December 6, 2021 by John Fernandez
When the Breast Surgeon Becomes the Patient: What It’s Like Getting a Breast MRI
As a breast surgical oncologist at Miami Cancer Institute and someone with a family history of breast cancer, I practice what I preach when it comes to screenings. I know I’m at greater risk for developing the disease, so I’ve always been diligent about my monthly self-exams and annual mammograms. This year, I even supplemented my regular screenings with breast magnetic resonance imaging (MRI). The results would give me a scare – and a greater appreciation for what my patients go through when they learn they may have breast cancer.
My mother was diagnosed with breast cancer at the age of 47, so I started my own screenings with mammograms and breast ultrasounds a couple of years ago. Although my breast tissue is dense, I’ve always been reassured by the fact that my mammograms have appeared normal and stable. For women like me, however, who have very dense tissue or a lifetime risk of breast cancer above 20 percent, a breast MRI is recommended because it is highly sensitive and can reveal even the smallest tumors.
Since I send my own patients to get MRIs when appropriate, I have a good idea of what it entails; most who’ve had one describe it as being “uncomfortable.” Now I was about to get a taste of my own medicine.
Welcome to the machine
For the breast MRI, I had to lie flat on my stomach on a table, my face cradled by a donut-shaped pillow and my breasts hanging down through two holes underneath. The nurses and radiology technicians were extremely nice and kept me informed of everything as it happened. As the table slowly moved through the MRI machine, a powerful magnetic force took images of my breast tissue. A contrasting agent was then injected through an IV and another set of images was taken.
The entire test took about 25 minutes. I didn’t find it particularly claustrophobic but the sound of the machine was still loud and startling, even though I was listening to music through headphones the entire time. Also, I was focused on lying perfectly still, as any motion during the test can render images blurry and unreadable.
False positives are common
When I send patients for a breast MRI, I warn them that due to its increased sensitivity, it’s very common to have a false positive reading, or an area that may “enhance” but not actually be cancer. Knowing this, I mentally prepared myself that my MRI would find something that requires follow-up.
I was surprised when my MRI revealed not one but three “enhancements” – one in my left breast and two in my right – that would require biopsies. I needed a few hours to process this news but after reviewing the images myself, I realized I really did need the biopsies.
It would mean going back into the MRI machine again, this time for even longer and with large needles inserted into my breasts (under local anesthesia, of course) to obtain samples for the biopsy. I freaked out a bit and cried some, but I reminded myself what I tell my own patients:
“This is your first breast MRI so you have nothing to compare it to and whatever shows up could be completely normal.”
“Because MRIs are so sensitive, it’s extremely common to find something.”
“If we do find something, it’ll most likely be benign.”
“If it really is cancer, it’s extremely small and was caught early enough to treat.”
The procedure itself took more than two hours, start to finish. Afterwards, I put on a tight-fitting sports bra and wrapped a compression bra on top of that with ice packs tucked in between to keep my breasts from moving and to limit any bruising or swelling. I put topical arnica on the sites to further limit the bruising and took it easy for about 24 hours.
The results come back
The next day, I was greatly relieved to learn that all three sites were indeed benign. I was so grateful to know that I’d be able to continue caring for my patients and my family without having to go through surgery or additional treatment. A week later, I was back to playing tennis with a tight sports bra and by two weeks the bruising and swelling had completely subsided.
Being a breast surgical oncologist, I pride myself on being able to relate to my patients and comfort them during their journey. Having experienced a small part of what many of them go through has given me even more empathy for how my patients feel during their diagnosis and follow-up.
My experience has also given me an even greater appreciation for my own staff here at Miami Cancer Institute’s Breast Center and who helped make me feel so comfortable. I know from working side-by-side with them every day that they do this for all of our patients, not just those who happen to be a breast surgeon here.
A final reminder to every woman reading this: please keep up with your annual mammograms and other health screenings. And if you’re like me and have dense breast tissue or an elevated risk of breast cancer, consider asking your doctor about getting a breast MRI. As with any type of cancer, early detection almost always leads to better outcomes.