How is breast cancer diagnosed?
Breast Cancer may get diagnosed as part of routine cancer screening or when a woman presents to the doctor with the symptoms resembling Breast Cancer. Listed below are the various methods to detect Breast Cancer:
1. Imaging tests
Different types of imaging tests are conducted to provide images of breast tissue. These include:
- Mammogram – A mammogram forms part of regular Breast cancer screening too. It is basically an x-ray of the breast tissue, creating images taken from different angles. A diagnostic mammogram is used to create images of specific breast tissue areas if a normal screening mammogram gives abnormal results.
- Ultrasound Breast – Breast ultrasound or sonography creates digital images of breast tissue using sound waves. It is commonly used to scan a particular area of breast tissue that shows abnormal result in a mammogram. It can also differentiate between a solid mass and cyst, and even benign and malignant tumours.
- Magnetic resonance imaging (MRI) – Together with mammograms, MRI is used in regular screening in high-risk women. It is also used to determine the actual size and location of the breast tumour.
- Ductogram – Also called galactogram, this test injects a contrast dye into the nipple duct to create its outline. This shows up as an x-ray image along with any solid tumour mass.
2. Other tests
- Nipple discharge test – Discharge from nipple is looked under the microscope, especially if it is red or brown (containing blood).
- Ductal lavage – High-risk women may undergo this test, which involves collecting nipple duct cells by inserting a catheter. Cells are examined under a microscope.
BIOPSY is the final confirmatory test for Breast Cancer. It is done when other tests and examinations suggest an abnormality in the breast. A biopsy involves removing a small sample tissue for microscopic examination. There are different types of biopsies that can be conducted, depending on the lump size and other medical conditions. These include:
- Fine Needle Aspiration Biopsy (FNA) – A special, thin, hollow needle is used to aspirate or withdraw tissue sample from the suspected area in the breast. However, this biopsy cannot tell if the cancer is invasive, and also sometimes there is a chance that sufficient or correct sample is not collected.
- Core Needle Biopsy – A larger needle is used to collect sample from the suspected area in the breast.
- Sentinel Node Biopsy – This biopsy is useful in identifying the initial lymph nodes (sentinel nodes) that the tumour drains or spreads to. This allows the doctor to remove only these specific nodes that contain the cancerous cells. In Breast Cancer, the first or sentinel nodes the breast tumour spreads to are the axillary nodes located under the arm. A positive sentinel node biopsy can suggest the cancer has spread to other nodes while a negative test confirms the tumour has not yet spread. Sentinel nodes are located using a labelling substance (radioactive tracer or dye), following the same path as the cancer would follow. This biopsy is useful in correctly pinpointing the location of the cancer, preventing unnecessary surgery or treatment complications.
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“Diagnosing breast cancer,” CancerResearchUK.org, http://www.cancerresearchuk.org/about-cancer/type/breast-cancer/diagnosis/
“Diagnosing breast cancer,” NHS.uk, http://www.nhs.uk/Conditions/Cancer-of-the-breast-female/Pages/Diagnosis.aspx
“Diagnosis & Tests,” WebMD.com, Breast Cancer Health Center, http://www.webmd.com/breast-cancer/guide/breast-cancer-diagnosis-tests
“How is breast cancer diagnosed?” Cancer.org, http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-diagnosis