Should I ask for an MRI exam or other tests?
Magnetic resonance imaging (MRI) can reveal a tumor that’s too small to be detected by a physical exam or is missed by a mammogram. “An MRI is valuable as a secondary diagnostic tool,” says Alschuler. “I know several patients who had a suspicious finding on a mammogram and followed up with ultrasound or an MRI and discovered cancer.”
That’s what happened to Cathy Gergen, 48, a human resources manager for a construction company in Arizona. After she discovered a lump in her right breast, she immediately scheduled a mammogram and ultrasound. When the tests produced conflicting results (the mammogram showed no thickening or lump; the ultrasound did), Gergen’s surgeon ordered an MRI, which revealed a tumor. “If I hadn’t felt the lump myself, I would have gone for a regular mammogram and thought everything was OK,” she says. After reviewing her options with both a traditional surgeon and Alschuler, Gergen had a double mastectomy. She did not receive chemotherapy or radiation and tamoxifen (the estimated benefit from these treatments was minimal given certain characteristics of her cancer), but she did add 30 minutes of walking to her routine, in addition to cutting back on processed and fatty foods and taking supplements prescribed by Alschuler.