Weird Mammogram Report

SpitFire · 09-06-2015, 03:58 PM

I just had my yearly mammogram last week. I had one in 2013, one in 2014, and one last week. The first 2 mammograms and both of my MRIs all said that both breasts were heterogeneously dense, but this last report said I had extremely dense breasts. What was weird was that the technologist told me there had been no change from my prior mammograms and it says unchanged also in my report. A lot of doctors looked at my mammograms and MRIs for the last 2 years, then all of a sudden someone decides to change me to extremely dense. I am just a little confused. Just wanted to share

tricia keegan · 09-07-2015, 11:11 AM

I think each Tech can read into it differently and use different terms but I agree its strange to have the wording come up now, but at least all is clear so that's the good news!

SpitFire · 09-07-2015, 02:20 PM

I am very grateful. I have been upgraded to BIRADS 3 also. I am glad I didn't have to worry for 2 years. I have to go back in 6 months then I should go back to yearly mammograms. She told me I was suppose to be getting a mammogram every 6 months for 2 years after a lumpectomy. I am very grateful everything is fine.

SpitFire · 09-10-2015, 09:23 AM

I'm so grateful I have this information now. No one in my city offers a 3d mammogram. But, I found one place an hour away that offers 3d mammograms. The insurance will pay for the 2d mammogram, then I have to pay $50 extra for the 3d upgrade. I hope the 3d is worth it.

thinkpositive · 09-10-2015, 09:32 AM

Spitfire,

Are you still getting breast MRI's every year? My breast were also very dense and I was told after I had cancer that I should have been getting MRI's yearly after the age of 40 because of this. I'm not familiar at all with 3d mammograms. It could be that this 3d technology addresses the issue of dense breasts.

Take care,
Brenda

SpitFire · 09-10-2015, 10:03 AM

I was told to just get a mammogram once every year, unless there are any changes of course. Last week, I went in for my yearly mammogram as advised to do (they offer 2d digital mammograms). And I was told that baseline recommendation was to get a mammogram every 6 months for two years out from the lumpectomy. I was also told that there was no change in my breasts, but the calcifications that were seen on the all 3 of the mammograms are stable but have always been linear so they need to watch that anyways. It was noted on my report that the calcifications are linear and need to be watched and that they were unchanged from the previous mammograms. So they didn't see that they were linear. Then, on my report, it also mentioned that I had extremely dense breasts. All of my other prior tests say that I had heterogeneously dense breasts. My first MRI just says that I have benign calcifications as do my first two mammograms, my second MRI says there are no calcifications. 3d mammograms are better than 2d mammograms, but may not replace a MRI of ultrasound.

I found this link from someone on this forum, it gives a lot of good information about dense breasts.

http://densebreast-info.org/default.aspx

I have had a rough time with some of my doctors. I get told something new every time I turn around. I am not getting the care I need from my doctors.

jacqueline1102 · 09-10-2015, 04:10 PM

Greetings Spitfire,

Please, please, please advocate to have the 3D mamm at the bare minimum. Back in 2004, I discovered that my BIRADS was a 3 and my breasts were extremely dense. I was never informed. During this time, there was no such thing as the Breast Notification Act which is now law requiring that all women will receive information about their dense breasts. During that time, your PCP would receive the report and the patient would receive the "all is well" report. Much has changed. Year after year, mammograms were not cutting it with my extremely dense breasts. So, when I was diagnosed with breast cancer in 2011 it was a shock; especially after in 2012 I requested all of my records from my PCP. IT was then that I discovered the whole issue with dense breasts. My radiation oncologist even said, "The health care system has failed you, Jackie." I was informed then that women with dense breasts should have an ultrasound and really a Breast MRI. The issue is with insurance. Insurance companies only pay for the following trajectory: Mammogram, Ultrasound, and then Breast MRI.

I refused to have a regular mammogram recently. With Stage IV it was like I really do not need to do these anymore. But with hospitals having the ACO connection, it's all about them getting higher scores and therefore more reimbursment at the end of the year. So, off to the 3D mammogram I went. Research says better but in my opinion try to get that ultrasound-Breast MRI.

I feel passionate about this matter. I have just known too many women with dense breasts where the whole cancer thing was missed. Even after the initial TCH and my right breast was removed, the surgeon removed a 2.5 cm tumor from my chest. Huh!

Good luck to you. And if you have to, use the power of your sign on name; Spitfire, to ensure that your health care needs are being adequately attended to. You can always change providers, hopefully, depending on your insurance situation.

Take care,

Jackie

SpitFire · 09-12-2015, 10:23 AM

Thank you very much Jackie!!!

I just thought that upgrading to a 3d mammogram would be enough. You have made me rethink my plan.

SpitFire · 09-16-2015, 09:32 AM

In theory, if I was 40 yrs old and went for my baseline mammogram and everything was fine and had no other risk factors or history of breast cancer other than having heterogeneously dense breasts, would I still need to be aware and try to get an ultrasound and/or MRI?

Or do the doctors pay attention only when your birads score is 3 or above? If you get a birads score of 2 or lower does that still mean some cancers are still missed?

thinkpositive · 09-16-2015, 12:09 PM

Spitfire,

I was told by my Dr that having dense breast IS a risk factor and that in itself warrants more testing than having MRI's. I'm not at all familiar with the birads scores so I cant comment on that.

Take care,
Brenda

SpitFire · 09-16-2015, 02:20 PM

Wow! No one EVER told me I had dense breasts or asked me about my breast density or anything! I was told to get a yearly mammogram (2D), and call if I had any problems.

Why wouldn't a doctor (especially breast cancer "specialists") talk to their patient about this? Are my breasts just ticking time bombs?

I have more risk factors than just dense breasts.

Thank you all for informing me

caya · 09-17-2015, 07:24 PM

Dense breasted women are 4 - 6 x more likely to get BC. This little fact came out in a study from Princess Margaret Hospital (here in Toronto) in January 2007, a couple of months after my diagnosis. My GP told me she already figured there was a correlation, as she had seen many dense breasted women in her practice get BC - especially pre-menopausal like me (I had just turned 48 at diagnosis). But who knows - I had a clean mammo and ultrasound 3 months before I had the breast reduction when my plastic surgeon found my tumour. Started getting breast MRIs afterwards on my remaining breast. A couple of years ago my density was down so now I only get a mammo.

SpitFire · 09-18-2015, 11:10 AM

There has to be a reason why I was just recommended a yearly mammogram. Maybe it is because I have small boobs?

Does heterogeneously dense still have the same increase in risk as extremely dense?

JessicaV · 09-20-2015, 11:52 AM

Could be just a matter of new research, new guidelines and new standards of care, and some organisations not being as up to date as others.

SpitFire · 09-21-2015, 10:37 AM

Then why do many women get a lumpectomy instead of mastectomy? I thought the outcome was the same.

Juls · 09-21-2015, 11:08 AM

Spitfire
I was told lumpectomy was just as good, unless I wanted to have a mastectomy! But - due to breast size, if they needed to go back in, because of poor margin, it would then be a mastectomy. Mammograms given 3 yearly here (after 50) but in my experience never happen on time - usually late! Like you Spitfire I was not given any info re density. Still haven't been. I think in UK now they have to tell you if breasts dense.

JessicaV · 09-21-2015, 05:24 PM

Two issues here.
First, with a lumpectomy you generally have to have radiotherapy so end up with damaged, non-stretchy skin for any breast reconstruction surgery. Which does not generally apply if you have only a mastectomy.

Second, I learnt that reason the outcome is the same for lumpectomy and for mastectomy is achieved via a step they fail to mention: there are a significant number of lumpectomies (from memory 25-30%)that progress to a recurrence requiring a mastectomy.

What they should say is that there are similar clinical outcomes for
a)those who have a mastectomy and
b)the combined figure of those who have a lumpectomy that progresses to a recurrence and needs a mastectomy plus those who have a lumpectomy that does not progress.

For many of those whose cancers progress after a lumpectomy, there is a deep sense of being on the path to death, hopelessness and despair. In fact, they are no more at risk that the matching 25-30% mastectomy patients who do not have the risk of that experience of recurrence to get to the post-surgery NED base one position. You are offered the possibility that you will retain your breast and not lose it, but at the risk of having to have a recurrence and then probably losing your breast anyway.

SpitFire · 09-22-2015, 07:12 AM

My Breast Surgeon told me that if I had a lumpectomy, I would have a 7% to 8% chance of local recurrence after radiation. My Radiologist Oncologist told me I would have 1% chance of recurrence after radiation. My Breast Surgeon also told me if I had a mastectomy, I would still have to have radiation and would have 1% chance of local recurrence after radiation. Based on the information I had, the lumpectomy was the best choice by far, until I got this new information concerning my mammograms.

Mammogram 1 - Benign scattered calcifications in both breasts
Mammogram 2 - Benign scattered calcifications in both breasts
Mammogram 3 - Left lumpectomy breast has no calcifications and is healthy, Right healthy breast had fine, linear calcifications that were missed on the two prior mammograms, but luckily have been stable for the last two years so I need to go in in 6 months so they can look at it again.

What would they look for in 6 months? Fine and linear are not good, but because it has been stable for 2 years, that means it is "probably benign" I guess.

SpitFire · 09-22-2015, 07:16 AM

Is there not as much increased risk with heterogeneously dense breasts as with extremely dense breasts?

When people refer to their breasts as "dense" does that mean either heterogeneously or extremely?

tricia keegan · 09-22-2015, 11:59 AM

I'm sorry I don't know Spitfire but do remember being told I'd lumpy dense breasts in my twenties when I went to have a suspicious lump checked. I have a friend who had a nine centimetre tumour missed due to dense breasts too, I found the lump myself although was very small breasted as they don't do routine Mammo's here in Ireland until age fifty and I was forty six at the time. I'm glad I chose the lumpectomy though and have no regrets about that and hope someone else can answer your questions.