Breast Cancer

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Early Detection, Diagnosis, and Staging TOPICS

How is breast cancer diagnosed?

Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms. This is why getting the recommended screening tests (as described in "Can breast cancer be found early?") before any symptoms develop is so important.

If something suspicious is found during a screening exam, or if you have any of the symptoms of breast cancer described in the previous section, your doctor will use one or more methods to find out if the disease is present. If cancer is found, other tests will be done to determine the stage (extent) of the cancer.

Medical history and physical exam

If you think you have any signs or symptoms that might mean breast cancer, be sure to see your doctor as soon as possible. Your doctor will ask you questions about your symptoms, any other health problems, and possible risk factors for benign breast conditions or breast cancer.

Your breasts will be thoroughly examined for any lumps or suspicious areas and to feel their texture, size, and relationship to the skin and chest muscles. Any changes in the nipples or the skin of your breasts will be noted. The lymph nodes in your armpit and above your collarbones may be palpated (felt), because enlargement or firmness of these lymph nodes might indicate spread of breast cancer. Your doctor will also do a complete physical exam to judge your general health and whether there is any evidence of cancer that may have spread.

If breast symptoms and/or the results of your physical exam suggest breast cancer might be present, more tests will probably be done. These might include imaging tests, looking at samples of nipple discharge, or doing biopsies of suspicious areas.

Imaging tests used to evaluate breast disease

An imaging test is a way to see what’s going on inside your body. The pictures can show normal body structures and functions, as well as abnormal ones caused by diseases like cancer.

These are some of the more common imaging tests used to look for or learn more about breast changes and breast cancer:

Mammograms

A mammogram is an x-ray of the breast. Screening mammograms are used to look for breast changes in women who have no signs or symptoms of a breast problem. Screening mammograms usually take 2 views (x-ray pictures taken from different angles) of each breast. Diagnostic mammograms are used to get a closer look of a change seen on a screening mammogram. More pictures are taken of the area that may be cancer.

See Mammograms and Other Breast Imaging Tests for more detailed information.

Breast ultrasound

Ultrasound, also known as sonography, uses sound waves to outline a part of the body. It’s useful for looking at some breast changes, such as those that can be felt but not seen on a mammogram. It also helps tell the difference between fluid-filled cysts and solid masses.

See Mammograms and Other Breast Imaging Tests for more detailed information.

Magnetic resonance imaging (MRI) of the breast

MRIs use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of body tissue and by certain diseases. A computer translates the pattern into a very detailed picture. For breast MRI to look for cancer, a contrast liquid called gadolinium is injected into a vein before or during the scan to show details better.

See Mammograms and Other Breast Imaging Tests for more detailed information.

Ductogram (galactogram)

A ductogram, also called a galactogram, is sometimes used to help find the cause of any worrisome nipple discharge. In this test, a very thin metal tube is put into the opening of a duct in the nipple that the discharge is coming from. A small amount of contrast material is put in. It outlines the shape of the duct on x-ray and can show if there’s is a mass inside the duct. If fluid is coming from your nipple, some of the fluid may be collected and checked for signs of infection or cancer cells.

Biopsy procedures

A biopsy is done when mammograms, other imaging tests, or the physical exam shows a breast change that may be cancer. A biopsy is the only way to know for sure if it’s cancer. For a biopsy, a sample (tiny piece) of the suspicious area is taken out and tested in the lab. The sample is called a biopsy specimen. See For Women Facing a Breast Biopsy for more information.


Last Medical Review: 09/25/2014
Last Revised: 05/04/2016