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Initially diagnosed June 4, 2009 Invasive Ductal Carcinoma Stage II,Grade II tumor size: 2-3 cm node positive ER/PR postive HER2 Neu - negative Current Diagnosis: Metastatic Invasive Ductal Carcinoma Grade 3 Mets: Scalp/skin, Liver, Spine, Bone ER/PR + HER2/NEU -

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Wednesday, June 17, 2009

MRI Questions and PET Scan Scheduled

PET Scan has been added to my calendar. It will be done on June 24th at 10:30 am. Maegan should be available to take Katie to swim lessons, but I would not mind having a back up just in case.

Today when I went to pick up a copy of the MRI films from Baylor in Irving, I spoke to someone and requested to talk to the doctor who had interpreted my MRI so I could ask her some questions. She should be calling me tomorrow. I made up a list of questions to ask her. Here is what I came up with (any input or additional questions you might ask would be appreciated):

All questions are in regards to the three paragraphs at the bottom of the first page of the report labelled: "Impression: Known Biopsy Proven Malignancy".

1.In the first paragraph of this section it states that there is extensive bilateral background enhancement, severely limiting the evaluation for any other possible lesions".

  • Does this mean that they were unable to tell, due to the density of my breasts, if there were other possible lesions/tumors in my breasts? Or, does it mean that the MRI was a bad MRI?
  • How effective IS MRI for screening dense breasts?

The reason I am concerned about this, is that they have difficulty on mammograms and ultrasounds due to the density of my breasts. I have been told that MRI is the most effective screening method for women with dense breast tissue. I am making decisions for surgery at this time and knowing that I have an effective screening method is important to me. If MRI is not an effective screening method for me, I may be more likely to go with a bilateral mastectomy vs unilateral mastectomy or lumpectomy + radiation to prevent risk of tumors not being found at earlier stages.

2. In the last paragraph it talks about a lymph node involvement indicator involving the loss of the "fatty hilum". I did some research online using pubmed and google and only found a couple of studies with less than 100 participants in each. I was unable to get any information on the use of this as an indicator from the American Cancer Society, National Cancer Institute, or Susan G Komen.

  • How effective an indicator is this? (ball park figures would be great if you have them even)
  • Are there any studies you know of that are larger that I could look at?
  • If you are unsure, is there a source I could go to that might be able to provide me with some research and information on this?
The reason I am wanting this information, is that it might affect my decisions on reconstruction. I was told that if there was extensive lymph node involvement, they often had to do radiation in addition to the masectomy. Radiation has different effects on different types of reconstructive procedures. The effectiveness of the indicator may help me to make decisions prior to the sentinal node biopsy to prevent future issues. I may also request to have a sentinal node biopsy done prior to the surgery, to aid in my decision making.


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