HOW BREAST CANCER IS DIAGNOSED

It is important to remember that four out of five breast lumps are not cancer. To diagnose breast cancer, a careful physical examination is done, including palpation of your breast, and you are asked about your personal and family history. One or more of these tests may also be done:

Aspiration: In this procedure, your doctor will use a thin needle to remove fluid or a small amount of tissue from your breast lump. This may show whether the lump is a fluid-filled cyst or a solid mass.

Mammography: In this examination, x-rays will be taken of your breast that can give both you and your doctor important information about your breast lump. A mammogram also can show any tumors you may have in your breast that are still too small to be felt. However, mammograms do not show all breast cancers.

Ultrasound: In this test, sometimes called a sonogram, high-frequency sound waves are sent into your breast. The pattern of echoes is shown on a monitor, like a TV screen. Ultrasound examination may be used to distinguish fluid-filled cysts from solid tumors.

Biopsy: A biopsy is surgery to take out part, or all, of a lump or suspicious area. After being removed, the tissue is examined under a microscope by a pathologist. A biopsy is the only sure way to know whether cancer is present. If you are going to have a biopsy, you have an important choice to make.

a. One-step procedure: You can decide that, if cancer is found, you will have surgery to treat your cancer at the same time as the biopsy (a one-step procedure).

b. Two-step procedure: Or, you can decide on only a biopsy and, if it shows cancer, have treatment at a later date. This gives you time to find out about your treatment choices, to get a second opinion, and to prepare for your stay in the hospital, but it does not reduce the chances for successful treatment. Many doctors and patients prefer the two-step procedure, and it is the most common approach.

Hormone receptor tests: If the biopsy shows that cancer is present, laboratory tests called estrogen and progesterone receptor tests are usually done on the tissue removed during the biopsy. These tests can tell whether these hormones help your particular kind of cancer to grow. This information helps your doctor decide whether hormone treatment is likely to be useful in your case.

If your biopsy shows that your lump is cancer, your doctor may order other special laboratory tests to learn more about the cancer. Your doctor may order chest x-rays, blood tests, and/or scans to determine whether or not the cancer has spread from your breast to other parts of your body. These tests help your doctor tell the extent, or stage, of the disease. Doctors use this staging system for breast cancer: