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Old 07-16-2013, 11:29 AM   #1
linn65
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Location: Attica, IN
Posts: 371
Brain MRI - Should I demand one??

First doctor and first path: Tumor, Grade 2, Her2+++, PR-, ER 30% - that was based on a Core biopsy results. Double masectomy scheduled the following week.

Second opinion doctor - based on the results about. He wanted Chemo then Masectomy.

I had the weekend to decide which path (no pund intended - LOL) to take.

I went with 2nd opinion and family was split. Some said get my breasts off immediately, and others said do chemo and be the human lab to see if it kills the cancer.

I went with TCH chemo first, but before I did these are the scans I received.

Breast MRI, Bone scan, and Cat Scan and everything came back clear accept the Breast MRI of course which first doctor hadn't done and second doctor said that is standard procedure.

After I had the masectomy the path report changed; Grade 3, ER +73% (big difference), PR 2% positive and HER+++, 6 of 8 lymph nodes with extracapsalur present and he said .5 margins meaning clear margins in masectomy?? I think. He said the Chemo was good response because tumors didn't grow and based on tests prior had shrunk some maybe.

So first off with all the scans I had no idea to even think of a Brain MRI until this board because I didn't know that herceptin didn't pass the blood brain barrier.

Now, I wonder if I should PUSH FOR BRAIN MRI because I haven't done one??

They scan everything else prior?? I am not to have any scans now until I would have symptoms of spread which hopefully that won't happen. But they never scanned my brain.

Also, based on my path reports do others on this board think I had good results??? On chemo vs. Masectomy first???
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant

9/2012 Pre-adjunctive TCH chemo.

12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.

12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+

2/27/13 6 weeks of IMRT radiation finished

2/2013 Started on Tamoxifan 5 years.

8/2013 will take last Herceptin, 17 treatments total every 3 weeks.

BRCA1 & BRAC2 - Negative

August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.

3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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Old 07-16-2013, 11:36 AM   #2
tricia keegan
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Re: Brain MRI - Should I demand one??

I can't answer all your queries but I'm sure others will, I have never had a brain mri either although my Onc would do one if I had symptoms or pain, the only extra I had that you didn't mention was a heart Mugga scan to ensure my heart was okay for chemo. I really don't think they do brain scans as standard for early stage bc.
My friend had chemo before surgery too but only to enable her to have a lumpectomy rather than a mast and she had a lot of shrinkage too, sending good wishes to you and hope any other treatments go well.
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 07-16-2013, 11:51 AM   #3
'lizbeth
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Location: Sunny San Diego
Posts: 2,214
Re: Brain MRI - Should I demand one??

Linn,

I wouldn't recommend the brain MRI unless you are experiencing symptoms.

I'm having a breast MRI in a couple days, but only because of symptoms that were similar to the Pagets in the other breast. I almost changed my mind yesterday - because of the chance of a false positive and a biopsy.

The detail on a MRI is so much greater than a mammogram. If you medical team finds anything they are obligated to do a biopsy. Are you ready to have a brain biopsy over a false positive MRI results?

You can't second guess your treatment plan now. You made a decision on the best information and advice available. Turn your focus from the past to the future. Exercise, fresh veggies and fruits, meditation, stress reduction and your Arimidex.

Lani's post said to prevent brain mets eat broccoli and brussell sprouts.

If you start to have headaches, poor balance, blurry vision. Don't wait - run to your oncologist and demand a brain MRI. Otherwise, don't open Pandora's box.
__________________
Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
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Old 07-16-2013, 12:04 PM   #4
linn65
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Posts: 371
Re: Brain MRI - Should I demand one??

Tricia sorry I forgot about the Muga scan, and I had one of those. Then I have had them every 3 months for the year, so I could continue the Herceptin and anything below 50% I couldn't but mine were all above that.

And does everyone call stage 111 early stage breast cancer?? I noticed people with IV do that.

Lizabth, I do like brocolli but uhm those brussel sprouts not so much!! I take tamoxifan now, and I sure hope that isn't the culprit for my side effects that I have, and I am blaming it all on the Herceptin. Sunday night my feet, knees, hands, and hips all ached, so I tossed and turned all night. Then Monday was the first time I haven't made it too work after Herceptin treatment, and I slept until Noon, woke up, and fell back asleep at 1:30 and woke up at 5:00 and then had a weird, itchy rash on my right arm!! I thought CRAP I am almost 48 (in sept), and I feel like I am 90 somedays. It feels like I have arthritis sometimes. Anyway, the pain is much better today, so hopefully it will stay that way until next treatment on July 30th.
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant

9/2012 Pre-adjunctive TCH chemo.

12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.

12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+

2/27/13 6 weeks of IMRT radiation finished

2/2013 Started on Tamoxifan 5 years.

8/2013 will take last Herceptin, 17 treatments total every 3 weeks.

BRCA1 & BRAC2 - Negative

August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.

3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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Old 07-16-2013, 12:07 PM   #5
linn65
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Location: Attica, IN
Posts: 371
Re: Brain MRI - Should I demand one??

I do wonder could the tumor in 3 months go from Grade 2 to Grade 3?? And could it go from ER 30% to ER 73%??

The only reason I am for sure happy that I did Chemo first is because it sucked so got that over with first!! LOL.

I am ready for October 24th and have my first out of three reconstructive surgeries done.
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant

9/2012 Pre-adjunctive TCH chemo.

12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.

12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+

2/27/13 6 weeks of IMRT radiation finished

2/2013 Started on Tamoxifan 5 years.

8/2013 will take last Herceptin, 17 treatments total every 3 weeks.

BRCA1 & BRAC2 - Negative

August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.

3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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Old 07-16-2013, 12:44 PM   #6
LeahM
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Location: Bethlehem PA
Posts: 395
Re: Brain MRI - Should I demand one??

Linn,
I had a very hard time accepting the "no scan" thing too. I even moaned and groaned about it here on this board...I was told the same things you are being told...don't go looking for trouble.

I did have a brain scan during chemo but that was because I woke up one day with blurry vision....my onc thought it was the chemo but scanned anyway. Scan was fine, chemo ended, blurry vision ended...

In Feb I had shortness of breath so off to another scan. Something was seen but it was small so rescan in 3 months. I did that and guess what! What they originally saw was GONE but now they see something NEW...good grief...scan again in 3 months. So I will (sept) but then I am closing this can of worms I opened....

Here is how I look at things now...and my onc (who offered me a PET scan after I finished Vit. H, which I said "no" too ) agrees...in the future...if something doesn't feel right inside me, we will rule out cancer first.

I know it scary...I feel like that guy who walked over the Grand Canyon without a safety net....and I did agree to tumor markers being drawn...but I had to take the advice of these smart women here and move on..
__________________
39 year old wife, mother of one and nurse.
April 20, 2012: Dx Invasive Ductal Carcinoma
April 25, 2012: ER+(5%), PR-, HER2+++
May 10, 2012: BRCA 1,2 Negative
May 23, 2012: MUGA Scan EF 70%
May 31, 2012: B/L Mastectomy. 2/2 nodes removed and CLEAR!! Power Port placed. 2 Drains. 2 Expanders placed
June 5, 2012: Drains OUT! Ahhhh..
June 12, 2012: Final Pathology Report, .8x.3cm tumor. Micromets to 1 node .35mm under cytokeratin staining. Stage 2A. Onc says "you are lucky to have found this early"
July 10, 2012: Started 6 rounds of TCH with weekly H
Sept 5, 2012: MUGA 65%
Sept 20, 2012: CAT scan of brain clear!
Oct 23, 2012: LAST TC! AMEN! Continue Herceptin every three weeks until July 2013.
Nov 19, 2012: Port out!
Dec 5, 2012: Started radiation
Dec. 10, 2012: MUGA 65%
Dec. 13, 2012: Turned 40. BEST BIRTHDAY EVER!
Jan 23, 2013: Last radiation. Told I am NED. Continue Herceptin every three weeks till July 2013.
Jan 29, 2013: Begin 5 years of Tamoxifen.
Feb 28, 2013: CT Scan with Contrast of lungs. 5mm and 4mm nodules of unknown origin. Rescan in 3 months.
Mar 6, 2013: EF 60%
May 8, 2013: Exanders out, implants implanted...abd. lipo and fat moved up. Girls are looking good!
June 3, 2013: CT Scan with Contrast of lungs. Previous nodules gone. New nodules (2mm and 3mm) found. Rescan in 3 months. So sorry I opened this can of worms...
June 11, 2013: EF 60%
June 25, 2013: Last Herceptin. wow...
Aug 20, 2013: Tumor markers within normal limits. Xray to sore left ribs shows no disease or fractures.
Sept 9, 2013: CT of lungs shows no disease. Closing this can of worms and moving on.
Nov 20, 2013: Tumor markers within normal limits. Severe Vit D deficiency, started on prescription Vit. D. Blaming chemo for this.
Feb 2014: Tumor markers within normal limits.
May 2014: Tumor markers within normal limits. Graduated to twice yearly onc appts.
Oct 2014: Tumor markers within normal limits.
May 2015: Tumor markers WNL. Bone density scan fine. Bone scan and xray of ribs shows "something" 4th right rib. Could be healed fracture but if it is healed why does it hurt?
Nov 2015: Tumor markers WNL. Follow up bone scan clear.
Feb 2016: Syncope! WTF? Dizzy too. Brain scan clear, ECHO EF 60%, Halter Monitor shows heart is fine. Viral? I will never know.
June 2016: Tumor markers WNL.
Oct 2016: Stabbing pain right eye. Long story short, trigeminal neuralgia.
Nov 2016 Brain MRI clear.
Jan 2017: Tumor markers WNL, still getting weird pain right rib area, and sometimes right upper chest. Xray x2, Bone Scan, Breast MRI all clear. Scar tissue? Rads. I may never know.
www.onmywaytosurvivorhood.blogspot.com
www.thechemobag.com
www.facebook.com/thechemobag
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Old 07-16-2013, 12:58 PM   #7
linn65
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Join Date: Dec 2012
Location: Attica, IN
Posts: 371
Re: Brain MRI - Should I demand one??

I understand now why "No" scans it makes sense. I would be afraid to scan me now after all this poison they put in my body to kill the poisin. However, the Brain scan had me perplexed whether people did one or did not do one.
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant

9/2012 Pre-adjunctive TCH chemo.

12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.

12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+

2/27/13 6 weeks of IMRT radiation finished

2/2013 Started on Tamoxifan 5 years.

8/2013 will take last Herceptin, 17 treatments total every 3 weeks.

BRCA1 & BRAC2 - Negative

August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.

3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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