|
Diagnosis
An abnormal area on a
mammogram, a lump, or other changes in the breast can be
caused by cancer or by other, less serious problems. To find
out the cause of any of these signs or symptoms, a woman's
doctor does a careful physical exam and asks about her
personal and family medical history. In addition to checking
general signs of health, the doctor may do one or more of the
breast exams described on the following page.
-
Palpation.
The doctor can tell a lot about a lump (its size, its
texture, and whether it moves easily) by palpation,
carefully feeling the lump and the tissue around it.
Benign lumps often feel different from cancerous ones.
-
Mammography.
X-rays of the breast can give the doctor important
information about a breast lump. If an area on the
mammogram looks suspicious or is not clear, additional
mammograms may be needed.
-
Ultrasonography.
Using high-frequency sound waves, ultrasonography can
often show whether a lump is solid or filled with fluid.
This exam may be used along with mammography.
Based on these exams, the
doctor may decide that no further tests are needed and no
treatment is necessary. (In such cases, the doctor may need to
check the woman regularly to watch for any changes.)
Often, however, fluid or
tissue must be removed from the breast to make a diagnosis. A
woman's doctor may refer her for further evaluation to a
surgeon or other health care professional who has experience
with breast diseases. These doctors may perform:
-
Fine needle aspiration.
A thin needle is used to remove fluid from a breast lump.
This procedure may show whether a lump is a fluid-filled cyst
(not cancer) or a solid mass (which may or may not be
cancer). Clear fluid removed from a cyst may not need to
be checked by a lab.
-
Needle biopsy.
Using special techniques, tissue can be removed with a
needle from an area that is suspicious on a mammogram but
cannot be felt. Tissue removed in a needle biopsy goes to
a lab to be checked by a pathologist
for cancer cells.
-
Surgical biopsy.
The surgeon cuts out part or all of a lump or suspicious
area. A pathologist examines the tissue under a microscope
to check for cancer cells.
|
When a woman needs
a biopsy, these are some questions she may want to ask
her doctor:
-
What type of
biopsy will I have? Why?
-
How long will
it take? Will I be awake? Will it hurt?
-
How soon will I
know the results?
-
If I do have
cancer, who will talk with me about treatment?
When?
|
When Cancer Is
Found
When cancer is found, the
pathologist can tell what kind of cancer it is (whether it
began in a duct or a lobule) and whether it is invasive
(has invaded nearby tissues in the breast).
Special lab tests of the
tissue help the doctor learn more about the cancer. For
example, hormone
receptor tests (estrogen and progesterone
receptor tests) can help predict whether the cancer is
sensitive to hormones. Positive test results mean hormones
help the cancer grow, and the cancer is likely to respond to hormonal
therapy. More information about hormonal therapy can
be found in the Treatment section.
Other lab tests are sometimes done to help the doctor predict
whether the cancer is likely to grow slowly or quickly. The
doctor may order x-rays and blood tests. The doctor may also
do special exams of the bones, liver, or lungs because breast
cancer may spread to these areas.
|
If the diagnosis is
cancer, the patient may want to ask these questions:
-
What kind of
breast cancer do I have? Is it invasive?
-
What did the
hormone receptor test show? What other lab tests
were done on the tumor tissue, and what did they
show?
-
How will this
information help in deciding what type of
treatment or further tests to recommend?
|
The patient's doctor may
refer her to other doctors who specialize in treating cancer,
or she may ask for a referral. Treatment generally begins
within a few weeks after the diagnosis. There will be time for
the woman to talk with the doctor about her treatment choices,
to get a second opinion, and to prepare herself and her loved
ones.
<< Back to
Introduction Page
|
