Mammogram vs MRI

[G. Ann]

Hi Tousled1,I have had many cysts in both breasts for over 10 years. I always had them drained at the next doctor visit if I had appt scheduled or made a new appt. In 2003 the OB/GYN suggested doing the mammo first rather than draining lump during my office visit, which was a different strategy. When I received the mammo results in the mail, it said "normal," I let too much time elapse, six months, before going back in to have lump drained... just got complacent and thought "it's just a cyst, like always." About three months after the 2003 mammo, I started to experience pain. I stupidly thought I remembered reading that cancerous tumors did not cause pain, only cysts, so wasn't worried, plus no BC in my family history, and besides my past experiences showed it was always a cyst/cysts. Also, my son was having his wedding, my father was in a nursing home and I needed to visit him 2000 miles away, Christmas was around the corner, etc. and I just dragged my feet. Believe me, I beat myself up for over a year after diagnosis. My friends reminded me that I was always good about going to check lumps out. If I ever hear of anyone delaying action, I warn them of risks because you never know. Any and every lump should be examined and in my opinion not just with a mammo.

Before BC in 2004, an ultrasound was never used, just the FNA once lump felt. Four months after chemo stopped, I had ultrasound done for one lump that I could feel on remaining breast--it showed three new cysts plus the one I felt and all were eventually drained, but it took several months, and lots of crazy making time. Last mammo in 1/06 showed "loosely clustered microcalcifications," and recommendation was to "wait and watch" for 6 mos (so easy for radiologist to say) as they are "probably benign," then do another digital mammo, which will happen in July. I did feel another lump 3/06, went to surgeon, and it was biopsied showing no evidence of cancer, but I still have the lump and it's hard not to worry that microcalcifications are getting tightly clustered, meaning BC again. The above is the reason why I have been pushing for MRI.

So my new plan is to get the remaining breast removed this fall since HMO will not perform the MRI. The surgeon agreed he would do it although doesn't think it is medically necessary at this time. Sorry to be so lengthy, but my frustration level gets me going.
G.Ann

[mekasan]

I believe the difference between the diagnositic mammo vs the screening mammo is not the process, but rather the purpose. It is an insurance billing coding thing. If the doctor feels that there might be a problem, the laws say the insurance companies must cover certain tests. I think the extra ultrasound was just a backup diagnostic tool. I had both done when they were looking for my cancer. And then an MRI.

I know that when digital mammo came out, they were permitted for diagnostic mammos, but not used for screening mammos. I believe this was because there were not that many machines available and someone with power felt they should be reserved for the most serious cases.

Now these are just my middle of the night thoughts, so anyone, please correct me where I am misinformed.

Thanks

[tousled1]

GAnn,

Thanks for your reply. I too had cysts drained before my diagnosis. Have been dealing with fibrocystic disease all my life. When I found my last lump I knew in my heart that it was breast cancer -- it was hard and wouldn't move around. Didn't feel like all the other lumps I'd had. I delayed going to the doc -- was just recovering from major back surgery, applying for disability retirement and social security and last but not least, moving. I wonder sometimes if I had gone to doc as soon as I found the lump if things would be different now, but then I realize we should never second guess ourselves. Breast cancer is a terrible disease and I've adopted the attitude "one day at a time." I wish you all the best.

[MCS]

This is such a timely question for me also.

I'm due for my first mammo after dx. I was told by my ob/gyn and onc that the mri is more sensitive so I definitely will ask for it- I don't think my insurance covers it, just mammos.

HOWEVER, I also have fought fibrocystic breasts all my life, have dense breasts and have had benign and malignant calcifications. I have scar tissue from previous cysts removed and have had cysts drained as well.

Maria ( mts), THANK YOU-has indicated the calcifications information; that mammos are better for this. Do you remember where you saw this information? I want to bring it up to the docs.

I want to be able to see as much as possible, as little as they come and as soon as able.

I think I will call the radiologist that did my mammo last year ask for his opinion.

Thank you for reference to article, I am also going to print it

XO

Maria (MCS)

[AlaskaAngel]

As mts said, mammograms pick up calcifications. Ultrasounds and MRI's do not. Screening mammos are the basic pictures of each side, and diagnostic mammos are the views that are done if they think there is something questionable in the basic pictures that were taken in a particular area and they want a closeup of that, etc.

[mts]

Below is some helpful info re: calcifications and MRI vs Mammo. At that same site, you can look-up mammos and do some comparisons.



http://www.breastcancer.org/testing_mri.html


MTS