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marigold
07-27-2013, 08:52 AM
Hi, I am 5 years NED and my oncologist has suggested I have a breast MRI with contrast. I have heard there are many false positive results and, therefore, much anguish. Any thoughts or suggestions?

'lizbeth
07-27-2013, 10:55 AM
I am waiting for the results of my breast MRI. I am just over 5 years NED.

Yes, the big argument by the surgical staff against my MRI was the large incidence of false positives, their number 20%. This number being generated by the specificity of the MRI as compared to mammograms or ultrasound. MRIs pick up every little detail.

My argument for the MRI was the larger risk of false negatives 22% - 50% based on a study that I can email to you if have a history of Paget's Disease of the Breast.

My request for an MRI was based my personal history of Paget's, with 2 lesions of breast cancer that were only discovered on a subsequent MRI during my initial diagnosis in 2007.

I have dense breasts. I also have had a similar inflammation of the nipple areola complex, ability to express fluid of various colors from the nipple and tiny flakes or crusting.

I wanted the peace of mind from an MRI that would show the mammograms are not producing a false negative, again.

Your doctor must have expressed some reasons behind the recommendation of an MRI. If you can share some of your history, and these reasons we can help you explore why this could be a good option for you.

My feelings about a false positive is yes, there is some anguish about worrying of another recurrence. But I'd rather face a false positive than the repercussions of a false negative on the mammogram.

'lizbeth
07-27-2013, 11:00 AM
I found this posting on cancerfocus.net

Women with personal history of breast cancer should be screened with MRI

CHICAGO – Women with a personal history of breast cancer should consider annual screening with MRI in addition to mammography, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

The American Cancer Society (ACS) guidelines currently recommend annual screening with breast MRI in women with a known gene mutation or with a strong family history indicating a lifetime risk of breast cancer greater than 20 percent. However, the guidelines say there is insufficient evidence to recommend for or against MRI screening in women who have already had breast cancer themselves.

"In our study using breast MRI screening, we actually detected proportionally more cancers in women with a personal history of breast cancer, compared with those women with a genetic mutation or strong family history who are currently recommended to have breast MRI," said Wendy B. DeMartini, M.D., assistant professor in the Department of Radiology at the University of Washington Medical Center and Seattle Cancer Care Alliance in Seattle. "Further, women with a personal history were less likely to be recalled for additional testing and less likely to have a biopsy for a false positive MRI finding."

Dr. DeMartini and colleagues performed a retrospective review of initial screening breast MRI examinations of 1,026 women from January 2004 to June 2009. Of the 1,026 women, 327 had a genetic or family history of breast cancer and 646 had a personal history of treated breast cancer.

Overall, MRI testing identified 25 of 27 cancers in the group for a sensitivity rate of 92.6 percent.

The cancer yield in the women with a personal history of breast cancer (3.1 percent) was double that of the women with a genetic or family history (1.5 percent). Specificity in women with a personal history was 93.6 percent, compared with 86.3 percent for the other group. Specificity refers to the accuracy of the exam in correctly ruling out cancer where it is not present, resulting in lower recall and biopsy rates due to false-positive findings.

Biopsy was recommended in 9.3 percent of the women with a personal history of breast cancer, compared with 15 percent of the genetic and family history group. The positive predictive value of biopsy was also higher in the personal history group, with 35.7 percent of biopsies yielding cancer, compared with only 12.2 percent in the other group.

"Our findings show that the diagnostic performance of MRI in patients with a personal history of treated breast cancer supports consideration of screening MRI as an adjunct to mammography," Dr. DeMartini said. "Additional studies such as ours are necessary to establish guidelines for screening this important group of women."

marigold
07-27-2013, 11:19 AM
Thanks for all the information, it certainly does cause me to consider doing this.

'lizbeth
07-27-2013, 11:25 AM
If you have a history of BRCA in the family, a personal history of Pagets Disease of the breast or dense breasts, or any symptoms of breast cancer it could be helpful.

It helps me to go and research an idea and get back to my doctor when I have a better understanding.

marigold
07-27-2013, 12:06 PM
I have never been tested for BRCA. I do have dense breasts. Both of my Aunts and a Great Grandmother had Breast Cancer.

'lizbeth
07-27-2013, 12:16 PM
If you haven't been tested for BRCA and you have a history of breast cancer in the family, the MRI your doctor suggested is a good idea. And another good reason is with the dense breasts.

Now the surgeons are obligated to check out anything they find, which would mean a biopsy, even with a false positive.

The actual breast MRI is not that bad, staying still for about 30 minutes, and the loud banging noise of the MRI equipment is the worst of it.

With the contrast, you might have a blood draw before the MRI to check the function of your kidneys to ensure the ability to eliminate the contrast.

marigold
07-27-2013, 03:13 PM
Once again, thank you for all the great input/advice. I really appreciate it. Good luck on your results...I'll be watching to see if you post them.

dooori
04-08-2015, 01:02 AM
Your doctor must have expressed some reasons behind the recommendation of an MRI. If you can share some of your history, and these reasons we can help you explore why this could be a good option for you?

Dakini52
04-25-2015, 08:54 PM
'lisbeth, I have a question. I know you have participated in a vaccine trial and wanted your thoughts. I have the potential opportunity to participate in this trial: http://www.cancer.gov/clinicaltrials/search/view?cdrid=730526&version=healthprofessional. Are you familiar with this trial and if so could you give me your thoughts. Thanks.

Catia
04-26-2015, 02:02 PM
Debbie,
I think you can't be HER2 overexpressing (3+). This study is aiming at lower expressers like Her2 1+ or 2+,...not amplified. I tried to get into this one and that's what I was told back then and I ended up entering a different trial.