Breast Cancer Diagnosis
are several methods of screening for breast cancer: breast self-examination (BSE), magnetic resonance imaging
(MRI), ultrasound, estrogen and progesterone receptor tests, genetic testing, mammography every 1-2 years, and
self-examination (BSE) - a
self-exam is the
easiest way to find breast cancer at an early stage. Women who practice regularly self-breast examination have
more chances to discover a smaller and less developed breast cancer than those who do not. They have more chance
of being cured or live longer with the disease. You can start practicing regular self-exam from the age of 20.
By doing so, you will become familiar with specific texture of your own breasts and know discover precancerous
abnormalities or early cancerous growth at an earlier stage.
recommended to do a breast self-exam during non hormonal stimulation, or 7 to 10 days after the end of your
menstruation. If you are irregular or postmenopausal, you can chose a specific date to do the test; chose a date
easy to be remembered. During the examination, you can find the following signs if you have breast
of a lump or thickening of the breast
of a nodule in the armpit or neck
retraction of the skin (like an orange peel) or the nipple
and painful inflammation of the skin of the breast
redness or other abnormalities in the nipple
or palpable change of breast.
Although you should always
take seriously any recent change in appearance of your mammary gland, a palpable nodule is not necessarily
cancer. It may be another breast disease such as mastitis, cyst or fibroadenoma, the most common noncancerous
breast tumor in young women. A change in your breast may also simply a hormonal change. Consult your doctor
before you panic or assume anything.
Clinical breast exam – your “self-breast exam” is not always enough to detect
abnormalities in your beast; you may need a breast examination by your doctor. It is an important consideration;
in fact, the American Cancer Society recommends this test once every three years until age 40 for even women who
are not at risk. The monthly self breast exam, clinical breast examination (by your doctor) and mammography are
three key tests in early detection of breast cancer.
Mammogram – this medical technique is often performed in breast
cancer diagnosis. It allows your physician to study your mammary gland and possibly detect anomalies, lesions
and breast cancer even at an early stage. This examination is recommended to be performed when the breasts are
not congested due to menstrual cycle; the breasts are less sensitive to pressure from the mammogram and require
lower doses of x-rays. The mammogram test is the most reliable in detecting breast cancer at a very early stage.
In fact, early mammography can increase your chance of healing up to 90%.
Other tests such as
clinical palpation, ultrasound, scintigraphy, CT scan, and magnetic resonance are often complementary to
mammography and can in no way replace it. However, although the risk of developing breast cancer due to
mammogram is negligible, excessive use can contribute to the development of breast cancer.
Digital mammography (Senographe 2000D) - this screening method is a little
bit recent, but effective. Invented by General Electric, senographe 2000D is approved by the FDA in January 2000
for the diagnosis of breast cancer. Digital mammography can detect breast cancer even when they are not
palpable, but already manifest by fine calcifications or discrete changes in the anatomy of the breast. The
image obtained with the Senographe 2000D is often more excellent than the standard imaging
Computer-aided detection (CAD) – this radiological procedure is a recent advance
in the diagnosis of breast cancer. It highlights micro calcification clusters and hyperdense structures in the
soft tissue of the breast. However, CAD seems less effective in detecting early breast cancer than the digital
mammography; therefore, it is often used complementary to a mammogram exam. In addition, the CAD is more
sensitive for microcalcifications than for masses.
Scintigraphy - Scintigraphy is a medical technique consists of using
radioactive materials to produce images of the breast. This examination is very specific in detecting
malignancy, but it cannot detect lesions that are not larger than 1 cm. scintigraphy presents no risk to your
health because the injected fluid is quickly excreted in your urine. Scintigraphy is complementary to mammogram
and it is recommended:
the mammogram indicates the possibility of a malignancy
cases of dense breasts that make difficult the interpretation of the mammogram
the results of the needle biopsy is not sufficiently conclusive - showing little cancerous cells
case the patient has had cosmetic surgery or breast implants
case of complications of a local cancer following a chemotherapy
during the palpitation, your doctor has discovered a mass that is not visible on mammography – scintigraphy is used
to determine if the mass is tumoral or not.
Magnetic resonance imaging (MRI)
- emerged in the early 1980s, MRI has
become an important tool in the diagnosis of many diseases including breast cancer. It is based on the
principle of nuclear magnetic resonance (NMR) which allows your doctor to take picture of the soft tissue of
your breast. Unlike CT-scan, MRI is noninvasive procedure that does not radiate. In addition, it can
visualize small sized-cancers through their neovascularization.
MRI participates widely in
the diagnosis of tumors and their extension, and plays an active role in many forms of biopsy. It is involved in
treatment decisions, and sometimes even directly involved in the treatment. An MRI helps your doctor to monitor
the evolution of the cancer during and after treatment. However, MRI can give false-positive results; therefore,
it is often used in complementary to mammography.
Breast ultrasound – a breast ultrasound is medical procedure that allows
your doctor to obtain images of your breasts by using sound waves of high frequency. Images obtained give your
doctor the possibility to evaluate abnormalities found during the mammogram or clinical exam. A breast
ultrasound involves no radiation, poses no health problem.
Biopsy – the imaging techniques can reveal a cancerous mass, but
they can’t confirm the presence of cancer cells in your breast. Your physician will perform a biopsy to
accurately confirm the diagnosis. In general, the biopsy consists of removing a sample from the breast tissue or
cells where the tumor is suspected. The sample will be microscopically studied to obtain accurate information on
the overall structure of the fragment removed. Biopsy is often associated with a bacteriological, immunological
or biochemical study. There are different types of biopsy that your doctor can perform:
- Thin Needle aspiration
biopsy(NAB) – also
called fine needle
aspiration cytology, NAB is
and fast procedure, yet reliable in detecting cancer cells. Usually, the pathologist uses a thin needle to
extract tissue or fluid samples from the lump in the breast to examine under microscope. The entire
procedure can last 30 minutes or less.
- Large needle aspiration biopsy (LNAB) –
this procedure is nearly the same as
the fine needle aspiration cytology.
The difference is that the needle is bigger and it takes more tissue for analysis, which allows a
- Surgical biopsy - performed under local or general anesthesia, a
surgical biopsy is the most reliable method to accurately confirm a breast cancer diagnosis. The surgeon
removes either a portion of the tumor (incisional biopsy) or the entire tumor plus the surrounding tissue
(excisional biopsy) to allow a pathologist to do a microscopic examination. After analysis, your oncologist
will be able to determine if your condition is cancer or a benign tumor.
biopsy - this
it is a
painless removal of samples from
a lump in your breast that is visible only by mammogram or ultrasound. During the procedure, your
pathologist will use special computer to guide the needle to the lump from which he will take the
samples. It is an
outpatient procedure done under local anesthesia, which can replace surgical biopsy with comparable
reliability. A stereotactic
be performed by a certified
technologist, but it requires interpretation of a physician or a board certified