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Breast Cancer: Diagnosis

How is breast cancer diagnosed?

It is important to remember that a lump or other changes in the breast, or an abnormal area on a mammogram, may be caused by cancer or by other, less serious problems.

To determine the cause of any signs or symptoms, your physician will perform a careful physical exam that includes:

• personal and family medical history
• current overall health status
• one or more of these breast exams:
  • palpation - carefully feeling the lump and the tissue around it - its size, its texture, and whether it moves easily. Benign lumps often feel different from cancerous ones.
  • diagnostic mammography - x-ray procedure of the breast.
  • ultrasonography - high-frequency sound waves, not heard by humans. The sound waves enter the breast and bounce back. The pattern of their echoes produces a picture called a sonogram, which is displayed on a screen. This exam is often used along with mammography.
  • nipple discharge examination

Based on these exams, your physician may decide that no further tests are needed and no treatment is necessary. In such cases, your physician may want to check you regularly to watch for any changes.

Often, however, the physician must remove fluid or tissue from the breast to be sent to the laboratory for diagnosis. This procedure is called biopsy, and there are several types:

• image-guided biopsies - those aided by ultrasound or other imaging technique
  • fine needle aspiration - a very fine needle is guided into the suspicious area and a small sample of the tissue is removed.
  • core needle biopsy - a larger needle is guided into the lump to remove a small cylinder of tissue.
• surgical biopsy - a surgeon removes part or all of a lump or suspicious area, which is followed by a pathological examination of the tissue to check for cancer cells.