Breast Cancer Diagnosis

Following years of media attention and public service announcements, many women now recognize that the earlier breast cancer is detected the better the long-term outcomes and success rate of treatments will be. A combination of early detection, improved technology and medical advancements have led to success rates of treatment greater than 95% in women are diagnosed with stage one breast cancer. This encouraging statistic continues to move more women to perform self breast examinations every month.
The diagnosis of breast cancer usually involves a three-pronged approach. The first is a self-examination which a woman should be doing every month at home. The second is an annual mammogram which should be performed on women over the age of 40 years every year and the third is a clinical breast examination performed by a healthcare professional. Both the self breast examination and the clinical examination should be started by the age of 20. (1)

Physicians consider specific risk factors, if a lump is found, to guide their diagnostic procedures. These risk factors include age, personal history of breast cancer, family history of breast cancer, specific types of breast changes, reproductive and menstrual history, genetic testing, previous radiation therapy to the chest, past history of specific types of medication, obesity, lack of physical exercise, breast density and history of alcohol intake. Each one of these factors will increase the risk that a woman will be diagnosed with breast cancer in her lifetime. However, because a woman has an increased risk does not mean that she will necessarily be diagnosed with breast cancer at any time during her life. (2)

A mammogram is a special type of x-ray which is used to screen breast tissue for breast cancer. However, mammograms are unable to distinguish between solid tumors and cysts. Once a lump is found and a mammogram is performed, the physician may also request an ultrasound to determine whether or not the object is filled with fluid or is a solid tumor. (3)

The next step is a biopsy of the tumor which may be done using a fine needle aspiration, a core needle aspiration or an open biopsy. If cancer is diagnosed the next step is to stage the cancer growth. Staging is based on the size of the current tumor, whether the cancer has invaded in a nearby tissue and whether the cancer has spread to other parts of the body. The physician may use bone scans, CT scans, lymph node biopsies or MRIs in order to accurately stage the cancer growth.

Breast cancer is staged from stage zero through stage four. Stage zero is sometimes used to describe abnormal cells that are not invasive cancer but lie in a breast duct. Although many doctors do not consider this to be cancer, if left untreated it can become invasive breast cancer.

Another option for physicians to use during diagnosis is elastography. This is a relatively new an investigational technology for imaging breast tissue. Proponents believe that it is better than mammography, ultrasound and MRI at distinguishing between benign and cancerous growths and may be able to distinguish cancer without a biopsy. (4)

In helping to determine the type of treatment protocols which may be more successful, physicians will also order specific types of blood tests. The first is to determine hormonal status in both the tumor cells and the woman’s body. Breast cancers are divided into two main types, those which are estrogen positive and those which are estrogen negative. If your particular breast cancer is positive for estrogen and progesterone it will help your physician determine what type of disease you have as well as a kind of treatment you should undergo. (5)

Another type of breast cancer growth is dependent upon a protein called HER2-human epidermal growth factor receptor 2. Knowing your HER2 status will affect both diagnosis and treatment of any breast cancer which is found.

Work with your gynecologist and primary care physician to help determine which type of breast cancer you may or may not have in order to assist in the development of a successful treatment protocol specifically for your breast cancer. This individualized treatment helps to improve the overall survival rate.
(1) American Cancer Society: Breast Cancer: Early Detection

(2) Breast Cancer Risk Factors

(3) American Cancer Society: How is Breast Cancer Diagnosed

(4) Radiological Society of North America: Elastography Reduces Unnecessary Breast Biopsies
(5) Lab Tests Online: Hormone Receptor Status




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