MRI and Herceptin - Question

[weezie1053]

Last summer when I was diagnosed with the BC in the right breast, they performed a MRI. This spring I had a mammogram of the left breast. I saw a genetic counselor in May, and she dx me as "high risk" for recurrence even though my BRCA tests were negative. (Grandmother had BC and Melanoma; brother had prostrate, etc.). As a result, the genetic counselor and my surgical oncologist recommends more aggressive screening including MRI's. The Surgical Onc, however, advised I should have the MRI after I complete the Herceptin in the fall so they have a clear reading. Why would Herceptin affect the outcome of a MRI? Biology was my worst grade in high school, and now I wish I was a better student because my learning curve is pretty crooked still.

Louise

[suzan w]

I would think it would be good to get an MRI now and then one after Herceptin, to compare? Perhaps they think that an MRI now might show something that Herceptin will zap??? I WAS a bio major, but chemo brain is the great equalizer!!!

[Lani]

on your MRI now it wouldn't mean that once you stop herceptin (which might be preventing then from waking up from a "dormant"phase) they suddenly begin to grow. That is an oversimplification as noone is sure of the real mechanism(s) of action of herceptin that result in its overall effect and if it cytostatic (stops tumors growing while on it) or cytotoxic (kills tumors, perhaps indirectly by making the immune system kill them or directly by other means) or a combine of several of these.

Also there are postoperative changes that decrease with time after a surgery. Those who do and read MRIs all the time seem to know how to tell the appearance of those from the appearance of recurrent tumor, but not all radioligists are equally experienced/skillful at reading. The longer you wait since surgery in that case, the less chance what they are seeing is post-operative change. Also, insurance companies fight getting MRIs too often, so they probably want you to get one AT THE TIME THAT it is most likely to be meaningful ( at a time when it is less likely to show things they don't know how to interpret and maybe just postop change, and most likely to be able to show any recurrence which might need a change in plans ie, after herceptin is stopped etc) That assumes you are one of the people in whom herceptin is working and that you have not become resistant to it.

A more sensitive test, and one which might show that earlier may end up to be either serum her2ECD or Circulating Tumor cells, but they are only considered helpful in the metastatic setting and large clinical trials have not yet been cone/completed to verify whether they can do the same thing in early breast cancer. Would be nice if they did--as they measure the tumor burden (content) of the WHOLE body and can be done economically much more often that an MRI, taking a lot less time, not requiring injection of dye, and have not been shown to normally be present after surgery and decrease with time (like post operative MRI changes) clouding interpretation of findings.

[Patb]

Do you have a port in. That is the reason they want me to wait unitl
I have my port out in November. Something about an artifact would
show and the MRI would not be clear?
patb

[weezie1053]

Yes, I have a port. In fact, I have a double port. Had not thought of that. Thank you all.

Louise

[Bev]

We had a thread going a few weeks ago. Many of us have had MRIs with ports. If an artifact shows up near your port site you can rightly or wrongly conclude it's your port. That still leaves plenty of geography to look at.

I'm on the May mammo and Nov MRI plan, irregardless of H or other drugs. I have not seen anything that says you can't do it on H.

I'm just doing what my docs reccomend. I am happy when they tell me my latest scan looks great. I think they'll lighten my schedule if I stay good for 5 years. I plan on staying good. Bev