Breast Cancer : Testing and Diagnosis

by National Institute on Aging

(Page 2 of 5)

Most cancers in their early, most treatable stages do not cause any symptoms. That is why it's important to have regular tests to check for cancer long before you might notice anything wrong.

When breast cancer is found early, it is more likely to be treated successfully. Checking for cancer in a person who does not have any symptoms is called screening. Screening tests for breast cancer include, among others, clinical breast exams and mammograms.

Side by side view of two nomal breasts. During a clinical breast exam, the doctor or other health care professional checks the breasts and underarms for lumps or other changes that could be a sign of breast cancer. A mammogram is a special x-ray of the breast that often can detect cancers that are too small for a woman or her doctor to feel.

Several studies show that mammography screening has reduced the number of deaths from breast cancer. However, some other studies have not shown a clear benefit from mammography.

Scientists are continuing to examine the level of benefit that mammography can produce. For the time being, the National Cancer Institute recommends the following:

• If you are a woman in your 40s, you should have mammography screening every one to two years.
• If you are a woman age 50 and older, you should have mammography screening every one to two years.
• If you are a woman who is at higher than average risk for breast cancer, you should seek expert medical advice about whether to begin screening before age 40 and how often to have screening mammography.

Small cancerous lesion. Between 5 and 10 percent of mammogram results are abnormal and require more testing. Most of these follow-up tests confirm that no cancer was present.

If needed, the most common follow-up test a doctor will recommend is called a biopsy. This is a procedure where a small amount of fluid or tissue is removed from the breast to make a diagnosis. A doctor might perform fine needle aspiration, a needle or core biopsy, or a surgical biopsy.

With fine needle aspiration, doctors numb the area and use a thin needle to remove fluid and/or cells from a breast lump. If the fluid is clear, it may not need to be checked out by a lab.

For a needle biopsy, sometimes called a core biopsy, doctors use a needle to remove tissue from an area that looks suspicious on a mammogram but cannot be felt. This tissue goes to a lab where a pathologist examines it to see if any of the cells are cancerous.

In a surgical biopsy, a surgeon removes a sample of a lump or suspicious area. Sometimes it is necessary to remove the entire lump or suspicious area, plus an area of healthy tissue around the edges. The tissue then goes to a lab where a pathologist examines it under a microscope to check for cancer cells.

Doctors are studying another type of surgical biopsy that removes less breast tissue. It is called an image-guided needle breast biopsy, or stereotactic biopsy. If approved for general use, it would become an important surgical tool.

Eighty percent of U.S. women who have a surgical breast biopsy do not have cancer. However, women who have breast biopsies are at higher risk of developing breast cancer than women who have never had a breast biopsy.

Mammogram vs. MRI.

Other techniques used to find cancer include a new way of reading mammograms called digital mammography. Magnetic resonance imaging, or MRI, and ultrasound are two other techniques which researchers think might detect breast cancer with greater accuracy.

Quiz

1. Early signs of cancer are often painful.

FALSE is the correct answer. Most cancers in their early, most treatable stages don't cause any symptoms.

2. A mammogram is a special type of breast x-ray.

TRUE is the correct answer. A mammogram is a special x-ray of the breast that often can detect cancers that are too small for a woman or her doctor to feel.

3. Women who have mammograms always require a second, follow-up test.

FALSE is the correct answer. Only 5 to 10 percent of mammogram results are abnormal and require more testing. Most of these follow-up tests confirm that no cancer is present.

4. Having a surgical biopsy means removing an entire breast.

FALSE is the correct answer. In a surgical biopsy, the surgeon removes a sample of a lump or suspicious area. Sometimes it is necessary to remove the entire lump or suspicious area, plus an area of healthy tissue around the edges.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.