13 11 20

Information and support

  • Get informed
  • Get support
  • Cut my risk
  • Get involved
  • Research
  • How is breast cancer diagnosed?

    Contents

    Diagnosis

    Several tests are usually used to find out if your breast change is due to cancer.

    Physical examination

    Your doctor will feel your breasts and the lymph nodes under your arms. They will also take a full medical history and ask about your family history.

    Mammogram

    A mammogram is a low-dose x-ray of the breast tissue. This x-ray can find changes that are too small to be felt during a physical examination. Your breast is pressed between two x-ray plates, which spread the breast tissue out so clear pictures can be taken. Both breasts are checked. This procedure can be uncomfortable, but it’s over in about 20 seconds.

    Ultrasound 

    An ultrasound is a painless scan that uses soundwaves to create a picture of your body. A gel is spread on your breast and a small device called a transducer is moved over the area. This sends out soundwaves that echo when they meet something dense, like an organ or tumour. A computer creates a picture from these echoes. The scan takes about 15–20 minutes. 

    Breast MRI

    This form of breast imaging uses a large magnet in a scanner to image breast tissue. Breast MRI (magnetic resonance imaging) is more sensitive than mammography or breast ultrasound. It is commonly used to screen women at high-risk of breast cancer, but it can also be used in women with very dense breast tissue. Breast MRI is becoming more widely available as an assessment tool.

    During the scan, you may have an injection of a contrast dye to make any potential cancerous breast tissue easier to see. To have the breast MRI, you will lie facedown on a screening table with cushioned openings for your breasts. The table slides into the machine. This test can take 30–60 minutes. 

    Biopsy

    Your doctor will suggest a biopsy if an abnormal or unusual area of tissue is found in your breast. During a biopsy a small amount of tissue is removed from your breast. A pathologist examines the removed tissue and checks for cancer cells under a microscope. 

    There are a few ways of doing a biopsy and you may need to have more than one:

    Fine needle aspiration (FNA)

    A thin needle is used to take some cells from the breast lump or abnormal area. Sometimes an ultrasound is used to help guide the needle. The test is a bit uncomfortable, it can feel similar to having blood taken. It is usually done in a specialist’s rooms, by a pathologist in a hospital outpatient department or at a radiology practice.

    Core biopsy

    A wider needle is used to remove a small piece of tissue, called a core, from the lump or abnormal area. It is usually done under local anaesthetic, so your breast is numb, though you may still feel some discomfort.

    During this procedure, a mammogram, ultrasound or MRI is used to help guide the needle.

    Vacuum-assisted stereotactic biopsy (VAB)

    This is also performed under local anaesthetic. Lots of small tissue samples are removed using a suction-type instrument and computer guided technology.

    Surgical biopsy

    If the abnormal area is too small to be biopsied using the methods above a surgical biopsy is done. Before the biopsy a guide wire may be put into the breast to help the surgeon find the abnormal tissue. You will be given local anaesthetic and the doctor may use an ultrasound or mammogram to insert the wire. This is done in the radiology department.

    The biopsy is then done in a separate operation using a general anaesthetic. The lump and a small area of breast tissue around the lump are removed along with the wire.

    This operation is usually done as day surgery but some women have an overnight stay in hospital.

    Further tests

    If the tests described previously, show you have breast cancer, one or more tests may be done to see if the cancer has spread to other parts of your body.

    The test and scan results will be written in a report.

    Blood tests

    Blood samples may be taken to check your general health, and also to look at your bone and liver function for signs of cancer.

    Chest x-ray

    Your doctor may take an x-ray of your chest to check your lungs for signs of cancer.

    CT scan

    A CT (computerised tomography) scan is a type of x-ray procedure that takes pictures of the inside of the body. Unlike a standard x-ray, which takes a single picture, a CT scan uses a computer to compile many pictures of the body. It can show if the cancer has spread to the lymph nodes or other organs.

    To make the scan pictures clearer and easier to read, you may have to fast (not eat or drink). You will also be asked to drink a liquid and have an injection of a dye into a vein in your arm. This can make you feel hot all over for a few minutes.

    You will lie flat on a table while the CT scanner, which is large and round like a doughnut, takes pictures. This painless test takes about 30–40 minutes.

    Bone scan

    A bone scan may be done to see if the breast cancer has spread to your bones. A small amount of radioactive material is injected into a vein, usually in your arm. This material is attracted to areas of bone where there is cancer.

    After a few hours, the bones are viewed with a scanning machine, which sends pictures to a computer. This scan is painless and will not make you radioactive. You should drink plenty of fluids on the day of and the day after the test.

    PET scan

    A PET (positron emission tomography) scan is a specialised test, which is rarely done for breast cancer. It uses low-dose radioactive glucose to measure cell activity in different parts of the body.

    A small amount of glucose is injected into a vein, usually in your arm. You will need to wait for about an hour for the fluid to flow through your body.

    You will then lie on a treatment table that moves through a scanning machine. This body scan will show ‘hot spots’ where the fluid has accumulated – this happens where there are active cells, like cancer cells.

    While a PET scan is not a routine test, it may be used if other types of scans don’t give doctors the information they need.

    There may be extra costs associated with some tests and scans, depending on whether you are treated in a public or private hospital. Talk to your medical team for information about how much you will be charged.

    Which health professionals will I see?

    You will be cared for by health professionals who specialise in different aspects of your treatment. You may also see other allied health professionals who work alongside the doctors and nurses.

    Allied health professionals provide important care and support services.The following health professionals may be in your multidisciplinary team (MDT). 

    Breast surgeon specialises in surgery and performs biopsies; some breast surgeons also perform breast reconstruction and specialised oncoplastic procedures as part of the breast cancer surgery

    Oncoplastic breast surgeon specialises in the use of plastic surgery techniques to achieve good appearance after surgery

    Pathologist examines cells and tissue that is removed from the breast to determine the type and extent of the cancer

    Breast care nurses specialist nurses who are trained in breast cancer care and provide information and support through all stages of treatment and ongoing care

    Radiologist specialises in reading x-rays, such as mammograms

    Radiation oncologist prescribes and coordinates radiotherapy

    Radiation therapist plans and delivers radiation treatment

    Medical oncologist prescribes and coordinates chemotherapy, hormone therapy and targeted drug therapies      

    GP (general practitioner) explains information provided by specialists, helps you with treatment decisions, assists you in obtaining practical and emotional support, and works in partnership with your specialist in providing your ongoing care

    Reconstructive (plastic) surgeon performs breast reconstruction for women who have had a mastectomy 

    Lymphoedema therapist educates patients about lymphoedema management and provides treatment if lymphoedema occurs 

    Physiotherapist, occupational therapist assist in restoring range of movement after surgery 

    Nurses support and help you through all stages of your treatment 

    Genetic counsellor provides advice for people with a strong family history of breast cancer 

    Counsellor, psychologist, psychiatrist provide emotional support and help manage anxiety and depression

    This website page was last reviewed and updated February 2016.

    Information last reviewed August 2014 by: Dr Carolyn Cho, Breast and General Surgeon, Surgical Oncology, Deakin, ACT; Lynn Buglar, Breast Physician, BreastScreen, NSW; Mena Crew, Consumer; Elizabeth Jacobson, Consumer; Jane Marsh, Clinical Manager, Breast Centre, Brian Fricker Oncology Centre and Burnside War Memorial Hospital, SA; Marie Murdoch, Breast Care Nurse, Cancer Council Queensland, QLD; and Marion Strong, Clinical Nurse Consultant Breast Care Nurse and Cancer Care Coordinator, Toowoomba Hospital, QLD.

    PDF
    email Email