To MRI or not to MRI, that's the question

October 20th, by roos

It has been written about a lot and it has been accepted by most medical professionals now: a woman who has had breast cancer should be screened by MRI, rather than mammograms on the opposite side, in order to detect a second breast cancer earlier. Because MRI 's can show the start of breast cancer much sooner.

That's what they do now in the US and also in Belgium, and other countries I am sure. But not in Ireland.

The first time I asked about MRI's is when the oncologists talked about the second tumor that was found during the second operation. I asked him if they would have noticed this tumor had they done an MRI instead of a mammogram. He said, possibly yes.

So I could have been spared two of the three operations. I had 3 tumors, of which only one was noticeable on the mammogram, that was the one I could feel! A year before nothing had been seen.

The second time I asked was when I read about how screening breast cancer survivors with MRI's will save more lives. Then there was a sigh from the doctors, yes that is the golden way… but not here.

I have been thinking about it ever since. My sister has had MRI's for the past two years now. Ok, the first time there was a little doubt , some unclear images that might or moght not have been cancer. That was a transition period from mammogram to MRI. Since then, it seems very straight forward.

If she would have the bad luck to develop another cancer, they would be on to it straight away. I, on the other hand, get the mammograms, even though when I had cancer, only 1 of the three tumors were visible on the mammogram.

I went to my surgeon's visit three weeks ago. As I am a public patient, I only get to see one of the registrars, who doesn't know anything about me, just prescribes another mammogram, prods my right breast a bit, and then sends me home.

This time I asked him about the possibility to be screened by MRI. He tried to laugh it away. ' Oh, but the golden standard is still the mammogram! '. 'Oh no it isn't ', I said, and I told him all I knew. He started to become a little agitated. I could see him thinking. 'Oh my God, one of those annoying patients who think they know it all!' so he said, well here they do it with mammograms, and filled out the form for the X-Ray department.

I didn't give up.

I asked him why my sister would get more chance then me? When all she had at the start was 1 small tumor that only needed removing and some radiation therapy. I have been through the lot,etc., etc.

This time he got really nervous. He stormed out and got Mrs. O'Hanlon, the surgeon in. She came in, and started explaining to me that only in very special cases do they do MRI's, but if there was the slightest doubt on a mammogram, they would do the MRI then. I had to explain again, that there had never even been a slightest doubt when I first had cancer. The other two tumors had simply never been seen! I mentioned Belgium and my sister again. ' It must be part of some study', she said. I told her that NO, it is normal practice over there, and again that my sister had more chance than me.

I was the difficult patient. Dr. O' Hanlon brushed me off by saying she would discuss it in the next meeting of the multi-disciplinary team, and sent me to the breast-care nurse.

I didn't understand why I had to go there. The nurse looked concerned when I arrived . She had obviously been informed about that patient with the crazy ideas in her head. I repeated my whole story again. She took note and promised me she would disscuss it a week later in the multi-disciplinary team meeting, and then she'd call me.

That't the last I've heard of that.

And I am wondering now, is there any way I can get my screening done in Belgium?

I don't trust this country and it's medical force any more!