Friday, September 18, 2009

MRI Report

Wanna read it?

Here is what it says:

(Lord help me trying to type this out)

TECHNIQUE: Bilateral breast MRI was performed using the following technique: Sagittal 2D FSE fat sat, VIBRANT pre-and postgandolium fat sat. Axial reconstructions were performed as well as MIP axial and sagittal reconstructions. Axial 2D FSPGR sequences were performed.

FINDINGS: There is mild glandular enhancement involving the left breast. There are scattered foci of benign-appearing enhancement throughout the left breast, but there are no areas of worrisome clumped enhancement or morphologically worrisome masses in the left breast. There are multiple cysts seen in the left breast. The largest measures approximately 4.8 cm in diameter. There are no enlarged lymph nodes seen in the visualized portions of the left axilla.

The right breast shows mild glandular enhancement. In the lower inner quadrant of the right breast, there is a mass with irregular margins, which measures approximately 2.3 cm in diameter and has a biopsy clip associated with it. This is consistent with the patient's biopsy-proven invasive carcinoma. Additionally, there are areas of abnormal enhancement along the margins of this mass, which make the entire area of abnormal enhancement measure approximately 4.6 x 2.6 x 3.0 cm in AP, cephalocaudel and transverse dimension. This associated abnormal enhancement is probably related to associated intraductal disease. Multiple abnormal appearing calcifications are seen on mammography in this area. Also, of note on this examination is abnormal appearing ductal enhancement in the medial aspect of the right breast, best seen on images #19 and #20. This is also appreciated on image #45 of the axial reconstruction study, as well as image #36 of the axial reconstructed breast. Additional area of neoplasm, i.e., DCIS, in this area cannot be ruled out. If breast conservation surgery is contemplated in this patient then would recommend MRI-guided core biopsy.

Of note, the area of abnormal enhancement in the lower outer quadrant of the right breast extends close to the chest wall, but there is no evidence of invasion of the chest wall. On image #29, in the posteroinferior aspect of the breast, close to the chest wall, are a few enhancing nodules, the largest measuring approximately 5 mm in diameter, which have increased signal on T2 weighting and are probably related to lymph nodes. Neoplastic involvement cannot be ruled out, but these are not morphologically enlarged. There are multiple cysts seen in the right breast, the largest measuring approximately 3.3 cm in diameter. There are no enlarged lymph nodes seen in the visualized portions of the right axilla.

After reading that, I can tell you one thing - if I ever have another child I'm going to name her Axilla. Axilla Silberman - has a ring to it, no?

I also kinda love Glandular Enhancement, but I'll let the movie stars take that one.

I looked up all the words I didn't know and sorted it all out. Lots of it has to do with the MRI testing, but basically, it confirms what the doctor said, I have a large tumor and possibly more in other areas, not all necessarily in the same quadrant - the fact that it's in the center (medial) is the concern. Nothing seems to be in the lymph nodes (as far as they can tell) and the cancer hasn't spread to the chest wall, all very good things. It hurts quite a bit and I figured the pain was from attachment to the chest wall, but now, who knows?

The one thing he didn't mention yesterday was the most important line to me: "If breast conservation surgery is contemplated in this patient, then would recommend MRI-guided core biopsy."

I live in California, for chrissakes, I want to conserve everything! I grew up with the idea of conservation rammed down my throat. I'm supposed to conserve the environment, conserve the river, electricity, the habitat of animals... They think I'm not going to contemplate conservation when it's my own body part?

My body is my environment and I want to save it.

So, I'll call him Monday and ask if he can set up that test, and hopefully, my insurance will approve it. I'm sure a mastectomy would be cheaper for them, but I'm still a young thing and I need to nurse little Axilla to give her a good healthy start in life.

I did call the oncologist to discuss shrinkage, but he didn't return my call. Not a good sign if you ask me - he did have all day.

I plan to get the MRI films, so when I do I'll post them for your general breastical titillation.

1 comment:

  1. After three surgeries removing tissue from my left breast, I named my girls Flopsy and Notsy.

    Seriously, your upbeat humor will get you through this. Mine did.

    Oh. And don't have another child. It would break my heart to think of little Axilla...


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