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Tuesday, September 22, 2009 ann51 asks

Q: are MRI with contrast almost always sensitive enough to trust interpretation?

51 y.o.- i am trying to consider R mastectomy. Just had L mastectomy. I had augmentation in 1990 and regular mammograms and even some diagnostics over the past 19 years- all negative. I detected a small "frozen pea" thing on my right breast at the sternum, felt almost in the bone . U/S discovered another flatter tumor just above it. I had left mastectomy done 9/3/09 after the open biopsy  showed tumor #1) IDC grade II 1.1 cm (with in situ part 1.3 cm intermediate grade w necrosis); tumor #2) IDC grade I  .95 cm (with in situ 1.9 intermediate grade w necrosis), sentinel nodes neg; Ki-67 >30% Er + PR+ Her2 1+ (but I guess that is neg)  BUT the  Bilateral MRI with contrast day before R mastectomy said no other lesions on R and L was clear. BUT R breast came back with 2 more sites: tumor #3) .8 cm IDC with lobular features; other site DCIS - these NOT SEEN ON MRI prior to surgery. I can feel lump now in L breast way upper outer quad 1:00 pos. U/S rad said he could feel it too, couldn't really see it on U/S but-said trust MRI.  no info on #3 tumor  from mastectomy since it was not ordered. OncDX pending  on largest tumor. Should I trust MRI for L breast?

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PJ Hamel, Health Guide
9/22/09 9:45pm

Hi Ann - Should you trust an MRI? Well, even though MRIs are considered the most sensitive diagnostic tool for breast tumors, nothing is guaranteed 100% accurate, ever. If you don't feel you can live with the uncertainty of not being absolutely sure there's no cancer in your remaining breast, then you'd best consider a mastectomy. If you'd be willing to do some "watchful waiting," and get re-tested regularly, you could save your breast. Tough decision - and only you can make it. Do what your gut tells you, and don't look back. Good luck - PJH

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By ann51— Last Modified: 12/26/10, First Published: 09/22/09