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HELP...confused with breast MRI results

Posts: 10
Joined: Jul 2011

Hi, I am hoping someone can help me with my recent MRI results and how I should proceed. A little history:

2009 (40 y.o.) DCIS diagnosis in left breast, 2.5 cm area and about 7 cm from nipple to chest wall. Bilateral mastectomy with DIEP reconstruction and no further treatment including no tamoxifen.

Regular check ups with no issues or lumps from surgury. Even though I "just had DCIS" I always wonder if I'd get cancer again, especially since I am having cycles and producing estrogen. My DCIS was both ER/PR+. Also my father's prostate cancer returned after 15 years despite not having a prostate, so wanting to be triple sure I insisted to my BS on having the MRI. My GP even ran blood tests to see my hormone levels and as she said my estrogen levels were "NOT low". 

So I had the MRI last Thursday and the phone call Friday from my BS. As they all like to do, she starts with "everything looks fine BUT there were 2 lymph nodes in your chest that weren't there 4 years ago and the largest is ONLY 6 mm". So glad she was happy about the results...I was still holding my mouth. All she recommended was a follow up in 4 mos. b/c there's really no chance it would be caused by my past DCIS...it was all removed. I had the nurse fax me the radiologist report. This is what it says:

"Left breast: no axillary lymphadenopathy is seen. There is new left internal mammary chain lymphadenopathy present with multiple new enlarged internal mammary chain lymph nodes with the largest being located superiorly measuring 6 mm short axis.

Impression: new left mammary chain lymphadenopathy. Differential diagnosis would include metastatic disease and an infectious or inflammatory process.

Suspicious: BIRADS category 4"

So naturally I'm in hypersensitive mode wanting to know who to go to next for reassurance. i guess I'll start with the new oncologist I just started seeing, wonder if that was fate?

If anyone can help me with digesting the results and if I need to follow up sooner than 4 mos? Thank you all!

Posts: 1191
Joined: Dec 2010

I had DCIS, too, and had a BMX with no reconstruction. Although it is rare for DCIS to come back, sometimes it happens. I know there is a lady on here that had breast cancer come back in her scar, I believe. Not having Tamoxifen for DCIS with a BMX is the norm. I didn't have it either. The oncologis explained it to me that since all the milk ducts are gone with the BMX, adding Tamoxifen would cause more harm than help.

I would write a list of all your questions and concerns and ask your oncologist when you see him/her.

Birads 4 means this:

Category 4 Suspicious or Indeterminate abnormality

A BI-RADS category 4 mammogram is where the concern for breast cancer begins to increase. A biopsy should be recommended with BI-RADS category 4. Typically, a lesion has been found, but does not initially appear to have the morphological characteristics of breast cancer. BI-RADS category 4 is therefore often subdivided into there smaller sub-categories: "A" for low suspicion of malignancy, "B" for moderate suspicion, and "C" for high suspicion.

You can look at http://www.breast-cancer.ca/screening/bi-rads.htm for more information about Birads.

I am sure that you are worried, I would be too. I am really hoping that it turns out to be something benign!

Lynne P
Posts: 165
Joined: May 2013

Hoping that this turns out to be nothing too.  Your oncologist will be able to explain it all to you.  When do you see him?  I'll be anxious to know what he says.

Good luck!

Posts: 10
Joined: Jul 2011

Lynne and Cinnamonsmile for your responses and help/advice - I so appreciate it.  It's a huge comfort to me knowing I have people that "get it" and understand what I'm going through and will support regardless.  I am meeting with the genetic counselor this afternoon anyway so I called my oncologist's office to see if I could see him after my meeting - it's at the same hospital why not right?  I'm also going to email/fax my results to my Gyn and PS so they are aware and if they have comments/suggestions to call me.  I want to be armed and educated for whatever happens - my best friend past away last fall from breast cancer after the 3rd time and she CHOSE not to be informed and educated - she just drank the kool-aid her MO told her and said she would have rather die going through chemo than give up - didn't want people to think she was giving up....wow!  Instead she never felt "well" to do much of anything b/c she was always getting tests or having procedures and of course chemo.  She did not have QUALITY of life b/c she was believing the next chemo would be the cure.  We missed out on so many good times with her b/c of that thinking so I'm not going to sit back and let the dr's tell me next steps - I have to be the CEO of my body and do what's best for me and my mental state!! 

Sorry for the tangent - I just get upset thinking of the "poo-pooing" I've received from my doctors over my diagnosis - "just DCIS"!  As someone said - cancer does not play by the "rules" so we can't be put in the same boxes/categories - we're all different and this disease is evil so it will change itself to not be "what the doctors think it's going to do". 

Thank you and more to come.....hugs and blessings to all!


Posts: 10
Joined: Jul 2011

I talked to my oncologist last night and after he consulted with others he feels that a PET scan is a good "next step".   So I'm having it on Wed - if something shows up we'll cross that bridge and if nothing shows up we'll repeat MRI in 3-4 months.  Having a full body makes me feel better - it's like a baseline mammo for your body.  :)  I told him how my BS was concerned that 6mm wouldn't show up on a PET scan but he said if it is cancer and aggressive that it will "light up" as they have seen something as small as 5mm so at least either way it's a "win-win" - we'll go to battle or we breathe and enjoy for another 3-4 months.  :)

Thanks and have a great weekend!

Lynn Smith
Posts: 1265
Joined: Mar 2011

I had DCIS non invasive.Stage 0 tumor was only 1/2 centimter.No chemo or radiation but take tamox for 5 years.I only had a lumpectomy so probably the reason for the tamox.  

Good they're doing a full body scan.I'm sure that makes you feel more comfortable.

Wish you the best on your test.Hope they find no tumors or any sign of cancer. 

Please let us know the results.

Lynn Smith

DebbyM's picture
Posts: 3293
Joined: Oct 2009

Wishing you good luck on Wednesday.  Keep us updated!


Lynne P
Posts: 165
Joined: May 2013

How did your Pet scan go?  Looking for any update on your test and results.

Posts: 42
Joined: May 2013

Hi..you dont know me..just found this website..here's my background..6 yrs ago diagnosed with stage 3 breast cancer..mammogram didnt pick it up..MRI did..I was given 56% survival..I'm here..I'm married, have 2 sons..I want you to listen to me..I read your report..get to an oncologist now..when the word metastatic is on a report..take it from me..dont waste time..get in to see him..if they tell you 2 weeks..you say NO..I need to be seen immediately..calm down..ask for an ultrasound..this will show if there's anything to worry about..I'm sorry to be so blunt..but what I went thru..I dont want anyone to go thru if it can be prevented..please let me know what happens..I truly care & want to help in any way possible

cathyp's picture
Posts: 365
Joined: Dec 2009

I'll offer the advice to try to relax!  I had Recurring Hodgkins Lymphoma almost 24 yrs ago.  In 2007 I was dx'd w/IDC stage 1 caused by the radiation treatments for the Hodgkin's. I had dbl mx's, couldn't have rads or tamoxifen.  No chemo (would only help 2%) no reconstruction.  During an exam for an unrelated problem my PCP felt a small lump.  Sent to BS for US.  They could barely find it.  Consulted with my Long Term specialist @ MSKCC and they suggested a biopsy only because I was a Hodgkin's survivor.  By the time I went for the fine needle aspiration, they could barely detect it.  It was a lymph node probably inflamed from an infectious process.  My US said metestatic disese could not be ruled out.  Today radiologist "over read" or put out those "probable" , "may be", "can not rule out" , etc to cover themselves.   I have stable lung lesions, liver lesions, lung opacity etc etc that are all noted as "can not rule out metestatic disease".  (I do not go for scans involving radiation unless it is a true emergency because of the radiation involved). 

I'm hoping that your nodes are temporarily inflamed.  Also, you may want to prepare yourself for the shades of gray that a pet or any medical test may come up with, false positives and or false negatives.  So... I have a binder w/many test results that note "metestatic disease" and I am stable and well.

Good Luck!


Posts: 259
Joined: Apr 2013

Pet scan results?  I am hoping that you got good news!

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