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Imaging Tests to Look for Breast Cancer Spread
If you have been diagnosed with breast cancer, you might need more imaging tests to help see if the cancer has spread to other parts of the body such as the bones, lungs, liver, or brain. Your doctor will talk with you about which of these tests you need.
Chest x-ray
A chest x-ray might be done to see if the cancer has spread to your lungs or bones. An x-ray can find larger tumors, but it isn’t as good as a CT scan for spotting smaller tumors. If you get a CT or MRI scan of an area, you might not need an x-ray.
Computed tomography (CT or CAT) scan
A CT scan combines x-ray pictures to make detailed cross-sectional images of the inside of your body. This test is most often used to look at the chest and belly (abdomen) to see if breast cancer has spread to other organs, such as the lungs, liver, or brain. You may be asked to drink contrast material or have contrast injected into a vein before the scan to help see details better.
CT-guided needle biopsy: CT scans can also be used to guide a biopsy needle into an abnormal area to collect a sample. For this test, you stay on the CT scanning table while the doctor moves a biopsy needle toward the area. CT scans are repeated until the tip of the needle is within the abnormal area.
Magnetic resonance imaging (MRI) scan
An MRI creates detailed images of soft tissues inside your body. This is done using radio waves and strong magnets instead of x-rays, so there is no radiation. A contrast material called gadolinium might be injected into your vein before the scan to see details better. An MRI scan usually shows better details than a CT scan, especially for looking at the brain or spine.
MRIs can help doctors see the extent of the cancer in the breast and any spread to nearby lymph nodes. This type of imaging shows the marrow inside bones and soft tissues of the body, including nearby blood vessels and nerves.
Ultrasound (sonogram)
Ultrasound uses sound waves and their echoes to create pictures of internal organs or masses. An ultrasound can be done in the breast or underarm area to investigate lymph nodes or the liver to look for spread.
Ultrasound-guided needle biopsy: Sometimes, ultrasound is also used to help guide a biopsy needle into an enlarged lymph node or abnormal area.
Positron emission tomography (PET) scan
For a PET scan, a radioactive substance, often a type of sugar called FDG, is injected into the blood. Cancer cells will absorb large amounts of FDG. A special camera can then create a picture of any areas of radioactivity in the body.
PET/CT scan: Often a PET scan is combined with a CT scan using a special machine that can do both at the same time. This lets the doctor compare areas of higher radioactivity on the PET scan with a more detailed picture of that area on the CT scan.
Bone scan
A bone scan can help show if the cancer has spread to the bones.
For this test, a small amount of low-level radioactive material called technetium-99 is injected into the blood and travels to the bones. The amount of radioactivity is very low and will pass out of the body within a day or so.
A special camera can detect this material, and it creates a picture of the skeleton. Areas of active bone changes attract the radioactivity and show up as “hot spots” on the scan. These areas might suggest cancer, but other bone diseases can also cause the same pattern, so your care team will compare these results with other tests like plain x-rays, MRI or CT scans, or biopsy.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Metastatic breast cancer: Learn More – Diagnostic tests for metastatic breast cancer. [Updated 2024 Jan 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK361015/
Joe BN. Clinical features, diagnosis, and staging of newly diagnosed breast cancer. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/clinical-features-diagnosis-and-staging-of-newly-diagnosed-breast-cancer on March 18, 2026.
National Cancer Institute. Breast Cancer Treatment (PDQ). Accessed at https://www.cancer.gov/types/breast/hp/breast-treatment-pdq on March 18, 2026.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Screening and Diagnosis Version 1.2026 – March 5, 2026. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf on March 18, 2026.
Last Revised: July 23, 2026
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