An MRI Girl

“Why should I keep these breasts if my annual mammograms aren’t effective?” I had been doing everything right. My surgeon’s response: “You are an MRI girl.” And guess what, I didn’t know I was an MRI girl until my breast cancer surgeon told me. In fact, I have probably been an MRI girl my whole adult life.

I have fibrocystic breasts, which is pretty common. My jaw nearly hit the floor when I saw the film from my mammogram as my surgeon said, “The problem is your breast tissue and cancer both appear white.” Indeed, the entire film was white. “The radiologist made a good catch; you were lucky.” This she said as she pointed to a smallish starburst, similar to pinching your shirt and giving the material a twist. That’s all there was on the mammogram. So that day, at 43 years old and not yet fully diagnosed with Stage IIa invasive ductal carcinoma, with one cancerous lymph node, I learned that I am an MRI girl. That means, after chemo and radiation, my follow-ups will be alternating every six months between a mammogram and an MRI. Had I had an MRI earlier, had my preventative plan included an MRI on occasion, well, perhaps I wouldn’t be bald now.

The task force currently suggesting the screening age be moved from women 40 years old to 50 years old claim to be making this recommendation not on costs but on scientific research. I don’t completely understand the members’ rationale. Stress is mentioned. Are the task force’s opinions weighing the benefits of mammograms with the “false positives” picked up by mammograms, causing stress in women who are left for some times weeks with the uncertainty of what the blip on the screen really is? That uncertainty was the most difficult part of this whole process, undeniably so. But knowledge is power. In the end, knowledge doesn’t always come easily. The school of hard knocks. It still exists.

As an MRI girl, WITH MY BREAST TYPE, I have a complete lack of faith in mammograms. For me, they are archaic. They are effective screening mechanisms for many women and my oncologist reminds me that it did pick up the cancer but… I am an MRI girl. And because of that I’ve had five areas biopsied, I’ve had numerous ultrasounds, I’ve had two MRI’s, I’ve had a PET scan, I’ve had three surgeries, I’m having chemo, and I’ll have radiation. Here and now, I’m thankful for each and every one of these treatments. Here and now, I’m choosing not to lift the heavy curtain, not to share the physical details of any of these treatments. Should I, the task force would have even a shinier new definition of stress.

When new computers come out, we wait for the hype to settle and when that happens, the price decreases and even more people buy. The economics of breast cancer screening does not work that way. I believe there are two reasons it was never suggested that I have a screening MRI: The cost of the initial test and the likelihood of false positives, of seeing too much, which would result in more expensive tests and biopsies.

As for a sampling of costs associated with my treatment, my MRI’s were approximately $2,500 each and one 6 mg shot of Neulasta, the white blood cell booster, is $3,000. As for seeing too much, while uncomfortable, I’d rather have had five sites biopsied a year or two ago than be wearing a red cap on my bald head today at 3 a.m.