How is breast cancer diagnosed?
Despite efforts to increase screening of older women, most women have breast cancer first present to their family practitioner with a lump in their breast. The mainstay of breast cancer diagnosis is the triad of clinical history, physical examination and imaging (either mammography or ultrasound). If clinically indicated, a suspicious lump will then be
biopsied for histological confirmation of whether it is cancerous or not. The biopsy is usually performed either with a fine needle guided by ultrasound or with a larger "core" needle. The diagnosis of breast cancer is confirmed by biopsy results. A pathology report will usually contain a description of cell type and grade. The most common invasive breast cancer cell type is infiltrating ductal carcinoma. Other types include adenocarcinoma, and infiltrating lobular carcinoma.
Your doctor will ask about factors that increase your risk of breast cancer, especially a family history of the illness. He or she also will look for the symptoms described above, including a lump or thickening in the breast, nipple inversion or discharge, swelling or changes in breast contour, redness or dimpling of breast skin, and enlarged lymph nodes in the armpit.
If your doctor discovers a lump in your breast during a physical examination or your screening mammogram detects an area of abnormal breast tissue, your doctor will recommend an evaluation for breast cancer. In some cases, the next step is an ultrasound examination to confirm whether the lump is a solid tumor or a fluid-filled, noncancerous cyst. If the lump is solid, your doctor probably will recommend a breast biopsy — removal of breast tissue for laboratory testing. Sometimes, your doctor will recommend a biopsy without doing an ultrasound first. Several types of breast biopsy are currently available, including fine-needle biopsy, core biopsy, stereotactic needle biopsy and surgical biopsy, which involves the removal of all or part of the breast lump.
The biopsy will confirm whether or not you have breast cancer. Depending on the specific type of biopsy, and whether neighboring lymph nodes were also removed and examined, the biopsy report also may clarify the extent of cancer spread, whether the tumor cells are estrogen-receptor positive or negative, and whether there are too many copies of the HER-2 gene in the cancer cells. These factors will help determine the type of recommended treatment .
After diagnosis, the next phase is tumour staging - this aims to measure the extent of the tumour and whether or not it has metastasized (spread to distant sites).
More information on breast cancer
What is breast cancer? - Breast cancer is cancer of breast tissue. Breast cancer starts in the cells of the breast. Breast tissue covers a larger area than just the breast.
What types of breast cancer are there? - Breast cancer is a type of uncontrolled growth of abnormal cells that can develop in one of several different areas of the breast.
What're the risk factors for breast cancer? - Risk factors for breast cancer include age, geographical variation, reproductive factors, inherited risk, previous breast disease.
What're the symptoms of breast cancer? - Symptoms of breast cancer include breast lump, breast discharge, nipple inversion, or changes in the skin overlying the breast.
How is breast cancer diagnosed? - The mainstay of breast cancer diagnosis is the triad of clinical history, physical examination and imaging (mammography or ultrasound).
What're the stages of breast cancer? - The stages of breast cancer depends on its size and the extent to which it has spread to other parts of the body.
What causes breast cancer? - The exact cause or causes of breast cancer remain unknown. Hormonal influences play a role in the development of breast cancer.
What're the treatments for breast cancer? - Treatment for breast cancer begins with a decision about the type of surgery. Breast implants is used for breast reconstruction.
What're the side effects of breast cancer treatment? - The type and extent of breast cancer treatment side effects vary depending on the particular treatment involved, its duration, and its dose.
How is breast cancer treated with surgery? - Surgery is the mainstay of therapy for breast cancer. A breast biopsy is the removal of breast tissue for examination by a pathologist.
What's the chemotherapy for breast care? - Chemotherapy is the use of anti-cancer drugs to treat cancerous cells. Chemotherapy involves being given a combination of anti-cancer medicines.
What's the radiation therapy for breast cancer? - Radiation therapy is often used to destroy any remaining breast cancer cells in the breast, chest wall, or axilla (underarm) area after surgery.
What's the hormone therapy for breast cancer? - Most breast cancer is sensitive to the female hormone oestrogen. Megestrol acetate is used for hormone treatment of advanced breast cancer.
What breast cancer medications are available? - Medications to treat breast cancer include selective estrogen-receptor modulators, aromatase inhibitors, biologic response modifiers.
Can breast cancer be prevented? - There is no known way to prevent breast cancer. But several preventive measures can be take to reduce risk of breast cancer.