QuestionMy wife had an MRI and U.S. done 6 months ago and then had another set of both done again last week. The findings were as follows: "Previously described right upper-outer quadrant nodule has enlarged slightly in size from approx. 7 x 5 mm to approx. 8 x 6 mm. It still demonstrates a smooth margin and progressive enhancement kinetics. The small focus of enhancement described in the left inner breast has enlarged from 3 mm in dia. to 4 mm in dia. It now demonstrates washout enhancement kinetics.This should also be viewed with suspicion. Impression: Right upper-outer quadrant nodule enlarged as compared with previous exam of 6/15/07. Although this reportedly demonstrated fragments of fibroadenomata on ultrasound core, enlargement warrants excision. In addition, a 4 mm nodule in the left inner-lower quadrant has enlarged from previous exam and demonstrates washout enhancement kinetics and, therefore, should be biopsied or excised as well"
The core needle biopsy of the right breast came back as benign. The questions I have is what are washout kinetic enhancements? Would you recommend getting a second opinion on this situation? We both are concerned that any surgery of this type may open a Pandoras box of problems. It just seems that sometimes people seem fine until they have a surgery for something and then it spreads like wild fire and they are gone in months. Is there any basis of fact to my previous statement?
Thank you.
AnswerLet me deal with the most important question. Will a biopsy open Pandora's box? The answer is no. Multiple longitudinal studies have shown that biopsy does not make cancer spread like wildfire or somehow "take-off," making matters worse. This is actually an old wives tales that likens cancers to dandelion blossoms that spread in the wind creating more weeds once disturbed. Breast cancer is not a weed.
There are many breast researchers who believe and with justification, that breast cancer is a systemic disease at the onset. This is why the treatment is multimodal requiring hormone manipulation, local and regional treatment and most of the time chemotherapy if it is considered anything but minimal.
As to the MRI, I cannot speculate on the interpretation of imaging studies without looking at the films, trying to correlate the findings to a clinical exam. I always suggest taking your list of questions to a breast specialist and if doubt or insecurity exist, obtain a second opinion. I hope this helps.
