Expert: Claes-Gustaf Nordquist, M.D. - 2/8/2009

Question
QUESTION: OK. I am 35 yrs old with Family History. 10 yrs ago they found a 1.8mm beign tumor (core biopsy) I have very dense breast tissue and am naturally lumpy. I recently had an MRI. It showed (attached) two areas in right breast that glowed with contrast. They told me that the best option is to have follow up MRI in 6 months. The first smaller bright spot is near the spot of my known tumor. The second area - when you go to the cross section - looks like attached. On the left side of the nipple (3oclock) is the base of a large probably begign object and the Right side is a bright white area surrounded by lots of dense tissue. I had a cold durring the MRI and moved often to sneeze and cough, which may have affected some result somewhere. I am attaching the images that were recieved. I don't think waiting 6 months is a good choice, but the doctor things so. Is she right? am I over reacting?
I hope that you can read the file. It would only allow me to post one picture. I removed all information identifying me.

ANSWER: Unfortunately the picture quality - after I have received your pictures - is not good enough for a sure & safe diagnosis. I would not like to wait for 6 months either. And there is NO reason to since all these lesions seen can be diagnosed by a pathologist by MRI guided needle biopsies! DEMAND it! INSIST on it! Good luck!
THANKS! No you are not! I myself am now under treatment for prostate cancer (hormone treatment & radiation therapy in combination). I was checked by a urologist because of my increased level of PSA (8.8). My urologist thought that the cause of it probably was my old man enlargement of my prostate. I replied that of course that was possible but I wanted to be SURE! So I demanded biopsies. 8 were done. Cancer was found in 5 of them! It is your body, your health and your future. So ONLY YOU can decide!



---------- FOLLOW-UP ----------

QUESTION: I really appreciated your response and I will follow up as suggested, but I am still wondering. When the MRI is with the contrast and you look at the image. The areas that are lit up would be those areas that they are concerned with? Right? Any Dark areas that show up on an MRI could be bad also, (ex. the benign tumor they know about) but I am mostly trying to understand the contrast view. I am trying to understand why they are acting not so concerned about those areas. It doesn't make sense to me. I do plan on insisting on the biopsy, but just trying to understand.

I'm sorry to hear about your own problems and I pray for the best for you. After reading so many of your postings, I know that there are many that are very appreciative of you.

Answer
Well Brandy, your technical questions are actually outside my area of expertise here - and I have to stick to my contract. You should direct them to a DIAGNOSTIC radiologist with MRI experience (of breasts). I'm a medical oncologist & radiation therapist with experience of breast cancer among other cancers. But I'm NOT a diagnostic radiologist. I have done diagnostic radiology but that was well before the time of the beginning of the use of MRI. Of course I have used MRI diagnostics in my practice. But it is NOT my specialty!
THANKS! Much appreciated!