Mammogram during Stage 4 metastatic ER+ HER2- cancer?

[Melpub]

In 2018, I was diagnosed with metastatic breast cancer, and had surgery, radiation, and have since been on Faslodex and Ibrance, which work. I have CTs or Skeletals every six months. My gynecolgist thinks I should get a mammogram; my oncologist thinks it's not necessary but will schedule one. ???? Who can advise?

[Discocat]

Hi,I had my last mammogram in June last year and that was when I was MBC diagnosed (after further tests).

My oncologist has already scheduled me to have next Mammogram within the oncology centre this June…

She recommends that I continue to get them annually this way.

I also had CT recently, at around 6 months from start of treatment, so I guess she sees them as both being necessary.

[blms in reply to Discocat]

Did you have a bilateral? Maybe consider if not probably need them periodically but I’d go with onco in this. You might want to ask if you can have mri of breast instead. Worth a conversation. Unless you primary felt a lump of concern before seeing onco

[Melpub in reply to blms]

Have no lumps now--had a lumpectomy in 2016 after finding one (then the works--chemo, radiation) but lately nothing. Just the gynecologist being cautious.

[Melpub in reply to Discocat]

Thanks. There does seem to be a lot of disagreement on this. I'm now thinking it won't hurt to get this test (although of course it will! That mechanical squeeze is sadistically tight). But if a lump shows on the mammogram that they wouldn't have caught until later on the CT, the pain's worth it.

[Rona777 in reply to Discocat]

Mammography shows thin lumps the size of sea sand. On CT no lump is seen that is less than 0.5 cm. The radiation in CT is much more powerful and dangerous. If the doctor could see on a mammogram I would do it. But I insist on an ultrasound every two months. It is important to have a serious and thorough radiologist. Insist he tell her and write down exactly what he sees.

[Melpub in reply to Rona777]

Thanks, Rona 777!

[Hazelgreen]

Since you have a scan every six months, what more could a mammogram tell you??

[Melpub in reply to Hazelgreen]

The gynecologist seems to think the mammogram would show more because the breast alone is seen, so if there's a two-milimeter tumor it'll show sooner.

I hope I'm not just in for an unneccesarily bruised breast.

[Hazelgreen in reply to Melpub]

Thanks for explaining your gynocologist's rationale. My scans have indicated very small 2mm mets on organs so I assume the CT scan of my chest would pick up any tiny tumour in a breast. In any case, I live in Canada. Socialized medicine means that no one stands to benefit from my having a mammogram which may be why no one has suggested I have one in the last 16+ years.

Warm wishes that your mammogram does not result in bruises (ouch! I don't remember that ever happening in my past.)

Hugs,

Cindy

[Hazelgreen]

P.S. Although I have breasts, I have not had a mammogram since 2006 when breast cancer was first diagnosed, and I had three lumpectomies. In 2019 when MBC was first diagnosed, I was found to have mets in most organs, but neither breast nor the brain.

[Beryl71]

I wasn't expecting to have mammograms. I had a clear mammogram the week before a scan showing widespread Mets when MBC was diagnosed , so can't imagine a mammogram would help. I'm thinking the scan will pick up the broad picture. X

[Melpub]

Wow. Thanks. It's just always disconcerting when doctors disagree. The gynecologist seemed worried they would "miss something" and even the oncologist said a mammogram showed things in greater detail--but the oncologist also said that according to "international standards" a mammogram was not necessary. Meanwhile, I'm thinking: the damn things are painful, but I'll put up with them if they reveal anything at all.

[MaryCos]

I read what everyone else had to say about this, and here is my experience. I recently changed my MBC care to Johns Hopkins (thank God). Prior to this, my former oncologist (not an MBC specialist) told me we don't do mammograms after stage IV diagnosis. So, when my nurse practitioner (at Hopkins) asked me about a mammogram two days ago, I was a little surprised. As I asked her about this, given what the former oncologist said, she told me there are two mindsets on this. But, (she said) since I am doing so well with my treatment so far, we would be looking out for potential secondary cancer. For me, personally, I jumped at the chance to be able to get some kind of firm measurement about the actual size of my tumors now. (My breast was terribly deformed at diagnosis, and you can SEE and feel the difference since treatment started in July 2020. It now LOOKS normal.) Anyway, I'll have this done next month. But, my sense is... it was kinda "up to me" on this.

[Melpub]

Thanks, MaryCos

The mammogram is now schedule for April 5 and I'll report back to this group when I get results.

[love2golfwell]

I had a long discussion with my oncologist, the nurse and my case management nurse about having Mammograms after an MBC diagnosis. I did not feel it was necessary with having PET scans every 4 months and felt it was excess radiation. I got lots of push back though and ended up having one in October along with an ultrasound. The facility was recommended by my oncologist and was wonderful. They gave me the results while I was there. I already have my appointment scheduled for the fall. I still don't agree that we need to have them yearly but it is not worth arguing about with my doctor.

[Buffwright]

I had a right mastectomy back in ‘05. Metastatic in ‘16. My left breast has never joined in. I do get mammograms.

[Teddielottie]

I had a right mastectomy and reconstruction (2017) , then I had an elective ‘rebalancing ‘ reduction (2018) on my non -affected left breast . For the past three years I have had an annual mammogram on my left breast . My last one was this January...it was slightly uncomfortable for a few minutes , but I wasn’t bruised from it , and I had verbal results from my breast care nurse that there was no malignancy seed and no signs of early bc in the last three annual mammograms. She said that mammograms are better for detecting early changes in breast tissue . It was my onc who recommended I continue to have them three years ago , and I have been ‘stable’ all that time (I have 6 monthly ct scans , my last one being a month before the mammogram). My onc did say that if something was found early I could have a small operation . I have been on ibrance /Letrozole for over four years and ‘stable’ since my first post treatment scan over three years ago . I am treated on the NHS in U.K. so no financial gain to those wonderful people that treat me ! I wish you well with yours next month x

[Melpub]

Thanks!!

[Tam-56]

No mamo since DX 2018…CT scan every 6 months. I have dense breasts so Mamo did not show tumor. Ibrance and letrozole working well so far.