papillary, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/13/2019 Mastectomy: Left, Right
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Jan 29, 2020 08:38AM Khakitag wrote:

I’m so fearful of SE of tamoxifen. I have uterine polyps and had a uterine ablation in Dec for abnormal bleeding. Fearful of the increased uterine ca risk with tamoxifen. Yes, I had the full genetic screening panel. I had one VUS but it was a gene my doctor wasn’t familiar with. After my lumpectomy incision heals, I will ask for the MRI. I’ll feel much better if that’s all clear. I have extremely dense breasts and just have a feeling that something is being missed.

Shari taglavore Surgery 1/4/2020 Lumpectomy: Left Dx 1/14/2020, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+
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Jan 29, 2020 12:11PM MinusTwo wrote:

Actually Khakitag - you didn't mention an ultrasound. Those are usually done after the mammo & often pick up things the mammo doesn't see. But yes - you should definitely request an MRI, even if you have an ULS that doesn't show problems.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 29, 2020 12:36PM Khakitag wrote:

I did have an US Inbetween my screening and Dx mammo. It didn’t show anything. I think I’d rather skip straight to the definitive test so I can rest easy finally, after two months of waiting.

Shari taglavore Surgery 1/4/2020 Lumpectomy: Left Dx 1/14/2020, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+
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Jan 29, 2020 12:45PM MinusTwo wrote:

Good plan. Hope your insurance agrees. Let us know.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 29, 2020 01:15PM ctmbsikia wrote:

I agree it's good to have MRI if for nothing more than a baseline for you. Hope all is well and clear now.

Dx 12/14/2017, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Dx 1/16/2018, LCIS, Right Surgery 1/30/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 4/10/2018 Whole-breast: Breast Hormonal Therapy 6/25/2018 Arimidex (anastrozole)
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Jan 29, 2020 06:54PM Falconer wrote:

yes

Strong is the new strong. Dx at 45. Onco 16. Monthly Lupron shots Nov. 2016-December 2017 Dx 7/2016, IDC, Left, 1cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 7/2016, DCIS, Left, 5cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2- Surgery 5/30/2017 Reconstruction (left): DIEP flap Surgery Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jan 29, 2020 07:12PM FarAwayToo wrote:

Yes. I had a lump in my right breast, had mammo, US, biopsy and it was confirmed to be IDC (or maybe ILC, we actually don't know for sure).

Right before starting treatment, I had an MRI that found DCIS in my left breast. I had biopsy (MRI guided, since mammo didn't see anything in my left breast). Moreover, I had multifocal DCIS - two regions in the left breast. Both Grade 1, so not aggressive, but, if left untreated, they would probably progress to invasive cancer eventually (considering I was 40 at DX). I'm glad I had the MRI. This guided my decision to have BMX.

Dx 8/31/2017, IDC, Right, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Dx 9/15/2017, DCIS, Left, 3cm, Stage 0, Grade 1, 0/3 nodes, ER+/PR+, HER2- Chemotherapy 9/29/2017 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxol (paclitaxel) Hormonal Therapy 2/23/2018 Zoladex (goserelin) Surgery 2/28/2018 Mastectomy: Left, Right Surgery 2/28/2018 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 4/5/2018 Femara (letrozole) Surgery 8/21/2018 Prophylactic ovary removal; Reconstruction (left): Saline implant; Reconstruction (right): Saline implant
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Jan 29, 2020 07:16PM Khakitag wrote:

this is my fear, that something is lurking in my right breast that mammo didn’t catch. Thanks for the info.

Shari taglavore Surgery 1/4/2020 Lumpectomy: Left Dx 1/14/2020, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+
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Jan 29, 2020 07:20PM UpstateNYer wrote:

yes, like summerangel, I also had a smaller tumor of 7mm detected by MRI not seen on mammogram or us. It was 6mm away from the 13mm tumor that was found on my mammogram. Hoping your insurance will pay for the MRI. Best of luck to you.

Into every life a little rain must fall Dx 2/6/2019, DCIS/IDC, Right, 1cm, Stage IA, Grade 3, 0/1 nodes, ER+/PR+, HER2- (FISH) Dx 2/8/2019, IDC, Right, <1cm, Stage IA, Grade 3, ER+/PR-, HER2- (FISH) Surgery 3/20/2019 Lumpectomy: Right Surgery 4/2/2019 Lumpectomy: Right Chemotherapy 5/7/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 8/6/2019 Lumpectomy Hormonal Therapy 9/5/2019 Arimidex (anastrozole) Radiation Therapy 9/10/2019
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Jan 29, 2020 07:51PM voraciousreader wrote:

first off..i had palpable mass that mammography missed for three years. Sonogram saw it but it was misidentified as a cyst. Finally, astute radiologist said, “That sucker on sonogram looks like cancer, let’s biopsy it.” And...the rest is history. Sent for baseline MRI and a “drop” of DCIS was found. So yes, MRI picks up more things especially if you have dense breasts.


uterine polyps? I had a gazillion of them. Lost track of the number of D&Cs that I had. Used to joke that I got more D&Cs for uterine polyps than teeth cleanings...was tearing my hair out! Was contemplating a hysterectomy which thankfully the doctors talked me out of. Did 3 years of Tamoxifen and ovarian suppression. Still got the polyps after I started doing an AI. Finally, polyps quieted down. The one thing that my gyno was concerned about was uterine thickening and an ablation fixed that problem. I would strongly recommend a baseline trans vaginal ultrasound and then discuss ovarian suppression and an AI based on the SOFT and TEXT trials...that said, as long as your team has a uterus surveillance protocal, Tamoxifen is also doable.

Any doubts, have your case presented to a tumor board and let them advise you. The fact your mom had a stage iv breast cancer diagnosis at a young age requires that no stone go unturned. Genetic testing, imaging, and opinions from many specialists is key to your future care.


good luck

Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 02/2010 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% /PR+ 70% HER2- (+1)
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Jan 29, 2020 09:16PM ps0705 wrote:

My story is not typical but I had grade 3 DCIS, ER/PR-, 1.5 cm which did NOT show on MRI. It was seen on mammogram. I was floored that it didn't show on mammogram but that was clear. Did a bilateral mastectomy and now, 2 years and 1 month later looks like a recurrence. I have 2 areas scheduled for biopsy in the same breast. I've followed every recommendation and even exercise 4-5 times a week. Do what you can to advocate for your health.

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Jan 29, 2020 09:25PM Khakitag wrote:

so sorry. What a stinker, to have a recurrence after BMX. Hopefully it just a scare. I’m alittle confused about your post. The MRI found it, or the Mammo?

Shari taglavore Surgery 1/4/2020 Lumpectomy: Left Dx 1/14/2020, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+
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Jan 29, 2020 09:36PM ps0705 wrote:

The mammogram found the original DCIS (1.5 cm) but it didn't show on MRI.

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Jun 21, 2020 03:15PM Momgr5 wrote:

I had DCIS stage 0 grade 3. left breast. Had surgery in January with lumpectomy followed by radiation and now on tamoxifen. I was told if they had not done a 3D mammogram they would not have detected it. There was no mass with monthly checks nor my yearly Dr. appointment. Many insurance companies will not pay for 3D which is crazy. I have told all my friends to pay the extra money to have the 3D if insurance refuses to cover.

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Jun 24, 2020 11:40AM - edited Jun 24, 2020 12:10PM by Tmh0921

At my first diagnosis, mammogram didn't pick up my tumor (even though it was palpable) but ultrasound did. I had dense breast tissue.

In 2018, a mammogram and US found what was determined by core needle and excisional biopsies to be DCIS, however, I really feel that they missed IDC deeper in my breast - in 2019 3D mammogram, US, and MRI identified what was thought to be a 1.9 cm tumor, but ended up being a 3.2cm IDC and 2.4cm of DCIS.

I don’t think any imaging is perfect unfortunately

First Dx at 27 years old in 1999, 2nd Dx 2018, 3rd Dx 2019... Current Oncotype: 26 Dx 12/7/1999, IDC, Left, 1cm, Stage IB, Grade 2, 0/15 nodes, ER+/PR+ Surgery 12/22/1999 Lumpectomy: Left; Lymph node removal: Left, Sentinel, Underarm/Axillary Radiation Therapy 1/31/2000 Whole-breast: Breast, Lymph nodes Hormonal Therapy 2/1/2000 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 8/24/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 9/5/2018 Lumpectomy: Left Dx 9/7/2018, DCIS, Left, <1cm, Stage 0, Grade 1 Dx 5/31/2019, IDC, Left, 3cm, Stage IIA, Grade 3, 0/2 nodes, ER+/PR+, HER2- (IHC) Surgery 8/5/2019 Lymph node removal: Left; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Latissimus dorsi flap, Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 9/4/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/2/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin) Hormonal Therapy 3/24/2020 Femara (letrozole), Zoladex (goserelin) Surgery 7/16/2020 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jun 24, 2020 12:18PM janeheg wrote:

I had a double mastectomy and reconstruction on June 8, 2020. A small spot showed up on the left side on a mammogram and ultrasound. An MRI showed the spot to actually be 5 times larger than the previous tests and it also showed 5 spots on the right side that did not appear on anything earlier!! Thank goodness for that MRI. 6 biopsies later they determined that I had all kinds of abnormal cells in both breasts so I opted for the mastectomies. The pathology report after surgery showed that I actually had malignant cells on both sides already. I am 100% cured. HAVE THE MRI!

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Jun 24, 2020 04:03PM MinusTwo wrote:

Jane - there is no 100% cured. But I'm glad to hear that you are NED (no evidence of disease)

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014

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