Enhanced vs. Non-Enhanced Breast MRI: What You Need to Know for Breast Cancer

[@naththomas9946]

Thank you, Dr. Griggs, for your medical advice and information.

[@yerbba]

Thank you for watching!

[@cherylbrash]

Thank you

[@yerbba]

Thank you for watching!

[@ashlovestoshop]

This was so helpful! Thank you so much!

[@yerbba]

Thank you for watching! We appreciate your support.

[@LB-zc1hj]

Just had an MRI that revealed the 16m x 16m diagnosed er+ her2 - cancer was 48 m in depth does this alter the stage or grade ?

[@yerbba]

It sounds as if by "depth" you are referring to how deep within the breast the tumor sits. If that is the case, no, the location does not alter the stage or grade. Thanks for writing, and if we misunderstood, please write back.

[@nehnuma]

Doctor i need ur suggestion- My sister has just been diagnosed with IDC..she had her breast MRI..report has been written- =>diffusion restrcitnig enhancing well defined rounded spherical lesion in left breast superior & medial quadrant - suggestive of BIRADS 5 lesion => minimal tethering of skin & pectoralis major muscle- possible infiltration ( we don't understand all of that mean) => Few tiny left axillary lymphadenopathies largest measuring 8mm ( we think its meaning she has axillary lymph nodes) But her oncologist has not suggested any biopsy from these lymph nodes moreover not given pet scan / bone scan.. Had core biopsy from her breast tumor (er+pr+ her2-)Now how could we know her cancer has spread or not?? Doctor suggested chemo first thn surgery.. Does the treatment sound right to u?? Or we will sub the doctor??? ( Srry for long comment)

[@yerbba]

Thanks for writing. It sounds as if the plan is to evaluate the lymph nodes after chemotherapy at the time the primary tumor is removed. This is quite common. Scans of the rest of the body are not necessarily done in everyone depending on the patient's symptoms and the clinical stage of the disease. If there are specific terms that would be helpful to understand, please write back. We're assuming that a biopsy has been done, but your comment doesn't indicate that. Please take care of yourself during what must be a difficult time. Your mother is fortunate to have you.

[@naweedfaiz7952]

Increased internal heterogeneity with areas of necrosis and nonenhancement, likely reflecting treatment-related changes. Pleaaw tell me what is this mean?

[@yerbba]

In someone who had chemotherapy before surgery, the cells can die (necrosis) and have other changes showing that the treatment worked. In general, this is a good finding.

[@emb74]

I had two small non aggressive grade 1 tumors removed via lumpectomy years ago. I had radiation. I was taking anastrozole for two years when I felt a lump. A mammogram showed a lipid or oil cyst. Harmless. I also had MRIs each year. The next (3rd year after lumpectomy) year a mammogram and ultra sound showed another lump and they insisted I have an MRI biopsy. It was another harmless necrosis or scar tissue lump. Why didn’t they just do an MRI first instead of going straight to a biopsy to see if the lump “enhanced.” Could have saved me from having another painful invasive procedure.

[@yerbba]

In someone with a history of breast cancer, a biopsy is almost always recommended regardless of what is seen in imaging studies such as MRI. Enhancement vs. no enhancement can be helpful in someone who is not known to have a history of breast cancer. We hope you're done with biopsies!

[@emb74]

Thanks. That makes sense.

[@purple777royal]

Thank you Doc. I am diagnosed with DCIS, done biopsy 4 spots, 1 DCIS, 1 PROLIFERATION, 2 BENIGN, then MRI showed enhancement between the 2 spots with problem, my oncologist's advice is just remove the glands/ masectomy. Shall I just surrender to masectomy for a stage 0 cancer and proliferation and enhancement seen in MRI? I'm in a stressful decision .please advice..thank you.

[@yerbba]

The decision about whether a mastectomy is necessary depends on how many quadrants of the breast are involved. If more than one quadrant has cancer, a mastectomy is generally the best way to control the disease. You are right that a mastectomy can be a lot of surgery for non-invasive breast cancer. The key thing to know is that surgery is done to prevent the development of invasive cancer in the event of a recurrence. While many people will not have a return of cancer, we do not have a way to identify which people will or will not. We hope this is helpful.

[@lisamurphy6203]

I've had an MRI recently after having a tumor removed and radiation treatment. Nurse said I need a bone scan . I had a clear bone scan before surgery. I asked why as earlier one clear , she said possible radiation damage. I'm not happy about another bone scan as I had 3 years of recommend radiation injected into me before the clear bone scan. I don't like the idea of more radiation if I have radiation damage. I'm seeing oncologist in 2 weeks any suggestions on what to ask Thank you .

[@yerbba]

We understand your confusion. In general, bone scans are not done to look for radiation damage, and current radiation therapy techniques do not put the bone at risk. It is worthwhile asking your oncologist for more information about the reason for the bone scan.

[@lisamurphy6203]

@@yerbba Thank you I'm seeing oncologist mid September. I was surprised when the nurse said I need a bone scan for possible radiation damage. I had read from American oncology society that someone my age 65 with a oncotypeDX score under 12 , mine was 6 that radiation risks outweigh any benefits from it. I had spoken to the radiation doctorsin Ireland ,and was told they follow European protocol not American. That radiation is part of my treatment. So I was upset when the BN was telling me I need another scan for possible damage. Hopefully I'll see a doctor next week and get answers. Thank you for taking the time to reply Lisa

[@mohdabdulbasith625]

My mom is going to have surgery on Thursday modified radical mastectomy. Oncologist said its stage 3 fnac suggest duct carcinoma and pet scan shows 3.3 cm and 2-3 axillary nodes. One lymph node is 1.9 cm shows in pet scan. No papable, not invasive,scr is normal and said it is present in breast did not spread outside breast. My question is after surgery what reports should we see ?? Like histopathology and receptors?? To see if it spread to axillary nodes and its cancer or not ?? My mom dont want to do chemotherapy. So we thinking after surgery we go for radiation therapy and medicine. Can my mom avoid chemotherapy?? Last year her mamogram report showed fibroglandular parenchyma and doctor said no need of any medicine that time. Then suddenly this year ..3 months back she observed a solid lump in breast Can you please make a video regarding after surgery what test reports to do to confirm cancer in lymph node and to avoid chemotherapy what should be there in test result after surgery??

[@yerbba]

Your mother is fortunate to have you. After surgery, the pathology report will provide information on the pathologic tumor size, the number of lymph nodes that have cancer if any, the histologic grade, the margin status, the estrogen and progesterone receptor status, the HER2 status, and whether or not there was angiolymphatic invasion (also called lymphovascular invasion). You will also find out the histologic type of the cancer (lobular, mucinous, ductal, etc.). We have videos on what each of these mean that may be helpful once you get the final report. Wishing you and your mother the best.

[@mohdabdulbasith625]

@@yerbba My mom had left modified radical mastectomy surgery 10 days back after surgery I want to know what treatment should do radiation and hormone therapy is it enough?? The biospy of the specimen came and shows in the report - large tumor - Invasive duct carcinoma , no special type , grade 2 Large tumor size - 2.5 x2.1x1.8 cm Modified bloom Richardson score is 7 (2+2+3) Duct carcinoma in situ : present, high grade DCIS. Lymphovascular invasion : present, numerous Perineural invasion: present Skin, nipple and areola: free of malignancy Dermal vascular invasion: absent Microcalcifications : absent Smaller tumor size : 2x 1.2 x 1 cm , grade 2, no special type , invasive duct carcinoma All resected margins are free of malignancy Distance of margin ( large tumor ) Deeper resected margin : 0.3 cm Superior margin : 11.2 cm Inferior margin : 2.4 cm Medial margin : 5.2 cm Lateral margin : 11.2 cm Distance of margin (small tumor ) Anterior margin : 0.8 cm Deeper margin : 1.8 cm Lymph nodes : 13 nodes out of 22 recovered shows metastasis (13/22) Size of largest lymph node : 2 x 1.2 cm Size of largest nodal deposit : 1.1 cm Extra nodal extension: present, multi foci, greater than 0.2 cm Pathologic Stage : pT2(m) pN3a Estrogen receptor - intensity of staining is intermediate , total allred score 4+2 =6, ER is positive Progesterone receptor - intensity of staining is strong, total allred score 4+3 = 7 , PR is positive Her2 protein is negative Ki index - 40 % Comments : Luminal B My question is already mastectomy surgery is completed what is the next treatment for my mom ?? My mom doesn't want to take chemotherapy. Her ER and PR is positive and her 2 is negative. So my mom should take radiation therapy and hormone therapy for 5 years ?? Please suggest to me my mom wants to skip chemo , so radiation therapy is necessary?? And directly only do hormone therapy? Or first radiation therapy and then hormone therapy or both together radiation therapy and hormone should start at the same time ?? Please can you answer my question it is necessary to make a correct decision for the next treatment of my mom.