[Hopeful]

At my last follow-up visit, my surgeon said her practice was going to start ordering breast MRI's on all patients who have had lumpectomies. I was then told I would have to first go for a preliminary test, to see if the dye used in the MRI would damage my kidneys. Since I still see my rads onc for follow-up (I am in a clinical trial comparing partial breast irradiation to standard radiation therapy), I asked her opinion on it when I saw her.

She told me that this is very controversial still; that conferences of radiation oncologists devote entire days to seminars on how to follow up bc patients. She told me in her opinion, my chance of having a local recurrence or a new cancer in the unaffected breast was 5% lower than the false positive rate for breast MRI's, and that I should decline this screening.

This report says that the high false positive rate associated with the initial screening goes down upon repeated screenings. However, if you have had a lumpectomy and rads and the initial false positive is to the treated breast, there are healing issues associated with having biopsy surgery performed on the irradiated breast.

I asked my rads onc about insurance coverage for this test, and here is the rub: she said that for women with dense breasts who have never had bc but want to have breast MRI, insurance will likely not pay for it. However, if you have had a lumpectomy already and your doctor writes the rx for the breast MRI to "follow up scar tissue," insurance will likely pay for it. So, the people who would most benefit from the test in having their initial bc dx early and who would not have compromised healing following a false-positive biopsy will likely be the people who will not have insurance coverage for the test.

Hopeful