MRI for breast cancer: not for everyone, all the time

My MRI yesterday showed that the area that was problematic last summer had cleared, but two other areas lit up. After about two hours of multiple mammograms and an ultrasound, I was cleared for being fine, but needing to come back again in six months.

This article in today’s Plain Dealer accurately describes that MRIs should not be used routinely for all women and my experience, even as a high-risk woman, is exactly why: MRI technology, when used for breast cancer detection, still requires follow-up – a lot of follow up. After last summer’s scare, I had multiple mammograms and ultrasounds because of the MRI and the clinicians said: come back in six months.

The two doctors quoted in the PD article, Dr. Alice Rim and Dr. Rosemary Leeming, are the absolutely tops here and I highly doubt there’s anyone in the country more capable of giving advice for which detection techniques best serve which women. I’m under the care of both (I feel like anyone who’s read this blog already knows this but for those who don’t: I’m clinically defined as high risk because my mother was diagnosed at 44 (my current age), her mother died of breast cancer at 52, my mother’s father’s sister (aunt) died of breast cancer in her early 70s, her daughter died of bone cancer in her 50s, and her daughter had breast cancer in her 30s. In addition, my mother’s brother has had four bouts with cancer (prostate and other – I’m not sure which); I went through genetic testing, because I’m an Ashkenazic Jew, eight years ago and my mother tested negative for the known mutations at that time; I had children later in life and that is also considered a risk).

That said, if you think you need a test, get it – ask for it, demand it if you think you need it. But don’t be afraid to trust the doctors, either. Especially if it’s one of these two women, or doctors who work under them. I’m 100% confident: they don’t want you to have breast cancer either. I asked the same question probably five different ways yesterday to be sure that Dr. Rim was convinced that what I could see on the mammogram and the MRI was nothing, based on the ultrasound and her knowledge and experience.

And I trust her, even if I still have in the back of mind, could those areas be some pre-cancerous growth? At some point, you have to trust and move on.

At least for six months.

11 thoughts on “MRI for breast cancer: not for everyone, all the time

  1. Breast CancerCommon Breast Cancer MythsThe first myth pertaining to this disease is that it only affects women.Second myth that is associated with this disease is that if one has found a lump during an examination, it is cancer.Third is that it is solely hereditaryThe next myth associated with breast cancer is downright ridiculous. Would you believe, that in this day and age, some individuals still think that breast cancer is contagious?Conversely, some individuals foolishly believe that breast size determines whether or not one gets cancer.Finally, another myth that is associated with this disease is that it only affects older people. This is not so. Although the chance of getting breast cancer increases with age, women as young as 18 have been diagnosed with the disease.You can find a number of helpful informative articles on Breast Cancer at breast-cancer1.comBreast Cancer

  2. Demgal – thanks – I just got an email from someone with NBCC – I don’t think it’s you, was it? (I’m terrible at guessing all but the most obvious pseudonyms).And I JUST this week heard Bernadine Healy and others talking about the proteomics. Fascinating. Again, thanks.

  3. Jill:I just read your essay. It never occurred to me before that my Mom didn’t have a parental role model, as she was orphaned at 11. After that she and her two siblings were farmed out to three separate aunts/uncles, during the Depression no less. She never talked about those times to any of us kids, nor did her siblings to theirs, but we all had the sense that it wasn’t a bed of roses.In spite of those challenges, she was a great mom. One of the powerful witnesses of that is how close we kids have stayed to each other. My cousin (Mom’s brother’s daughter) is trying to capture what we can from her Dad, who at 92 yrs old is feeling like opening up a little. I think he’s recognizing that as the sole surviving sibling, the story will die with him if he doesn’t tell it now.Anyway, nice piece. It certainly struck a cord with me.PL

  4. Women have to advocate for research into betters ways to detect breast cancer, methods that are less invasive, have much lower false-positive and false-negative rates and provide more information. Imagine if the only way to detect pregnancy was with an x-ray or MRI.The area holding most promise involves proteomics – detecting proteins or similar tumor by products in blood or saliva. Women have to push for focusing publicly funded research programs to shift away from the highly lucrative, but ineffective imaging industry.Keep in mind, also, that early detection is no guarantee of a good outcome for breast cancer. Its an incredibly complex disease.Better yet, join Sheryl Crow and other breast cancer activists at the National Breast Cancer Coalition in calling for passage of the Breast Cancer & Environmental Research Act funding research into what causes breast cancer and how to prevent it.Visit http://www.stopbreastcancer.org and http://www.nobcc.org and sign up for legislative alerts.

  5. Thanks for sharing that, Paul.Here’s an essay I wrote about my mom losing her mom when my mom was 26 with three small children.Obviously there are millions too many stories like this.Glad to know your sister is doing well.

  6. Cancer is also a killer of women in my family. My sister, mother and grandmother all were diagnosed in their middle years. My grandmother died when Mom was 11 years old, so I never knew her. Mom was diagnosed about the same age, but because of better detection and treatment, lived another decade before it finally got her. My sister was diagnosed at about the same age, and is now consider a survivor.May you enjoy both health and peace.PL

  7. why don’t US companies or other foreign companies make and/or provide the equipmentAt least GE, a US company, makes the equipment. I don’t know if there’s a significant difference in the capabilities/pricing of the equipment made by GE, Siemens, and others, though.

  8. Thanks for that. I’ll check it out.If you didn’t know already, they work like clockwork there. It’s amazing. And I’d had my previous MRI at UH. They were nice and fine there, but the Clinic folks do all the training of the UH folks. The technician I had told me that they do something like six breast, then a few other and then more breast MRIs every day. And the equipment and facilities are just in constant use, with staff everywhere and patients a plenty.One curious point, which deserves its own post: much of the equipment? Manufactured by Siemens, the same company that has extensive business dealings with Iran and is a company in which Ohio’s pensions have investments and which my state Rep, among others, wants to divest from (sorry for the hanging end there).I’m not pointing this out to zutz Josh Mandel or Shannon Johnson but rather to point out: it’s one thing to say we should divest, it’s another thing to say that when you look at how embedded we are with that company’s products and technology. When I’m in the hospital, benefitting from that tech, all I can think is, 1) why don’t US companies or other foreign companies make and/or provide the equipment and 2) what if it’s the only provider – do we really deny American women, for whom there’s nothing more than detection when it comes to breast cancer right now (as opposed to real prevention) this technology?No easy answer, but definitely a problem.

  9. Jill, glad to hear things are currently OK.As it happens, I served on jury duty last week with a woman who does MRIs at the Cleveland Clinic’s Breast Center. (FWIW, I think she displayed excellent judgment in the jury deliberation room.) She mentioned to me that the NBC Nightly News had a recent segment on MRIs for breast cancer. The video is available here. While most of the video seems to have been shot elsewhere, she told me that a short segment (about 90 seconds in) was done at the Cleveland Clinic.

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