OpenHealth Q&A

MRI Findings Post-Lumpectomy and Sentinel Lymph Node Dissection

Greetings, I am a 39-year-old female who has recently received a diagnosis of stage 1 invasive ductal carcinoma (IDC), classified as ER/PR positive and HER2 negative. The MRI I underwent was conducted approximately one week following my lumpectomy accompanied by sentinel lymph node dissection. During the surgery, four axillary lymph nodes were extracted, and pathology confirmed that all were benign. Despite this, I’ve noticed persistent swelling in my breast, even seven weeks post-operation, prompting me to revisit the MRI results, which has reignited my anxiety. With radiation therapy on the horizon, I find this especially concerning, as the procedure is generally straightforward. The terminology regarding abnormal lymph nodes and the Birads 3 classification has particularly troubled me. I reached out to my surgical oncologist for clarification, and she reassured me that such findings are frequently encountered and often deemed normal. However, I’m keen to know if, in your opinion, this appears typical or if a biopsy is warranted? Thank you for your assistance. Here’s a summary of my MRI findings: Right breast: Postsurgical alterations with widespread dermal thickening. The previously noted periareolar enhancing lesions are absent, including those adjacent to the cancer site, which aligns with surgical margins. There is diffuse enhancement of the underlying normal fibroglandular tissue, with no evidence of abnormal discrete enhancing lesions. There are postsurgical changes observed in the axillary region, with a few remaining small subcentimeter axillary lymph nodes correlating with the surgical intervention and any concerning lymph nodes. No signs of abnormal internal mammary lymphadenopathy are noted. IMPRESSION: BI-RAD 3: Likely Benign. Postsurgical changes in the right breast; no further periareolar enhancing breast lesions observed. The presumed axillary lymph node dissection shows postsurgical changes, with only a few nonspecific subcentimeter axillary lymph nodes remaining, which correlate with the surgical procedure for diagnosis. It is advised to adhere to the current oncological treatment plan and schedule a follow-up mammogram and MRI of the right breast, both with and without intravenous contrast, in six months.

Answers (1)

8/2/2025, 7:40:40 AM

OpenHealth AI

It's understandable to feel anxious after a cancer diagnosis and subsequent surgery. Your MRI findings indicate that your surgery has resulted in changes that appear typical, and the BI-RADS 3 classification suggests that the findings are likely benign, although close monitoring is necessary.

Explanation:

• MRI Findings: Your MRI results show that the surgical site is healing with expected postsurgical changes, including dermal thickening, which is a common reaction after lumpectomy and sentinel lymph node dissection. The absence of concerning lesions near the cancer site is a positive sign.
• BI-RADS 3: This classification means that the findings are likely benign, but follow-up is recommended to ensure they remain stable. It's reassuring that your oncologist mentioned these findings are not uncommon and usually not cause for alarm.

Next Steps:

1. Monitor Symptoms: While it's normal to experience swelling post-surgery, track any changes in size, consistency, or associated symptoms (like pain or redness) in your breast. If the swelling significantly increases or you notice new symptoms, it may warrant additional attention.

2. Follow-Up Appointments: Stick to the current treatment plan as advised by your oncologist. Attend all follow-up appointments and imaging (the mammogram and MRI in six months). This will ensure any changes can be monitored over time.

3. Communicate Your Concerns: Since you have lingering anxiety, continue discussing your fears and symptoms with your surgical oncologist. It can be helpful to ask specific questions about what to watch for and express any worries you have about the MRI findings or upcoming treatments.

4. Support System: Engage with support groups or counseling services. Connecting with others who have undergone similar experiences can provide emotional relief and shared knowledge.

It's important to stay informed and proactive while also giving yourself space to process this experience. Remember, it's perfectly okay to seek reassurance when you feel uncertain. If you have further questions or need clarification, don't hesitate to reach out.