Diagnosis of Breast cancer usually happens in two common ways:
- Screening mammogram: This is an X-Ray of the breast done to detect small cancers that are still too small to feel.
- Patients or their GPs notice symptoms or signs of Breast cancer like a mass (lump) in the breast or in the armpit.
Breast cancer may also be diagnosed incidentally when patients are having tests for something else.
Patients with suspected breast cancer will be referred to their specialist breast cancer clinic to have three main tests. These tests called collectively triple assessment: mammogram, ultrasound and biopsy:
Mammogram and breast ultrasound
A mammogram is an X-ray of your breasts while an ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts, showing any lumps or abnormalities.
Your doctor may suggest that you only have a breast ultrasound scan if you’re under the age of 35. This is because younger women have denser breasts, which means a mammogram isn’t as effective as ultrasound in detecting cancer. Your breast specialist may also suggest a breast ultrasound if they need to know whether a lump in your breast is solid or contains liquid.
A biopsy is where a sample of tissue cells is taken from your breast or from one of the lymph nodes in your armpit (axilla) and tested to see if it’s cancerous. During the biopsy, you’ll have a local anaesthetic, which means you’ll be awake during the procedure, but your breast will be numb.
Further tests for breast cancer
If a diagnosis of breast cancer is confirmed, more tests may be needed to determine the stage and grade of breast cancer and work out the best method of treatment.
- Computerised tomography (CT) scans or chest X-ray and liver ultrasound scans may be needed to check whether cancer has spread.
- An MRI scan of the breast may be needed to clarify the results or assess the extent of the condition within the breast.
- If your doctor thinks cancer could have spread to your bones, you may need a bone scan. Before having a bone scan, a substance containing a small amount of radiation known as an isotope will be injected into a vein in your arm. This will be absorbed into your bone if it’s been affected by cancer. The affected areas of bone will show up as highlighted areas on the bone scan, which is carried out using a special camera.
Tests to determine specific types of treatment
You’ll also need tests that show whether cancer will respond to specific types of treatment. The results of these tests can give a complete picture of the type of cancer you have and how best to treat it. The types of test you could be offered are discussed below.
- In some cases, breast cancer cells can be stimulated to grow by hormones that occur naturally in our bodies, such as oestrogen and progesterone. If this is the case, cancer may be treated by stopping the effects of the hormones or by lowering the level of these hormones in your body. This is known as hormone therapy.
- While hormones can encourage the growth of some types of breast cancer, other types are stimulated by a protein called human epidermal growth factor receptor 2 (HER2). These types of cancer can be diagnosed using a HER2 test, and are treated with medication to block the effects of HER2. This is known as biological or targeted therapy.