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  • doctor insisting on mri for breast

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    Old 08-18-2009, 04:25 PM   #1
    molly168
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    doctor insisting on mri for breast

    Here is my story.

    My nipple looked crusty so my gyn ordered an ultrasound of the right breast.
    The facility is up the street 5 blocks from my gyn.
    On the ultra sound they found a NOT well defined darkened area 1 cm by .7cm.
    So the doctor who read the ultrasound suggested getting an mri to further investigate. ( They have a brand new mri machine in the same building ).

    My insurance company rejected the mri request.
    So I met with the surgeon, who is also in the neighborhood.
    He said, Well I could have you come in for a biopsy but I probably wont be able to see anytihing here in my office ( on HIS ultrasound machine ), so you will end up having to do an mri anyway so I can see where to place the needle.
    I thought this was strange. What would make him say that?

    So I said that I did not want an mri because I am so afraid of having a reaction to the dye Gadalynium that they inject, and could we please just go right for the needle biopsy. ( Which the insurance company has approved ).

    So he finally agreed to try and do a core biopsy today in his office.
    Well sure enough, he could not see any unhealthy tissue using his ultrasound machine, so we did not do the biopsy.

    The first thing out of him again is that we must push the insurance company for the mri.
    I said, well I may opt to just wait and do another ultrasound in 6 months. If there is nothing there today, then there is nothing there.
    He insists that this is the wrong decision.

    So I am wondering:
    1- Why did he so correctly predict that he would not be able to see the so called mass with his ultrasound machine?
    2- Does he get a "kick back" for referring someone to have the mri up the street?
    ( They have a brand new GE mri machine in this facility that I assume needs to be paid for ).
    This sounds fishy to me and I wonder if there was anything in the breast at all. We cannot feel a thing.
    Thanks for any insite.
    El

     
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    Old 08-18-2009, 06:32 PM   #2
    ritualangst
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    Re: doctor insisting on mri for breast

    as a two time breast cancer survivor i would do all i could to get that MRI- often if your surgeon will call the insurance company and plead his case they will approve it- that may be an option and i do not want to scare you but finding an area that "is not well defined" can be a bit more alarming to a radiologist or physician that an area that is well formed can be- PLEASE DO NOT LET THAT WORRY YOU- I AM NOT A DOCTOR!! i am just offering my opinion having been through this twice- and why didn't the doctor take a tissue sample when he was there? it is a simple process and you would already have an answer by now- keep bugging someone until you get the answers you need and deserve- never give up-

     
    Old 08-19-2009, 05:49 AM   #3
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    Re: doctor insisting on mri for breast

    He didnt take a tissue sample because he didnt see any thing abnormal on his screen.
    The other imaging place told him the dark area was at 9:00.
    However he didnt know how far away from the nipple the area was. He said he couldnt read the cd or film from the original imaging center.
    That does not seem right either. All they told him was it is at 9 oclock.
    So he went from under the arm to the nipple and it all looked normal to him, so he could not just shoot in the dark to get a sample of something.

    Last edited by molly168; 08-19-2009 at 05:50 AM. Reason: Add: there was nothing there to test.

     
    Old 08-19-2009, 05:51 AM   #4
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    Re: doctor insisting on mri for breast

    Have you had a breast mri where they inject that awful dye into you?
    If so, did you feel anything at the time or after?

     
    Old 08-19-2009, 07:09 AM   #5
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    Re: doctor insisting on mri for breast

    yes i have had the dye 3 times- first for a full body MRI after my car was totaled- then for the breast cancer and then an MRI of the brain for vertigo- it is not bad- it gives you a flushed feeling then it's gone- they do have a long list of things you cannot be allergic to so make sure they go over that with you before you consider agreeing to it- they can do the MRI without it however the doctors always insist they can see the images better with the dye- very rarely do people have any kind of reaction to it- i live in florida also- if you have any more questions you can PM if you would like-

     
    Old 08-19-2009, 03:50 PM   #6
    Mel52
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    Re: doctor insisting on mri for breast

    I can't have MRIs because I have metal in my face but I have had the contrast injected for cat scans. Usually they do a quick kidney function blood test just before the test. If you have severe asthma they may give you an antihistimine. Otherwise, it is a warm rush that lasts for a second and then that is it. Drink lots of water afterwards to flush it out of your system. Very very rare to have a reaction

     
    Old 08-20-2009, 06:17 AM   #7
    molly168
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    Re: doctor insisting on mri for breast

    Here is what the research says:

    Unfortunately, MRI and MRA contrast dye containing the heavy metal gadolinium has been the cause of a disease called Nephrogenic Systemic Fibrosis (NSF) or Nephrogenic Fibrosing Dermotherapy (NFD), a serious condition that starts in the skin of the arms and legs and spreads to other parts of the body. People who undergo an MRI–especially those with kidney disease–in which this contrast dye is used are particularly at risk for developing this disease.

     
    Old 08-20-2009, 11:18 AM   #8
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    Re: doctor insisting on mri for breast

    Elle,

    Here in Massachusetts, once you have a mammogram, which I think is in order to see if the suspicious lesion shows up on mammo, than the insurance company approves the MRI, especially when the radiologist mentions the suspicious area on his/her report and recommends a Breast MRI to further evaluate. If the radiologist can see the suspicious lesion on the MRI and this lesion is accessiable, than they can do the needle biopsies while you are in the MRI machine. This needle biopsies also sucks the whole lesion out, so even if you do have a positive pathology finding, sometimes that is all that is needed.

    If they want to do a Breast MRI and you are successful in getting it approved--do the Breast MRI, I had to beg my surgeon to order one because he really does not like the MRI's I gave you the reason for the dislike of MRI's in my earlier post to you.

    Write with any further questions.

     
    Old 08-22-2009, 01:31 PM   #9
    molly168
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    Re: doctor insisting on mri for breast

    They dont like mris because there are lots of false positives??

     
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