Learn More About How Breast Cancer is Diagnosed —
In India, breast cancer cases are increasing at an unprecedented rate, affecting all segments of society, whether urban or rural. Knowing the diagnostic methods and following an effective treatment plan is the only way to slow the country’s disease trajectory.
The diagnosis of breast cancer is not straightforward. If you have breast symptoms, your doctor may use several tests to find breast cancer, its spread, and the appropriate treatment plan. Although a biopsy is the most definitive method for confirming cancer diagnosis, several factors such as the type of cancer suspected, an individual’s signs and symptoms, personal health status, and medical history can influence the test choice.
Details of some of the widely used diagnostic tests for breast cancer or other breast conditions are as follows:
Imaging tests
- Diagnostic Mammogram: Mammograms are the breast X-rays recommended when there are suspicious findings on the annual screening mammogram or any breast cancer signs in physical examination. In certain women with a high risk of invasive cancer, a mammogram can also help diagnose ductal carcinoma in situ (DCIS), a tumor of the duct in the breast.
Be informed that the procedure, while being reliable, has a 20% chance of missing breast cancer cases and at times may provide false-positive results even when there is no malignancy.
- Ultrasound: A machine produces sound waves to create detailed images of the area inside the breast. Your doctor can use it to detect a solid mass and find whether it is cancer or a fluid-filled cyst.
- Magnetic Resonance Imaging (MRI): It provides detailed images of the area inside your breast. But, it isn’t typically a tool for cancer screening. In most cases, breast MRI is done as an adjunct to regular annual mammography or ultrasound for some women at very high risk of developing breast cancer as well as in women who have a history of breast cancer or in young women with dense breasts.
Biopsy
A biopsy is an outpatient procedure that usually involves collecting a small sample from the lump or the build-up fluid. Based on the tumor size, the commonly used breast biopsy techniques are:
- Fine needle aspiration biopsy (FNAC): It is performed by sticking a needle into the breast and withdrawing a tiny breast tissue for pathological analysis under a microscope.
- Core needle biopsy: This is a test done with the help of a biopsy gun with a hollow needle. After injecting local anesthesia, a small tissue sample is extracted with the help of this instrument. It may be done directly or via ultrasound guidance. If a mammogram is used for guidance, the procedure is called stereotactic breast biopsy.
- Your doctor will suggest the type of biopsy you require
- Surgical or open biopsy: In this type of biopsy, the surgeon makes a large cut to recover the lump before evaluating it under a microscope. If the removed lump is small or difficult to map, a wire-guided procedure may also be used before the surgery.
- Imaging-guided biopsy: For this type of biopsy, imaging tests such as a mammogram, ultrasound, or an MRI is used to create images of the dubious area that are not felt usually. Using these images, your doctor can then pinpoint a suitable spot for collecting the cells.
- Skin punch biopsy: It is useful when inflammatory breast cancer is suspected. What is looked for is a change in the skin of the breast or nipple. Next, samples of cells are taken for further testing.
- Vacuum-assisted biopsy (VAB): In this test, a special needle is connected to a vacuum device to collect the breast tissue samples.
Once the biopsy is complete, the pathology report, which usually takes about 1–2 weeks, will be sent to your doctor to determine whether the suspicious area is cancerous or not and how aggressive your cancer is, that is, the cancer’s grade.
After the confirmed diagnosis, additional tests may be done to learn more about the tumor’s features, such as the presence of hormone receptors and whether cancer has spread across the breast or to other areas of the body (staging tests).
Some tests used in the staging process are listed below:
- Sentinal Lymph node Biopsy: In the case of breast cancer, the lymph node or group of lymph nodes under your armpit is usually biopsied to determine cancer in the lymph nodes on the side of the breast affected by cancer. This procedure is performed using blue dye or radio colloid or both.
The following scans are done in cases of locally advanced breast cancer to determine whether the cancer has spread to different parts of the body of not.
- Bone scan: It aids in the diagnosis of metastatic bone cancer. The doctor will inject a radioactive dye into your blood vessel, which will allow a scanner to make images of the bone area having the cancerous cells.
- Positron emission tomography scan (PET scan): As a bone scan, in PET scan too, radioactive glucose is injected into the vein, and pictures are made to locate the tumor.
- Computed tomography (CT) scan: It is an X-ray that takes pictures of the inside the body from various angles to know whether cancer has spread beyond the breast to other body organs such as the chest, lungs, or stomach.
Breast cancer has a better chance of survival if it is diagnosed and treated early. Talk to your doctor if you have any concerns or questions about the various diagnostic methods, including checking for breast cancer at home.
References
- Breast Cancer Treatment (Adult) (PDQ®)–Patient Version—National Cancer Institute (2021, January 8). https://www.cancer.gov/types/breast/patient/breast-treatment-pdq
- Breast Cancer Tests. (2014, August 28). Healthline. https://www.healthline.com/health/breast cancer-tests
- Breast Cancer—Diagnosis. (2012, June 25). Cancer.Net. https://www.cancer.net/cancer-types/breast cancer/diagnosis
- Tests to diagnose breast cancer | Cancer Research UK. (n.d.). Retrieved April 5, 2021, from https://www.cancerresearchuk.org/about-cancer/breast cancer/getting-diagnosed/tests-diagnose
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