Breast Cancer Testing

It is important to remember that a lump or other changes in the breast, or an abnormal area on a mammogram, may be caused by cancer or by other, less serious problems.

To determine the cause of any signs or symptoms, your physician will perform a careful physical exam that includes a personal and family medical history as well as determining current overall health status.

In addition, an examination may include the following:

palpation- carefully feeling the lump and the tissue around it - its size, its texture, and whether it moves easily. Benign lumps often feel different from cancerous ones.

nipple discharge examination - fluid may be collected from spontaneous nipple discharge and then sent to the lab to look for cancer cells. Most nipple secretions are not due to cancer. An injury, infection, or benign tumor may cause discharge.

For women who are at high risk for breast cancer, a procedure called ductal lavage may be used. Cells are collected from inside the milk ductal system - the location where most breast cancers begin.

In addition to a physical examination by your physician, an imaging test will be performed.

Imaging tests may include one or more of the following:

digital mammography (Also called full-field digital mammography, or FFDM) - a diagnostic mammogram using solid-state detectors instead of x-rays to diagnose unusual breast changes, such as a lump, pain, nipple thickening or discharge, or a change in breast size or shape.

A diagnostic mammogram is also used to evaluate abnormalities detected on a screening mammogram. It is a basic medical tool and is appropriate in the workup of breast changes, regardless of a woman's age.

Some studies have found FFDM to be more accurate in finding cancers in women younger than 50. Also, it has been found that women undergoing digital mammography do not have to return for additional studies as often as with standard film mammography because the digital images have fewer questionable spots needing more investigation.

However, not all hospitals and mammography facilities have digital equipment available.

ultrasonography - a procedure that uses high-frequency sound waves, not heard by humans. The sound waves enter the breast and bounce back. The pattern of their echoes produces a picture called a sonogram, which is displayed on a screen. This exam is often used along with mammography.

scintimammography- a specialized breast scan that uses a tiny amount of radioactive substance to assess the breasts.

The radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is injected and absorbed by certain types of body tissues. Images are taken of the breasts and analyzed.

magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

In early 2007, the American Cancer Society (ACS)recommended new guidelines which include screening MRI with mammography for certain high-risk women.

According to the ACS, contrast-enhanced MRI of the breasts has been shown to have a high sensitivity for detecting breast cancer in women either with or without symptoms.

A physician may need to remove fluid or tissue from the breast to be sent to the lab to look for cancer cells. The procedure, known as a breast biopsy, may be performed using a needle to acquire the tissue sample or by a surgical method.

Always consult your physician for more information.