Forum Discussion

suzieq's avatar
suzieq
Member
11 years ago

Campaign free MRIs for dense breasts

I think it is about time we campaigned for MRIs to be standard for women with dense breasts and for women newly diagnosed with breast cancer.  Who out there knows if they have dense breasts?  Don't confuse dense breasts with big breasts - they can be small and still dense.  In the USA it is legislated a woman must be told if she has dense breasts after mammogram.  My first breast surgeon's reason for not giving me an MRI was because it gave false positive/ negative results.  To some extent that may be true but an MRI is the only way to pick up all breast cancers.  Mammograms and breast scans only pick up 50% of breast cancers 75% chance if you have both.  It is only an MRI that has 100% success rate.  

I have recently moved and changed my breast surgeon.  He is an American specialist and the first thing he did was send me for an MRI.  He simply said he couldn't be sure what was happening in the breasts otherwise.  We talked about why Australia doesn't give women with breast cancer MRIs and I told him my previous Breast Surgeon's response.  He did not agree.  He said good radiologists can certainly tell the difference with false positive/negatives. He did say Australia probably doesn't do it because of the cost on Medicare.

My argument is - I have dense breasts.  Had I been told I had dense breasts when I was young and told to be vigilent I would have had regular mammograms and breast scans and at the earliest onset of suspicious activity would have had an MRI.  Had I done this I would have picked up breast cancer very early while it was still in the duct.  This means small surgery and some radiation and I would be 100% cured.  Very little cost on medicate.  However, because I was kept ignorant all these years and not vigilant my breast cancer was allowed to grow and burst out the duct so the impost on medicare is enormous!  

We need to put MRIs on the agenda for women with dense breasts and for women diagnosed with breast cancer - it is a must.  I know of at least 3 women on this site who had mammograms scans surgery with clear margins, chemo, radiation etc and there was still canacer in the breast only picked up later on MRI.  It really is a "no brainer".

Why aren't we on the front foot with this.

Any thoughts?

9 Replies

  • suzieq's avatar
    suzieq
    Member
    11 years ago

    Hi Jane

    MRIs are imperative for women with dense breasts.  They are routine elsewhere in he world.  MRIs pick up all breast cancers.  A friend of mine with breast cancer had mammograms and scans and breast cancer was detected.  Surgeon went in and removed carcinoma but could not get clear margins.  Went in again and again could not get clear margins. SO FINALLY the surgeon ordered an MRI and two large tumors were found in this breast that was not picked up on mammogram or scan or during two surgeries!   We have to keep fighting for MRIs to be standard.  It will save a lot of money on the health care system to detect breast cancer when it is microscopic ergo 100% cure.  BCNA have put something together for the Govt.  Let's hope they are successful.  If not, we have to keep lobbying and keep trying.  Suexx 

  • suzieq's avatar
    suzieq
    Member
    11 years ago

    Hi Jane

    MRIs are imperative for women with dense breasts.  They are routine elsewhere in he world.  MRIs pick up all breast cancers.  A friend of mine with breast cancer had mammograms and scans and breast cancer was detected.  Surgeon went in and removed carcinoma but could not get clear margins.  Went in again and again could not get clear margins. SO FINALLY the surgeon ordered an MRI and two large tumors were found in this breast that was not picked up on mammogram or scan or during two surgeries!   We have to keep fighting for MRIs to be standard.  It will save a lot of money on the health care system to detect breast cancer when it is microscopic ergo 100% cure.  BCNA have put something together for the Govt.  Let's hope they are successful.  If not, we have to keep lobbying and keep trying.  Suexx 

  • suzieq's avatar
    suzieq
    Member
    11 years ago

    Hi Lisa

    Well done!  Elsewhere in the world women are told if they have dense breasts on their first mammogram and MRs are standard.

    For those of us at risk MRIs will detect tumors while still in the duct.  Resulting in massive savings on the health system.

    About 10 years ago I had a lumpectomy on the other breast.  It was benign.  What my breast surgeon should have told me was: "you have dense breasts and you need regular mammograms and breast scans or MRI. Breast cancer is harder to detect in dense breasts and you have greater chance of developing breast cancer.  Also, having had a lumpectomy - risk is higher".  Instead he said to me: "you are fine - nothing wrong with you - you just have lumpy breasts - goodbye!"  So, I never bothered with mammograms after that and when I discovered the new lump I didnt worry.  I only had it checked when it started to itch and of course it was breast cancer.

    I now research everything! Women need access to as much information as they can get their hands on and it should be readily available in Australia.  Most of my information comes from major websites in America or England.  Australian women deserve to be fully informed and they deserve worlds best practice - not third world care!  MRIs are a necessity not an extravagance!

    Well done to BCNA.  Given current policital climate response may be in the negative but we need to keep fighting for this -  it will save many lives.  If the Govt put their thinking caps on they will see the cost benefit of MRIs.

    Thanks Sue 

  • Jane221's avatar
    Jane221
    Member
    11 years ago

    Hi Suzieq,

    This is an interesting area of discussion and I'm pleased to see that BCNA is lobbying for greater access to MRI for women with dense breast tissue.

    I had 3 tumours in my breast, 2 of which were invasive lobular carcinomas, which were difficult to pick up on a mammogram, and even with an ultrasound the true extent of the tumours was not realised and this appears to have been partly due to the fact I also had dense breast tissue, as well as the fact that lobular tumours are notoriously "tricky".  I ended up needing to have a mastectomy as clear margins could not be achieved with the initial lumpectomy. I'm sure an MRI could have provided a clearer picture ealier in the piece and perhaps have saved me from at least one surgery along the way.

    Given the cost of MRIs and the enormous out of pocket medical expenses our family has endured over the last few years, further support from Medicare to recognise the need and usefulness of such technology in diagnosing and understanding the extent of disease is vitally important and surely more cost effective (both for the patient and the health system) in the long run.

    Jane

  • Lisa_BCNA's avatar
    Lisa_BCNA
    Member
    11 years ago

    Hi Suzie,

    It’s Lisa from the Policy Team. Thanks very much for your post. I wanted to let you know about an application currently before the Medical Services Advisory Committee (MSAC). MSAC is the committee that provides advice to the Australian Minister for Health about the safety, effectiveness and cost-effectiveness of new medical procedures and technologies.

    The application before MSAC calls for Medicare rebates for breast MRI to be extended for a number of new purposes, including for women who’ve been newly diagnosed with breast cancer who have very dense breasts which make it hard for clinicians to properly assess a tumour using a mammogram.

    BCNA made a submission in support of this application. In our submission, we said that women with dense breast tissue should be able to access the type of imaging that is most appropriate for them, including breast MRI. We also highlighted the high out-of-pocket costs many women have to pay for breast MRI scans.  More information and a link to our submission can be found on our website.

    MSAC will be considering the application in March. We will post the outcomes on our website when they are available.

  • Lisa_BCNA's avatar
    Lisa_BCNA
    Member
    11 years ago

    Hi Suzie,

    It’s Lisa from the Policy Team. Thanks very much for your post. I wanted to let you know about an application currently before the Medical Services Advisory Committee (MSAC). MSAC is the committee that provides advice to the Australian Minister for Health about the safety, effectiveness and cost-effectiveness of new medical procedures and technologies.

    The application before MSAC calls for Medicare rebates for breast MRI to be extended for a number of new purposes, including for women who’ve been newly diagnosed with breast cancer who have very dense breasts which make it hard for clinicians to properly assess a tumour using a mammogram.

    BCNA made a submission in support of this application. In our submission, we said that women with dense breast tissue should be able to access the type of imaging that is most appropriate for them, including breast MRI. We also highlighted the high out-of-pocket costs many women have to pay for breast MRI scans.  More information and a link to our submission can be found on our website.

    MSAC will be considering the application in March. We will post the outcomes on our website when they are available.

  • suzieq's avatar
    suzieq
    Member
    11 years ago

    What is interesting is that on my last mammogram the pathologist actually reported I had dense breasts (this is a first).  As such my doctor should weigh up the information and if further testing needed suggested an MRI.

  • suzieq's avatar
    suzieq
    Member
    11 years ago

    You should ask your doctor about dense breasts.  It is important to know and I don't want to give you misinformation.  I can tell you this:  dense breasts:  mammogram alone has 50% chance of picking up all breast cancers; breast scan alone has 50% chance.  Have both and you increase your chance of picking up all breast cancers to 75%.  However, that still leaves 25% unknown? Again, this is something you need to talk to your doctor about.  Also, talk to your doctor also about the possiblility of having your girls genetically tested for the gene. The Australian Govt will not recommend MRIs for women with breast cancer - yes, due to cost.  However, I can go and play footie and hurt my knew and have an MRI.  Does this make you angry?  It makes me angry!

  • Natasha's avatar
    Natasha
    Member
    11 years ago

    I was sent for an MRI after diagnosis by ultrasound and then mammogram. I am interested in what you are saying about dense breasts though because I have breast cancer but I also have two girls in their twenties. Their father comes from a family where all but one of the women have the BCR1 mutation - his mother, grandmother, great aunties, and all his sisters.  They have all had breast cancer and it's only in the last decade that we've realised why.  I don't know if my girls have inherited this mutation but they are at very high risk and they have dense breasts. My doctor has recommended they get ultrasounds done biannually as mammograms are not likely to be very informative.  MRIs have not been recommended, perahps due to cost.