Methods of Diagnosing Breast Cancer

Screening Mammogram

A mammogram uses a series of X-rays to show images of your breast tissue. It is the best imaging technique for detecting tumors before you or your physician can feel them. Screening mammograms are used to look for breast changes in women who have no signs of breast cancer. Mammograms often can 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.

During the 30-minute procedure, your breasts are squeezed together between plastic plates while a radiology technician takes a series of X-rays. If you have tender breasts, schedule your mammogram for a time after your menstrual period. Avoid caffeine for two days before the test to help reduce breast tenderness.

While mammograms are the best way to find breast abnormalities early, they are not perfect. A mammogram may miss about 10 to 15 percent of cancers that are present (false negative) or may find things that are not cancerous (false positive). Some fast-growing breast cancers already may have spread to other parts of the body before being detected. While the efficacy of mammography has been questioned in recent years, studies show that mammograms reduce the risk of dying from breast cancer. The American Cancer Society issued updated guidelines on breast cancer screening, strongly reaffirming its recommendation that women 40 and older have annual mammograms.

The Kentucky Cancer Program, many state health departments and Planned Parenthood clinics offer low-cost or free screenings.

If the mammogram shows something suspicious, your physician may order an ultrasound to take additional views of your breast to decipher the findings from the mammogram. Ultrasound is a procedure that uses sound waves to create an image of your breast on a computer screen. By analyzing this image, your physician may be able to tell whether a lump is a cyst or a solid mass. Cysts, which are sacs of fluid, usually aren't cancerous, although you may want to have a painful cyst drained with a needle.

If you, your physician, a mammogram or ultrasound detects a lump in your breast, you'll likely have a biopsy to determine if the lump is cancerous.

Biopsy

Your physician may want to remove a small sample of tissue (biopsy) for analysis in the laboratory. A surgeon usually will use a technique called core needle biopsy. During this procedure, a surgeon uses a hollow needle to remove tissue samples from a breast lump. Several samples may be taken, and a pathologist then analyzes them for malignant cells. The advantage of a core needle biopsy is that it removes tissue, rather than just cells, for analysis. Your surgeon or radiologist may use ultrasound to help guide the placement of the needle.

Sometimes, this procedure is done under mammography. This technique, stereotactic biopsy, evaluates an area of concern that can be seen on a mammogram. During the procedure, a radiologist takes a core needle biopsy, using your mammogram as a guide.

Estrogen and progesterone receptor tests -- If a biopsy reveals malignant cells, your physician will recommend additional tests - such as estrogen and progesterone receptors tests - on the malignant cells. These tests help determine whether your cancer is fed by estrogen. If the cancer cells have receptors for estrogen or progesterone or both, your physician may recommend treatment with a drug such as tamoxifen that blocks estrogen and therefore may starve the cancer cells.

Staging tests -- Staging tests help determine the size and location of your cancer, and whether it has spread. They also help your physician determine the best treatment for you.

If cancer is detected please click the "If cancer is detected" link in the left margin.