Diagnostic Tests for Breast Cancer


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Diagnostic Test list for Breast Cancer: The list of diagnostic tests mentioned in various sources as used in the diagnosis of Breast Cancer includes:

  • Self breast examination
  • Clinical breast examination
  • Screening mammogram
  • Diagnostic mammograms - more detailed mammograms than the basic screening.
  • Ultrasonography
  • Breast biopsy
  • Pathology test - the cells from a biopsy are sent to a pathologist or lab for analysis.
  • HER-2 gene test - tests for the human epidermal growth factor receptor-2 (HER-2) gene that indicates how fast a tumor may grow.
  • Tests for spreading (metastisis) of breast cancer to other areas of the body:

Tests and diagnosis discussion for Breast Cancer: As a matter of routine, women should perform monthly breast self-examinations, go for a breast exam by a doctor or nurse, and have a mammogram (an x-ray picture of the breast that can detect breast cancer when it is in its earliest, most treatable stage, up to 2 years before a lump can be felt) performed every 1 to 2 years. This will increase the chance of discovering breast cancer early. When detected and treated at an early stage, chances for survival will increase and the woman will have more options for treatment.1

A screening mammogram is the best tool available to find breast cancer before symptoms appear. A mammogram is a special kind of x-ray image of the breasts. Breast cancer screening has been shown to reduce the risk of dying from this disease. The National Cancer Institute recommends that women in their forties and older have mammograms on a regular basis, every 1 to 2 years.2

Women can take an active part in the early detection of breast cancer by having regularly scheduled screening mammograms and clinical breast exams (breast exams performed by health professionals). Some women also perform breast self-exams.

A screening mammogram is the best tool available for finding breast cancer early, before symptoms appear. A mammogram is a special kind of x-ray. Screening mammograms are used to look for breast changes in women who have no signs of breast cancer.

Mammograms can often detect a breast lump before it can be felt. Also, a mammogram can show small deposits of calcium in the breast. Although most calcium deposits are benign, a cluster of very tiny specks of calcium (called microcalcifications) may be an early sign of cancer.

If an area of the breast looks suspicious on the screening mammogram, additional (diagnostic) mammograms may be needed. Depending on the results, the doctor may advise the woman to have a biopsy.

Although mammograms are the best way to find breast abnormalities early, they do have some limitations. A mammogram may miss some cancers that are present (false negative) or may find things that turn out not to be cancer (false positive). And detecting a tumor early does not guarantee that a woman's life will be saved. Some fast-growing breast cancers may already have spread to other parts of the body before being detected.

Nevertheless, studies show that mammograms reduce the risk of dying from breast cancer. Most doctors recommend that women in their forties and older have mammograms regularly, every 1 to 2 years.

Some women perform monthly breast self-exams to check for any changes in their breasts. When doing a breast self-exam, it's important to remember that each woman's breasts are different, and that changes can occur because of aging, the menstrual cycle, pregnancy, menopause, or taking birth control pills or other hormones. It is normal for the breasts to feel a little lumpy and uneven. Also, it is common for a woman's breasts to be swollen and tender right before or during her menstrual period. Women in their forties and older should be aware that a monthly breast self-exam is not a substitute for regularly scheduled screening mammograms and clinical breast exams by a health professional.3

To help find the cause of any sign or symptom, a doctor does a careful physical exam and asks about personal and family medical history. In addition, the doctor may do one or more breast exams:

  • Clinical breast exam. The doctor can tell a lot about a lump by carefully feeling it and the tissue around it. Benign lumps often feel different from cancerous ones. The doctor can examine the size and texture of the lump and determine whether the lump moves easily.

  • Mammography. X-rays of the breast can give the doctor important information about a breast lump.

  • Ultrasonography. Using high-frequency sound waves, ultrasonography can often show whether a lump is a fluid-filled cyst (not cancer) or a solid mass (which may or may not be cancer). This exam may be used along with mammography.

Based on these exams, the doctor may decide that no further tests are needed and no treatment is necessary. In such cases, the doctor may need to check the woman regularly to watch for any changes.

Biopsy

Often, fluid or tissue must be removed from the breast so the doctor can make a diagnosis. A woman's doctor may refer her for further evaluation to a surgeon or other health care professional who has experience with breast diseases. These doctors may perform:

  • Fine-needle aspiration. A thin needle is used to remove fluid and/or cells from a breast lump. If the fluid is clear, it may not need to be checked by a lab.

  • Needle biopsy. Using special techniques, tissue can be removed with a needle from an area that looks suspicious on a mammogram but cannot be felt. Tissue removed in a needle biopsy goes to a lab to be checked by a pathologist for cancer cells.

  • Surgical biopsy. In an incisional biopsy, the surgeon cuts out a sample of a lump or suspicious area. In an excisional biopsy, the surgeon removes all of a lump or suspicious area and an area of healthy tissue around the edges. A pathologist then examines the tissue under a microscope to check for cancer cells.

When a woman needs a biopsy, these are some questions she may want to ask her doctor:

  • What type of biopsy will I have? Why?

  • How long will it take? Will I be awake? Will it hurt?

  • How soon will I know the results?

  • If I do have cancer, who will talk with me about treatment? When?

3

Special lab tests of the tissue help the doctor learn more about the cancer. For example, hormone receptor tests (estrogen and progesterone receptor tests) can help determine whether hormones help the cancer to grow. If test results show that hormones do affect the cancer's growth (a positive test result), the cancer is likely to respond to hormonal therapy. This therapy deprives the cancer cells of estrogen. More information about hormonal therapy can be found in the "Planning Treatment" section.

Other tests are sometimes done to help the doctor predict whether the cancer is likely to progress. For example, the doctor may order x-rays and lab tests. Sometimes a sample of breast tissue is checked for a gene (the human epidermal growth factor receptor-2 or HER-2 gene) that is associated with a higher risk that the breast cancer will come back. The doctor may also order special exams of the bones, liver, or lungs because breast cancer may spread to these areas.3

Diagnosis of Breast Cancer: medical news summaries: The following medical news items are relevant to diagnosis of Breast Cancer:



Footnotes:
1. excerpt from Breast Cancer: NWHIC
2. excerpt from What You Need To Know About Cancer - An Overview: NCI
3. excerpt from What You Need To Know About Breast Cancer: NCI

Last revision: April 9, 2003

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