Hi,
I’m looking for advice or shared experiences. For annual monitoring (e.g. after a diagnosis of DCIS), has anyone been offered the choice between a mammogram with contrast and an MRI with contrast? What did you choose, and why? Thank you
I can't comment from a decision perspective as I was invasive carcinoma. I have mets now and still get a mammogram and ultrasound every year because I still could get another breast cancer. If you have dense breast tissue i would ask your dr for annual checks. However regardless talk to your dr about which will give you the best reading and assurance for your situation.
Hello aj456,
Mammogram with contrast or MRI with contrast are usually used for those with dense breasts.
In my case, nothing could be seen in the mammogram even when a 7cm lump could be seen and felt!
It was the MRI that showed how extensive the disease was and confirmed the need for a mastectomy, so I was glad I pushed for it.
I have a 3d mammogram on my good side & ultrasound every year and then an MRI every two years. My doctor is hesitant to do the MRI more often as he says too much 'contrast'(or dye),can cause Parkinson's.
Every treatment option has risks so it's about weighing those up. Have a discussion with your doctor and if your gut tells you that you need an MRI , ask for it.
Always keep up your regular self checks too.. I've had two recurrences & it's the self checks that did more for me than any scans have!
HiEsjay my surgeon and oncologist discussed my annual monitoring with me taking into account various risk factors and recommended an ultrasound and 3D mammogram (tomography). The relevant factors for them included the pathology results from samples taken after neo adjuvant chemotherapy and targeted therapy and surgery, further chemotherapy after surgery, my cancer type (invasive lobular cancer) and not having dense breasts.
Just to clarify & save any confusion... the Mammogram and MRI mentioned in the original question here, are referring to scans using 'contrast', which is a dye injected during the scan to enhance the image and show up any anomalies. This is different to a standard mammogram or 3d mammogram which doesn't use 'contrast' to enhance the image.
Thank you for sharing. Please could I ask was the mammogram that didn't show the issue, with 3D with contrast? Thank you
Hello,
In 2021 at 46 I was diagnosed with DCIS intermediate grade - I had lumpectomy and radiation treatment on left breast. 4 years later -March 2025 -Had standard (no contrast) annual mammogram and ultrasound which was also to check on lump I found in same radiated breast, lump could not be found in these scans due to breast density, (no pain in lump and no swelling etc). Due to the fact that my existing surgeon could tick lots of boxes(breast density increase since radiation, BC in maternal and paternal family, previous DCIS in 2021) I was able to have an MRI with contrast (2 month wait). I was told by my specialist you can't have more than one MRI with contrast annually regardless of history. My MRI with contrast shows lump is benign in left (woohoo) but also shows new potential DCIS found in right breast that did not show in standard no contrast mammogram and ultrasound. Now staring down a tunnel at DCIS in other breast but (WAITING) for focussed ultrasound + -biopsy appointment and next steps. I am realising more and more it is important women are told by specialists, GP etc about their breast density as contrast can by paramount for women with dense breast tissue.
I am including three links to an open access article in Lancet just published on MRI with contrast and other tests with contrast, a page on the Mayo Clinic site on what it means to have dense breasts for anyone interested and a recent article in The Conversation on density and BC (all reputable medical info and all these are legitimate, verifiable, non bias and medical based Comparison of supplemental breast cancer imaging techniques—interim results from the BRAID randomised controlled trial - The Lancet
Dense breast tissue: What it means to have dense breasts
How breast tissue density affects your risk of breast cancer
If you have any questions, advocate for your health by speaking to your specialists, GP etc
I am so sorry to read about your recent MRI and the potential new site. Sending positive energy your way as you await the results.
It seems breast density awareness is so important - thanks for sharing these articlesBaggyPants33
Thank you for sharing and I hope you are going ok.
Helpful articles, thanks. I am told that both options have their pros and cons as you have said, and alternating each year between contrast mammo and MRI can be a good idea with DCIS, as 3D mammograms with contrast can sometimes be slightly better at detecting the microcalcifications apparently.
My annual screening is just 3D tomosyntheis / mammography and ultrasound. I always get done by breast experts, same breast clinic so they can compare. Ever since happened at age 40. No dyes. Plus the specialist physical check. Mine was not institu , but Invasive Breast Cancer throughout breast and into lymph nodes. ( I always thought contrast mammos and MRI only for diagnosistic and MRI does not replace mammograms- each gives different information.Not for ongoing screening )Of course it can vary case by case,doctor by doctor.
